When Hailey Boss was admitted to Chillicothe Dialysis, a DaVita center in Missouri, she was just 18 years old and dealing with the overwhelming emotion of her diagnosis. She had been recently diagnosed with a rare autoimmune disorder, Henoch-Schonein purpura, that caused her kidneys to fail at a young age. “All I remember is hysterically crying when I got the diagnosis,” Boss recalls.

What comforted her, though, was meeting her DaVita care team, all of whom felt passionate about doing everything in their power to help this young woman. For Rachel Alexander, the facility administrator at the Chillicothe dialysis center, it was heartbreaking to see someone the same age as her own kids need dialysis. So, as Boss started treatments, Alexander made sure Boss had the support she needed.

“Rachel gave me so much advice and gave me options,” says Boss.

It was Alexander who encouraged Hailey to explore peritoneal dialysis (PD) with her doctor so she could treat in the comfort of her home — and ultimately, Alexander also had a huge impact in Boss’s transplant journey. 

Boss says that her care team provided her with a variety of resources and advice surrounding transplant. What stuck out to her the most was the education she received on living donation.

Living donor transplantation offers a lifeline to people living with end stage kidney disease (ESKD). Through living donation, someone with healthy kidneys can choose to give one of their kidneys to someone in need, helping them return to a dialysis-free life. In addition to offering improved long-term outcomes for recipients — including the potential of more immediate function and increased longevity — living-donor transplant can also reduce how long someone must wait to receive a transplant.

But while Boss felt encouraged by the benefits her care team helped educate her on, she was still apprehensive about pursuing the transplant. “It was mentally draining to think about having to ask someone I know for a kidney. I was nervous to put someone in that position,” Boss says.

Boss didn’t have to ask, though: When her aunt, Tina Traweek, learned Boss was pursuing a living donor, she immediately stepped up.

“My niece needed help, and that was all I needed to know before stepping up,” Traweek says.

When Traweek was evaluated, the transplant team at Research Medical Center identified an opportunity for them to be a part of a transplant chain, a process that can amplify the impact of living donation. Paired exchange and transplant chains are innovative strategies designed to maximize the number of transplant candidates who can receive a living donor, especially when intended recipients and their potential donors are incompatible due to factors including blood type and tissue mismatches. Expanding on the benefits of paired exchange, transplant chains involve a sequence of interconnected transplants, creating a “domino effect” — where one donation triggers another, and so on.

When Traweek and Boss learned they could impact a larger chain, they decided they wanted to be a part of it. This meant Traweek’s decision to become a living donor helped initiate a series of transplants, offering a lifeline to not only her niece, but also multiple others awaiting a kidney.

“I had never heard of a paired exchange transplant before, but as long as the transplant happened quickly for Hailey, I was happy to be a part of something larger,” Traweek says.

Cheryl Matlack, the lead social worker for the division, highlights how actively engaged and hands on the teammates are when it comes to helping their patients receive a transplant.

“A transplant takes a team,” Matlack says.

Caregivers across different points of care come collaborate to share crucial medical data, help manage patients’ eligibility needs and support optimal conditions when a transplant opportunity arises. Strong teamwork with transplant centers like Research Medical Center becomes critical for the complex choreography involved with a transplant chain.

“I always want my patients to feel as little stress as possible when it comes to assistance programs, insurance and out-of-pocket costs after transplant,” said Sybert. “One program that would benefit Hailey was only available while she was on dialysis, but I also wanted her to be enrolled in a more sustainable, long-term option. Hailey’s DaVita social worker and I collaborated almost daily—often exchanging application forms—so Hailey could complete them during appointments at either DaVita or Research Medical Center,” said Deanna Seabert, the social worker at Research Medical Center. “That close coordination, along with Hailey’s responsiveness, is what made it possible to have everything in place for the transplant chain to move forward as scheduled.”

Alexander shares that the care teams took the young patient under their wing to make sure she understood the process and the paperwork so she felt confident in the next steps.

This support was important to not just Boss’s success; it was critical in making sure that the transplant chain could proceed. The DaVita care team, including the patient assistance department, helped Boss review her insurance coverage options.

“At one point, there was a potential impact to the transplant chain,” Matlack shares. “The transplant team at Research Medical Center worked with the DaVita care team directly to make sure Hailey had everything she needed to avoid that barrier. It really shows the importance of how we work with transplant teams so patients can reach their transplant goals.”

For Boss, it was more than administrative assistance: Her DaVita care team became an emotional support system as she pursued transplant and even helped calm her nerves as surgery drew closer.

Flash forward to today: Boss has been living with her transplant after undergoing surgery in June 2024.

Leaning into her own personal journey, Boss is currently in nursing school and hopes to start a career working in kidney care. She hasn’t forgotten the role her care team played for her, and she continues to visit the Chillicothe dialysis center and shares her experience with other patients. She also looks back with appreciation that her personal journey created a chain of hope:

“When my aunt volunteered to get tested, I was nervous and so appreciative,” Boss shares. “It’s such an amazing gift, and I am so grateful that her decision was able to help so many others achieve their own transplant goals, too.”