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How Ed O'Keefe decided to give a kidney to a stranger

O'Keefe, CEO of the Theodore Roosevelt Library Foundation, always planned on donating a kidney to help his mother. He never suspected that his kidney would end up going to someone he's never met.

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Heather O'Keefe of Grand Forks, North Dakota, and her son, Ed, outside Rochester Methodist Hospital. Heather O'Keefe received a donor kidney at the hospital, where Ed later donated one of his kidneys for transplantation in a stranger. Allison Davis O'Keefe / Special to The Forum

FARGO — Ed O’Keefe had long planned to donate one of his kidneys to his mother. Years ago doctors warned the family that she’d need a replacement kidney or would have to go on dialysis.

That day came, as expected, five years later when her kidney function, which had been steadily declining, had become too low to do the job of cleansing toxins from her blood.

O’Keefe, CEO of the Theodore Roosevelt Library Foundation in Medora, had always assumed that his donated kidney would go to his mother. But compatibility testing found a better match in Minnesota through the National Kidney Registry’s paired exchange program.

A better match meant it was less likely that Heather Holmes O’Keefe’s immune system would reject the donated organ.

So a stranger would donate a kidney to O’Keefe’s mother and in return he would donate one of his kidneys to another stranger.


“You don’t have to be a direct blood match to become a donor,” O’Keefe said. “You don’t have to be a relative.”

That was a revelation for O’Keefe, who’d always assumed a kidney he donated would go to his mother. He’s telling his story as a donor through the paired exchange program to raise awareness that a person can donate a kidney and help a relative — as well as a stranger — through the chain of donation created by the national registry.

“I’m not suggesting that’s easy or for everyone,” said O’Keefe, who is 43 and healthy. “It’s an option.”

The National Kidney Registry has facilitated 5,310 transplants from living donors, including O’Keefe.

After extensive testing at the Mayo Clinic to ensure that she’d be a good transplant candidate, Heather, who lives in Grand Forks, cleared the recipient protocol. Her name was placed on the national registry in November 2020.

Ed underwent testing for the donor protocol in June 2021, when it became clear his mother would need a kidney transplant within months. He was cleared and placed on the donor registry in July.

“It’s such a small sacrifice,” he said. His body can function perfectly well with one kidney, although he’s now extra careful to avoid accidents and pays attention to diet and keeping his body well hydrated to keep his kidney healthy.

“It does not affect your longevity,” he said. “It does not affect your health. It’s no small thing, but it’s also no big thing. It doesn’t force you to live a completely different life.”


Also, all of the donor’s expenses, including travel expenses, are paid and donors receive support from the network of donors.

At the time Ed was added as a donor candidate to the National Kidney Registry in July, he was told a match usually takes six to nine months. Waits for matches from deceased donors take much, much longer, he said.

But a good match was found much quicker. Heather received her donor kidney at Rochester Methodist Hospital on Aug. 5 and Ed’s donor surgery followed two weeks later. Normally, his surgery would have been on the same day as his mother’s, but O’Keefe’s work schedule wouldn’t allow that.

The Mayo transplant team trusted him to follow through. “It was an incredible leap of faith,” he said.

O’Keefe’s unexpected medical leave request was readily granted by the library foundation board. Ken Vein, director of design and construction for the project, filled in for O’Keefe during his four-week absence.

O’Keefe’s wife, Allison, jokes that the anesthesia he received apparently made him even more inclined to drum up support for the Theodore Presidential Library, which is slated to open in Medora in 2024 or 2025.

The O’Keefes don’t know who donated the kidney given to Heather. They only know the donor was an adult from Minnesota. Similarly, Ed doesn’t know who received his kidney, except that it was flown by commercial air service to Chicago.


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Ed O'Keefe is CEO of the Theodore Roosevelt Library Foundation in Medora, North Dakota. David Hume Kennerly / Special to The Forum

When he was told, O’Keefe quipped that he should receive Delta Medallion frequent flyer miles.

O’Keefe has been told that he was soliciting donations for the $100 million library from his recovery nurse. He also gave a plug to one of the nurses on his floor, a Dickinson native.

After his surgery, O’Keefe was sore for a time, but quickly felt better. He still is restricted from lifting anything heavier than five pounds, meaning that his wrestling bouts with his five-year-old son have been suspended.

O’Keefe had to remain in Rochester for several weeks after the surgery, and was able to return home to Long Island, New York, on Aug. 23. By Sept. 13, he was back at work.

His 68-year-old mother has a longer recovery period, but soon after the surgery had greatly improved energy. Before the surgery, her kidneys were performing at 18%; after surgery, her kidney function increased to 70%.

A transplanted kidney has an expected lifespan of 17 to 22 years. “So she’s got a lot of years ahead of her,” O’Keefe said.

As for his part, “I don’t think it was all that great of an act,” he said. “I’m feeling better already. It’s such a small sacrifice.”

Want to know more about kidney donation?

Anyone considering becoming a living kidney donor through the National Kidney Registry can visit www.kidneyregistry.org .

People also can sign up to become organ donors upon death. Kidneys are by far the most-needed organs for donation. Minnesota has 2,543 patients waiting for donated organs, including 2,120 in need of a kidney. North Dakota has 145 on the waiting list, all in need of a kidney.

“Kidneys are the real organ in demand,” said Sarah Sonn of LifeSource , the organization involved in coordinating organ and tissue transplants in Minnesota, the Dakotas and part of Wisconsin.

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