But, that is exactly what happened in December, when Graiser had surgery to donate his kidney. It turned out that he wasn't a match for his twin brother's son, Marc Graiser. But when he was informed about a multiple kidney swap process in which he could donate to someone else, and in return have another person donate a kidney to Marc, Phil jumped at the opportunity.
"To me, it didn't matter that my kidney would end up in Marc as long as he got a healthy kidney. That was really the bottom line," said Phil, 51, an IT director. "I really looked at it like I was helping two people."
New York-Presbyterian/Weill Cornell Medical Center in Manhattan - where the procedures were performed - is where one of the nation's first three-way living-donor kidney transplant chains was initiated in February 2008, according to Medical News Today.
So-called kidney transplant chains occur when a chain of surgeries are arranged, in which each donor is paired through a database with a recipient he or she doesn't know, but who is compatible with the kidney donor. The Graisers case involved a 10-way swap in which there were five donors and five recipients. Several surgical teams at four hospitals in New York, California, New Jersey and Pennsylvania performed the procedure.
About 100,000 Americans have donated kidneys since 1988, according to the United Network for Organ Sharing. However, more than 105,000 people in the U.S. are currently listed as needing kidney transplants.
Kidney chain transplants are becoming increasingly common because of better computer programs for matching donors, according to a report published in March 2009 in the New England Journal of Medicine. Blood type and antibodies are important factors in a successful kidney transplant. Kidney chain transplants are performed simultaneous to prevent participating parties from reneging at the last minute.
Marc, 28, had been on dialysis for over two years because of renal failure before the transplant. He had been living out his dream as a set designer in Hollywood - working on the last "Die Hard" movie and second "National Treasure" film - before he suffered near fatal renal failure. So he moved back home to New York to begin dialysis treatment in October 2007.
It was a grueling process.
"I went three times a week. It started off at night at first until I switched to the morning at 6 a.m.," Marc said.
"I would be on there for about three-and-a-half hours. So it pretty much took up my day. It was pretty hard to go through considering that I was working all the time. With dialysis, it was hard for me to work."
Last summer, when Marc collapsed on the dance floor of a relative's wedding, Phil said he knew it was time he did something to help his nephew. Though he is of a different blood type than Marc, Phil went ahead with the long process of getting evaluated.
"Once they figured out he was healthy they said, 'O.K., we can put Marc in the match,'" remembered Phil's wife, Julie Graiser, a nurse practitioner.
"Then they said it would probably take six months to match Marc because he had already had so many antibodies. But they called the very next day and said they had a match for both Phil and Marc."
As part of the exchange, Phil donated his kidney to a stranger in New Jersey. And a woman from Toronto donated her kidney to Marc. The transplant chain surgeries - which were covered by Marc's health insurance - occurred on Dec. 18, 2009, Marc's 28th birthday.
"This probably couldn't have happened at a better time," Marc said. "I knew that when they said it was Dec. 18, I was like wow, this is my birthday, it has to work!"
It did work. Both Marc and Phil report to be in good health. Though he has to continue taking anti-rejection medicines as part of his lifelong therapy, Marc said he plans to follow his dream of working in entertainment again. Phil said he was back at work two weeks after the procedure that required a small incision near his belly button.
Phil said he hopes to one day talk to the recipient of his kidney. But most importantly, he said he wants others who face what his family experienced to know that kidney transplant chains may be the solution they're looking for.
"My main goal is to promote this exchange program," he said. "I had never heard of it before I started through this process."