"I have two birthdays. The moment my father's kidney started beating inside my body, I felt reborn. The joy of holding my two children in my arms after receiving a second life through my father's gift is beyond words."
Lee Eun-hwa, 41, smiled as she spoke at Seoul St. Mary's Hospital's outpatient clinic in Seocho-gu, Seoul, on January 6. "I never realized how precious an ordinary day with my children could be," she said.
Lee's life came to a halt in late 2016 when she was diagnosed with end-stage kidney disease at age 31. She initially told her parents she would wait for a brain-dead donor transplant, putting on a brave face. But reality proved harsh. In Korea, kidney transplant waiting lists far exceed brain-dead donors, with average wait times reaching 8 to 10 years.
As Lee began a grueling routine of four-hour hemodialysis sessions three times weekly, despair set in. Her condition deteriorated into uremia, where abnormally high levels of waste products accumulate in the blood, making even breathing difficult.
Her father, then 65, stepped forward to save her. "I've lived more than 60 years—isn't that enough?" he said, offering one of his kidneys without hesitation. While Lee's three older sisters and other family members were all type A, her father was type O, making him compatible. Type O donors can give organs to recipients with other blood types.
On January 17, 2017, the father's kidney began functioning in his daughter's body—the day Lee considers her second birth.
After regaining her health, Lee met her husband at age 34. When she cautiously revealed her transplant history, he encouraged her, saying medical advances would continue to expand treatment options.
As normalcy returned, Lee yearned for children. But those around her advised against it. Pregnancy after organ transplantation is considered extremely challenging. Anti-rejection medications make conception difficult, and doctors must carefully monitor whether the transplanted kidney can maintain function during pregnancy. Some medications can cause fetal abnormalities and must be stopped before conception, risking rejection. Pregnancy-induced hypertension and proteinuria pose additional dangers that could harm both the pregnancy and the transplanted organ.
Professor Yoon Hye-eun, Lee's nephrologist at Seoul St. Mary's Hospital, recognized the couple's determination. Fortunately, Lee's condition allowed for pregnancy with proper management. Yoon had observed Lee carefully protecting her father's gift since her emergency room arrival years earlier.
While post-transplant live birth rates are generally high, cases like Lee's—two children conceived naturally and delivered vaginally—are extremely rare. Yoon meticulously managed every aspect of both pregnancies, including asymptomatic bacteriuria that persisted throughout.
Lee visited the hospital every two weeks during her pregnancies, following Yoon's guidance faithfully. She welcomed daughter Chae-yi, now 7, in 2020, and son Eun-cham, now 3, in 2024. Her father's gift of life had passed through his daughter to two grandchildren.
The family's ordeal transformed into a mission. Shortly after both father and daughter recovered from surgery, all six family members registered as organ donors, their fears replaced by appreciation for life-sharing's profound value.
Lee found courage in online communities of transplant patients, connecting with women contemplating pregnancy. She created and shared a vlog documenting her second child's birth on YouTube and willingly counsels others.
"If I hadn't experienced this myself, I wouldn't have understood the preciousness of life-sharing," Lee said. "When the opportunity comes, I want to return the miracle I received through service to society."
Success stories like Lee's offer hope to patients awaiting transplants. Lee Ji-won, 34, faced death before her first birthday due to liver cirrhosis from congenital biliary atresia. She became a productive member of society through Korea's first living-donor liver transplant, receiving part of her father's liver at nine months old.
Living-donor liver transplants eliminate the wait for brain-dead donors, preventing disease progression. The transplanted liver quality is superior since it avoids potential damage during brain death. However, these surgeries are more complex than deceased-donor transplants, with higher complication risks.
Ji-won's journey from critically ill infant to thriving adult marks a significant milestone in Korea's organ transplant history.
A patient identified only by surname Bae, who received a kidney transplant at Seoul National University Hospital 46 years ago, continues to set national longevity records. The hospital reports 47 patients surviving more than 30 years on a single transplant, shattering the old assumption that transplanted organs last only 10 to 15 years.
"Organ donation doesn't just save one patient—it becomes the beginning of a family, a generation," Professor Yoon emphasized. "We've proven that with timely transplantation, patients can easily live 30 to 40 years. I hope donation culture becomes more active so more people can return to healthy lives in society."