JOILEY, IL, UNITED STATES (AHN) -- It all started with Rick Ruzzamenti, a 44-year-old from Riverside, California.

On impulse, inspired after hearing a moving story while grocery from a woman he didn't know, who gave one of her kidneys to a relative, he decided to donate a kidney to a complete stranger. He was resolute, even after his wife threatened to leave him.

What followed was a domino chain of transplants that took place over four months, involved 60 patients and 30 kidneys at 17 hospitals across 11 states.

It ended with Donald C. Terry Jr, from Joliet, Illinois, who was dying of renal failure and had no family either willing to or able to donate a kidney to him.

Because Mr. Ruzzamenti was not a match for Mr. Terry, staff at the National Kidney Registry set up a series of connected transplant operations which connected people willing to donate with those in need of a kidney.

The linked procedures, called Chain 124, were carried out between Aug. 15 and Dec. 20, 2011.

All but one of the patients involved have now come forward to share their role in these record-breaking, history making and life-saving series of transplants.

Those involved include husbands who donated to wives, children for a parent, a nephew for an uncle, a mother-in-law for her daughter's son, and an ex-boyfriend for a former girlfriend.

The kidneys traveled on commercial airlines all across the United States, from coast to coast, in specially iced cardboard boxes with GPS tracking devices attached.

Since the recipients were not well enough to travel, the operations could not be done simultaneously. That meant that trust was placed in the hands of the donors, even as fears lingered that some might pull out.

In the end, all of the donors kept their sides of the bargain.

This heart-warming story has a storied and happy ending. But not all kidney patients have such as happily-ever-after ending.

Currently, some 400,000 Americans with kidney failure undergo dialysis daily, and every year, 4,500 die while waiting for a transplant.

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