A rare kidney transplant chain involving 18 patients – nine donors and nine recipients – has been completed in San Francisco, with the hospital reporting that all patients are doing fine.

The surgeries began on Thursday, with 56-year-old Reid Moran-Haywood, who had a kidney removed at the University of San Francisco, and was soon rushed to the California Pacific Medical Center less than two miles away.

"There was nothing unexpected, and everything has gone smoothly," said Dean Fryer, a spokesperson for the California Pacific Medical Center.

According to reports, Moran-Haywood first wanted to donate for a friend who needed a kidney, but the two turned out not to be a match. Moran-Haywood decided to donate the kidney anyway, offering it to a stranger.

Another donor was married to a patient in need of a kidney, but they were also not a match. The man then offered to donate his kidney to a stranger in exchange for his wife being paired with someone else who was compatible.

While the nine-way kidney transplant was a success, doctors note that there are still thousands of people on the waiting list for kidneys. There are over 7,000 people waiting for a kidney in San Francisco alone, and each time someone receives a kidney, everyone moves up on the list.

Kidney transplant chains such as this one are becoming increasingly common both in San Francisco and around the United States. The longest kidney transplant chain in the country consisted of 68 surgeries in 26 hospitals around the U.S. The transplants occurred over a three-month period, with the final one taking place on March 26 in Wisconsin.

The chains are largely made possible by software matching programs, which use medical data such as blood type to connect people who are compatible with each other. This means that even if you aren't compatible with a loved one in need of a kidney, your donation can still ensure that your friend or family member receives a match from someone else. And of course, someone has to start the chain.

While the process does need to take place as quickly as possible, speed is not as much an issue for kidneys as it is for organs like the heart and lungs. Whereas a properly preserved kidney can remain outside of the body for as long as 24 hours, a heart or a lung must be transplanted within a few hours at maximum.

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