Richard Cohen figured you could find just about anything you wanted these days, no matter how elusive or obscure, in the quick zip of an internet search. So, with his health declining and all other options failing him, he typed into Google: I need a kidney.

It was a shot in the dark, Cohen knew. But what else did he have?

Several years after doctors diagnosed him with incurable kidney disease, his appetite, energy and hope were on a steady dwindle. The busy attorney declined the traditional dialysis treatments, worrying that the physically draining sessions would impede his already eroding lifestyle. He opted for a kidney transplant that might give him a second chance. But the procedure wouldn't come easily.

With no compatible kidney donors among his family and friends, Cohen, now 55, would have to put his name on the backlogged national wait list for organs from deceased donors. On a register that recently neared 73,000 waiting kidney recipients, that easily could have meant four years before Cohen's name was called. And if he wanted to move up that list, it would mean he would have to undergo the dialysis he didn't want, required by the organization until the patient-kidney match is made.

"The clock was ticking," says Cohen, who lives in Hartford, Conn. "My feeling was, there had to be people out there who are altruists, who are willing to donate a kidney."

And so Cohen typed those search terms at his computer, and his hunch led him to an online living-donor service called MatchingDonors.com. A cynic by his legal trade, he wasn't sure about it. "My wife really thought I was being taken to the cleaners on this one," he says.

But, sure enough, it led him to Margie Stevens-Beville, an emergency-room nurse from New Hampshire. And on June 20, doctors at Hartford Hospital successfully transplanted one of her kidneys into Cohen's ailing body. The surgery went smoothly, and both donor and recipient are recovering well. It was the 46th transplant facilitated by a Matching Donors search.

"What she did was just so breathtaking and awesome, and so unselfish," Cohen says, back at work and visibly at ease behind a desk of folders and messy paper piles.

"It's the ultimate gift."

Off the list

It's also a controversial one.

When a Massachusetts doctor launched the site in 2004, MatchingDonors.com ignited an intense debate over the ethics of seeking live organ donors through the internet. With its members paying $595 for a lifetime subscription - or $295 per month - to scroll through donor-recipient profiles, critics argued that the site reduced the serious issue of organ donation to the medical equivalent of an online dating service. (Donors are not permitted by law to be compensated, although their medical bills and lost wages can be reimbursed by recipients).

Opponents contended it gave unfair advantage to the wealthy and sophisticated. They worried it would leave the poorer, perhaps sicker patients - or those whose member profiles weren't written with as much heartbreaking savvy - to wait under a national shortage of organ donors. And they contended it would fuel illicit trade in human organs.

But that's not what has happened, says Matching Donors medical director Jeremiah Lowney.

"Any time you can take someone off that (wait) list, you're allowing someone else to move up that list," Lowney says. "Instead of passively waiting, this is allowing patients to take their health care into their own hands."

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