Triple Pair Living Kidney Donation Changes Lives at UF Health Shands Hospital

On a sunny December afternoon, in a room high atop the UF Health Heart and Vascular Hospital overlooking the University of Florida campus, six people whose lives are now forever intertwined met for the first time. The three kidney donors and three kidney recipients — participants in a rare three-way paired exchange — greeted one another with heartfelt gratitude and warm smiles.

The UF Health Living Donor Program facilitated the three-way exchange and represents a rare event for the system: three donors and three recipients all matched internally.

The decision to donate an organ to a loved one is not an easy one for most people. Evelyn Jackl found herself faced with this dilemma when she saw a Facebook post from her best friend, Melissa. Melissa’s father, Michael Griffin, needed a kidney, but a heart condition prevented her from donating herself.

Georgios Vrakas, MD, MSc, PhD, director of the UF Health Adult and Pediatric Kidney and Pancreas Program, said it’s important to weigh program growth against outcomes.

“We’re not a high-volume program, but we’re growing,” Dr. Vrakas said. “We have a focused team, and we have excellent outcomes.”

Excellent outcomes is something of an understatement. The UF Health Kidney Transplant Program has consistently ranked among the top 10 nationwide on various quality metrics by the Scientific Registry of Transplant Recipients, or SRTR. Recent data released in July 2025 placed UF Health No. 3 in one-year patient survival among all programs in the Southeast.

Melissa was turned away because the transplant team at UF Health is focused on ensuring the long-term survival and continued health of both donors and recipients.

Evelyn knew she had to do something.

“It wasn’t even a question,” Evelyn said. “I asked how I could help.”

Evelyn signed up as a living donor and, after the battery of tests and interviews, learned that she would be an acceptable candidate. She also learned about the UF Health Living Donor Program.

By donating her kidney to a stranger instead of Michael, Evelyn could facilitate a rare three-way paired exchange, allowing two other incompatible pairs to participate in a swap that enabled three compatible transplants.

Evelyn’s decision to give her kidney to a stranger was the catalyst that enabled three donations instead of just one. Still, it was the robust clinical enterprise and focused effort of the living donor team that made it happen in a timely fashion.

“Once I was assured that Michael would be getting a comparable kidney in the same time frame, it seemed like an obvious choice,” Evelyn said. “If I’m doing it anyway, why would I not help other people who don’t have the same option?”

Dr. Vrakas emphasized that living donations, such as those offered by these donors, are typically safe. They’re carefully evaluated, can shorten waitlists and give recipients the best possible start to their new lives after surgery. Kidney transplant outcomes are the most optimal when recipients receive living organs.

According to the SRTR, more than 140,000 individuals were on a waitlist for a kidney at some point during 2023, while just over 28,000 transplants were performed. Living donor programs such as the one at UF Health streamline the process, allowing for faster matching and typically better clinical outcomes.

“We bend over backwards to make things like this triple pairing happen,” said Wen Xie, MD, the clinical assistant professor in the UF departments of urology and surgery who performed all three of the donor operations. “It can be a challenge to make sure the operating rooms will be available and that we’ll have the staff support we need, especially since there are always other cases and emergencies that need to be addressed. But Dr. Vrakas and I were dedicated to getting donors and recipients done within a short timeframe.”

Looking ahead, Dr. Vrakas expects his program to continue to grow and mature, thanks in part to the efforts of living donor transplant coordinators like Jessica King, BSN, RN. Dr. Vrakas said the strength of the program lies with coordinators who know how to think outside the box, connect with patients and bring them together to facilitate paired donations.

For King, one of the biggest takeaways in her role as a living donor coordinator comes from witnessing these acts of selflessness up close.

“When we arrange these meetings between donors and recipients, our staff get to witness something most people never see — pure kindness in action,” King said.

That kindness was evident when the six UF Health patients met for the first time, swapping stories and hugging their physicians.

Michael, Evelyn’s original intended recipient, expressed his gratitude to all of the donors.

“I can’t go without saying how grateful I am for everything you all did,” he said. “It’s like throwing a rock at a pond: everything ripples.”

Dr. Xie said moments like the donor meeting on that sunny afternoon were why she went into transplant surgery in the first place.

“Being a living donor is scary,” Dr. Xie told the patients. “It’s giving a piece of yourself; trusting your surgeons to keep you safe through the journey and to keep that part of yourself healthy for your recipient. Thank you for your generosity and for allowing us to do this.”