By Les Carpenter
Washington Post Staff Writer
Wednesday, August 2, 2006

OWINGS MILLS, Md. -- The call came to Baltimore Ravens President Dick Cass from deep in the past. It was a friend, talking about another friend, an old law school pal from Yale. And did he know, the friend on the phone said, about their other friend's kidneys, about how they were failing and he was going to need a new one soon and they were looking for donors and, well, you know how that goes.

It took Cass a moment to grasp what the caller wanted.

"Are you asking me if I will give him a kidney?" he remembers saying.

Thus began a four-month odyssey of needles and syringes and examinations that culminated in June with a team of doctors at Massachusetts General Hospital slicing open Cass's side and extracting a kidney to save his friend. In an offseason of significant transactions for the Ravens, this might have been the biggest of them all.

"Maybe I'm intellectualizing this too much. But it's not a great risk," he said late last week as he sat in his office at the team's headquarters. "When you can do this for someone, it makes you feel good. It's really easy. It sounds silly, I know, to say that, but it's not that big a deal."

They are probably not best friends -- the team president and the man he saved. But they were good friends in law school who wound up in Washington, where they worked as young lawyers. The friend eventually moved to Massachusetts and they would talk regularly and visit every couple of years.

Cass, who recently turned down a chance to interview for the NFL commissioner's job, will not name the man, saying the person does not want to be identified. The only clue he gave was that the man is known in Washington law circles, but this is as far as he goes. He did say, however, that the man is doing well and has had no complications from the transplant. Nor has Cass, who was walking around Ravens headquarters only days after the operation.

"I was happy to do it and he was very grateful, really," Cass said.

Still, it was a grueling process. Cass first had to take a test to see if he had the same blood type as his friend. He did. But even after he delivered the news to his friend, the man told Cass to hold off. He had another donor, a woman in his Boston office who was younger. When the prospective donor was run through the armada of tests, she was rejected and Cass was called back.

As far as organ transplants go, kidneys usually have the best rate of success. The surgery often has few complications for the donors, who can live almost normally with only one kidney. Cass knew none of this when he first received the call last winter. He had to do research. So he began scouring the Internet for information.

What he discovered was that the wait for a kidney just from a cadaver in New England is four years. Finding a kidney from a living patient is even harder. And Cass's friend was not doing well. Besieged with kidney problems for more than a decade, the man already had a kidney donated to him by a family member. But complications set in and things had gotten so bad that the only solution was to go on dialysis -- an exhausting process that is undergone three times a week. This is when the man's friends put on a search for a donor and Cass, after consulting with his wife, agreed.

In many cases, the surgery to remove the kidney is not complicated. The doctors make a tiny incision around the belly button and essentially squeeze the organ out through the opening. They were not able to do it in Cass's case. He said he had an artery that had grown too close to his kidney, so the surgeons instead had to make a significant opening near his abdomen and slowly cut the kidney away. The whole process took five hours.

A week later, he was back at work and a few weeks after that he started exercising. Now he feels fine. In his research he learned that someone who has 100 percent kidney function before losing a kidney immediately retains 75 percent function with just one. Over time, that kidney grows larger and becomes more effective.

"Someday you may wish you had two kidneys," Cass said. "You might be in an accident or have cancer. But with all the tests I took, I felt it was no big risk."

Of course, there was something else, too. Something that might not be apparent upon first meeting the slender, subdued Cass. He wanted to prove he could do this. Early in his research, he came across a note that said that donors should be between the ages of 25 and 60.

Cass is 60.

He smiled. He is just an executive, after all, not a player or a coach. But for a moment on an afternoon before the players came back for training camp, there was a glimmer of competitive fire at the Ravens headquarters.