SPRING VALLEY — On the Friday before Mother's Day, Spring Valley resident David Thouin heard a knock on the door. 

It was Julie Mlinar and her husband, Mark. Mlinar said she had some news to share. She had been approved to donate a kidney. Thouin and his wife, Carol, were in tears. 

"It is still so memorable to me," Thouin said. 

Thouin had made no secret of his need. With his kidneys shutting down and just months from starting dialysis, the retired nurse had launched an all-out blitz, blanketing the area with newspaper ads, personalized cards and posters about his need for a kidney donor. The Post-Bulletin did a story about his extraordinary campaign. 

Mlinar had seen the ad. She had also seen that Thouin was O positive. She was O positive. Mlinar clipped it out and slipped it with some other papers. She figured somebody else would step forward.

But then something strange happened. Or a lot of strange things happened. Wherever she went, Mlinar would hear or see messages about kidney donation. During a church conference one day, the speaker asked audience members to recall the good things they had done in their lives. Maybe, it was a kidney donation?

"I'm like, 'What?' I kept having these suggestions," Mlinar said. "So, finally, I'd had enough. I decided to go on the Mayo website and research it."

On June 11, several weeks later, Thouin and Mlinar underwent surgery at Mayo Clinic. Mlinar was out of the hospital two days later. During a recent four-month check-up, Thouin and his new kidney got a clean bill of health.

But unlike Thouin, who was willing to shout his need for a kidney from the highest mountaintops, Mlinar wasn't all that interested in talking about her life-giving donation. She didn't want the attention. She was prepared to move on with her life.

But secrets don't keep in a small community like Spring Valley. She could tell word of her donation had gotten out from the funny looks people gave her. She could also tell from the curiosity and questions it generated from those brave enough to ask. A cousin, when he learned of it, said he was interested in donating, too.

Mlinar began to rethink her attitude, that speaking up might encourage more people to donate and save lives. 

"Maybe I'm in error here," Mlinar recalled thinking. "I need to let people know that's it not something that they're ever going to die from. It's not something that is a terrible thing. And you could really help somebody." 

Although the majority of kidney transplants performed nationally in 2018 originated from deceased donors, the trend is reversed at Mayo Clinic in Rochester. Of the 261 transplants done at the clinic in 2018, 76 percent came from living donors, according to Mayo Clinic spokeswoman Heather Carlson. 

That compares to the 30 percent from living donors nationally, according to the United Network for Organ Sharing. 

Dr. Patrick Dean, a Mayo transplant surgeon, said part of the difference is regional. People in the Midwest are "very much in favor of organ donation." Another factor is the emphasis that Mayo places on living donation. The clinic far prefers it. 

A living donor in many cases allows the patient to avoid dialysis, Dean said. That's a good thing for many reasons, but most importantly it improves the long-term outlook of the patient. The survival of a person on dialysis for more than a couple of years prior to a transplant simply "isn't as good," Dean said.

A living donor kidney also lasts longer on average than one from a deceased donor — 14 years compared to nine and half years.

Dean said the biggest question he gets from people about kidney donation is whether it entails a heightened risk of kidney failure down the road for the donor. Statistically speaking, there is no increased risk, Dean said. Donors are no more at risk of developing renal failure than the general population. 

But Dean notes that the deck is stacked in favor of the donor population, because they are quite healthy to begin with and tend to live longer than the general population. 

Of the 95,000 people waiting for kidney donation last year, 6,000 people died while waiting.

It wasn't Mlinar's first instinct to talk publicly about her donation. But once she realized how curious people were and how her example might prompt others to consider donating, she overcame her reluctance.

"I really haven't had any surgeries before. So I wasn't sure what to expect. But Mayo was really good," Mlinar said. "They talked you through everything. They made you very comfortable. It was a very good experience."

1. Do I need to be related to someone to be a donor.

Anyone can be a donor. You can consider donating a kidney to a relative, friend, acquaintance or stranger. All potential donors undergo a thorough medical evaluation to make sure they are suitable for donation. 

2. What if I'm not a match?

In those situations, "paired donation" is considered. Donors and recipients are matched with other donors and recipients, creating a so-called "kidney chain."

3. Do I need to know someone in need of a transplant to be a donor?

No. For people who want to help someone in need of a kidney but don't have a particular recipient in mind, they can elect a non-directed donation, which is also known as an altruistic or "Good Samaritan" donation. 

4. How serious is the surgery?

Living kidney donation surgery is minimally invasive. Donors undergo laparoscopic surgery - a procedure that involves making a few small incisions instead of a larger one. This type of surgery reduces recovery time. Medical costs associated with donation are covered by the recipient's insurance. 

Source: Mayo Clinic

Spring Valley man needs a kidney