They worked together for years at the same bank branch in the northwestern Quebec city of Rouyn-Noranda, where she was a teller with failing kidneys and he was a financial counsellor whose wife was living the same plight.
Acquaintances more than friends, the two colleagues would occasionally exchange medical notes. Both women needed transplants. The teller would tell him about her seven-year wait for a matching kidney. The financial adviser would speak about his wife's deteriorating condition and impending dialysis. Each husband had volunteered to donate for a transplant, but their kidneys did not match those of their wives.
One day last February, after the teller, Nathalie Ouellette, had stopped working at the bank, she stopped in to chat with her former colleague, Marc Lacroix. She spotted an opening and played a hunch.
"What's your blood type?" she asked.
His type, O-positive, matched hers. One year and a battery of tests later, Ms. Ouellette and Mr. Lacroix's wife, Lyne Laflamme, are in separate Montreal hospitals awaiting kidney transplants scheduled for Wednesday.
The two husbands are headed to the hospitals too, but not to be with their wives. Each woman will receive a kidney from the other's husband in a living-donor kidney swap that doctors describe as highly unusual and statistically improbable.
"It's rather unique that they aren't related and figured it out for themselves," said Michel Paquet, Ms. Laflamme's kidney specialist and the Quebec representative on the advisory committee of the national kidney-transplant registry. "Statistically speaking, the odds of it working are highly improbable. But it worked for them. If you set out to find your own donor like that, it would never work."
Mr. Lacroix sees the match as nothing short of a miracle. "It's like the story where a guy spends his life looking for love, and never sees the woman right next to him. All these years Nathalie and I worked together and had the solution to our biggest problem, but didn't know it."
A new kidney registry that just went national may diminish the need for local miracles of the kind conjured up by the two women and their husbands.
At the end of 2010, Quebec joined the national registry for living kidney donors, launched in 2009 by Canadian Blood Services. With about one-third of the 2,732 Canadians waiting for kidneys, Quebec was the last province to join the program.
Quebeckers awaiting kidney transplants have traditionally relied on deceased organ donors more than in the rest of Canada, resulting in long waits for transplants. Only 25 per cent of kidneys come from living donors in Quebec, compared to 61 per cent in Ontario.
Living donors are usually a spouse or other close relative of the patient. When a family match fails, the potential donor can go into the Blood Services registry, which attempts to match the donors with recipients across Canada. The system vastly increases the odds of finding a match quickly.
Traditionally the donor and recipient matched through the registry have remained anonymous to one another, but swaps sometimes make anonymity impossible. Donors and recipients can also choose to have their identities revealed.
Seventy-three patients have found matching kidneys through the national registry.
"The concept of exchange is not new, but it's hard to find the right combinations when the exchange is limited to a hospital or province," Dr. Paquet said.
Ms. Laflamme, her husband, Mr. Lacroix, and Ms. Ouellette and her husband, Gaétan Turcotte, who are all in their late 40s, initially signed up for the national registry when Quebec joined in November. But they quickly decided they would be better off taking kidneys from each other.
By donating to each other, they won't have to wait and the men save having to travel to other parts of Canada to donate their kidneys.
The kidney specialist stressed that donors live normal lives with one kidney and the surgery is safe, although all surgeries carry some basic risk. There are no guarantees, but one-year success rates rise above 95 per cent for patients with transplants from living donors.
But the process has already brought unanticipated benefits, the couples agree.
"Gaétan has become like a brother to me," said Ms. Laflamme, who is anxious to hit the golf course this summer and hopes to return to her job as a nurse.
"We were very lucky to find such great friends along this road," Ms. Ouellette added.
Mr. Lacroix is a bit nervous about undergoing his first major operation, while Mr. Turcotte just wants to get started.
"I couldn't be more confident," he said. "There's no way this fairy tale is going to be ruined."