When Elizabeth Lehman, a nurse working in a Honolulu pediatrician’s office, found out that the mother of two of her young patients desperately needed a kidney transplant, she started researching organ donations and eventually offered one of her own.

At first, doctors thought she was a match with Cherish Matautia, a 25-year-old mother of 2- and 3-year-old boys, but later discovered antibodies that would likely cause her donated kidney to be rejected.

“That was a bummer,” Lehman said. “It was a little bit frustrating, and then we decided to join the Kidney Registry exchange program,” which allows pairs of recipients and donors to swap kidneys with another matching pair. “If I was willing to donate one to somebody else, then in turn they would find one for her. Otherwise she would have to wait on the deceased (organ donor) list. They can keep you on the list for years.”

Last month, Matautia became the first trans-Pacific kidney transplant patient at the Queen’s Medical Center through the National Kidney Registry, the largest organ exchange program in the United States, which has facilitated nearly 2,000 kidney swaps since 2008.

Lehman’s kidney was removed and flown to a patient awaiting a transplant in Colorado. At the same time, a Colorado donor matching Matautia had surgery to remove the organ, which was flown to Queen’s. The surgeries thousands of miles apart were done simultaneously to ensure successful transplantation, hospital officials said.

“This event marks the first time that live donor kidneys have been couriered over the Pacific Ocean. The National Kidney Registry has allowed a local recipient to receive a transplant which would have otherwise not been possible,” according to a Queen’s statement.

Lehman, who at the time was just an acquaintance of Matautia, said it was important for her to help the young mother who was struggling with dialysis treatments four hours a day, three times a week.

“I saw the struggle she was going through as a mom and I just wanted her to have the same chance as everybody else to spend quality time with her kids and her family,” said Lehman, 30. “The dialysis is what was saving her, basically. I thought that was a poor quality of life for somebody her age. I feel that it’s the greatest gift that I’ve ever been able to give somebody.”

There are about 400 patients waiting for kidney transplants in Hawaii. Typically, the wait is three to five years, with most of them having to go through the rigorous process of dialysis to stay alive. Queen’s said it does about 10 to 15 living donor kidney transplants a year, in addition to 40 to 50 deceased kidney replacements.

Because Hawaii has a small number of people who volunteer to participate in kidney paired donations, it is difficult to find a match for incompatible pairs, which is why Queen’s decided to participate with the National Kidney Registry, said Dr. Makoto Ogihara, a kidney transplant surgeon at the Queen’s Transplant Center.

“It’s been difficult for us because we’re so far away from the West Coast centers, transportation time is a minimum 12 hours. Kidneys work better with a shorter transportation time,” Ogihara said. “This will potentially increase the number of living donor transplants in Hawaii.”

A donor needs to have a compatible blood type and a negative cross-match test to be successfully matched with a kidney transplant recipient. The cross-match test looks for antibodies that could react against a donor kidney.

The National Kidney Registry identifies compatible recipient-donor pairs from multiple transplant centers nationwide, greatly increasing the chances of a compatible kidney transplant.

Before this, local kidney transplant candidates would have to fly to the mainland to other transplant centers with trade programs, often incurring large out-of-pocket expenses for travel and recovery that takes at least a month.

“We are very excited to have facilitated the world’s first trans-Pacific paired exchange kidney swap between Hawaii and the mainland,” Joe Sinacore, director of education and development for the National Kidney Registry, said in an email. “After much coordination and careful preparation with the Queen’s Transplant Center in Honolulu, we are very pleased with how smoothly the logistics took place for this first trans-Pacific kidney swap. We look forward to helping many more Hawaiian patients experience the benefits of participation in our thriving, national paired kidney exchange.”

Matautia, who was on dialysis for a year and a half after doctors discovered her kidneys were failing when she gave birth to her second child, said she is still in shock with the turn of events.

“From the beginning when (Lehman) first told me that she wanted to donate her kidney to me, I actually thought she was joking,” she said. “Nobody really comes out of the blue and says they want to donate a kidney. I can’t even describe it because it feels like I was part of a movie. These things only happen in movies. I’m kind of still in disbelief that all of this happened, but I’m more blessed and thankful that she wanted to do this for me.”