This is a story of love, five times over.
It's estimated that every hour, someone in America dies because they need a kidney and can't get one.
A Roanoke County couple was determined to not be a statistic, so they did something incredible.
"When it become obvious that the current kidney was failing, I just offered my kidney," Ron Downing says very matter-of-factly.
He says it was an easy decision; a sign of the love he has for his wife Veronica.
"He always tells me, 'I need you more here and I really want you to stay with me,'" Veronica Downing said.
Unfortunately, Ron wasn't a match for his ailing wife, who's failing kidney was the one she got from her mother 18 years ago.
It was looking gloomy, the prospect of years of dialysis while waiting for a kidney to become available, "But then they said, "'However, there is another option,'" Ron added.
Doctors and nurses at UVA even say when they explain the "Paired Exchange" program, it sounds like science fiction.
"If you can imagine, when we present it to patients, you have to tell them, well your kidney gets removed, and goes to some unknown location, and your loved one will get a kidney from some unknown location so there's a tremendous amount of apprehension both in the patient and even in the center," says Doctor Avi Agarwal, a transplant surgeon at UVA.
But two weeks ago, Ron and Veronica Downing did a paired exchange.
After extensive screenings, a willing Ron was deemed healthy enough to give up one of his kidneys to a complete stranger.
In turn, Veronica was able to receive her new kidney from a different complete stranger.
They were one of five pairs in five states that participated in the highly orchestrated surgeries. They all had to happen the exact same morning.
The Downings were UVA's first participants in a Paired Exhange.
"It's definitely a team approach, not only involves the transplant teams here, but as you can imagine, all the transplant centers that are involved," says transplant coordinator Anita Sites.
"It truly is a remarkable process to take part in," Dr. Agarwal said.
"It's a humbling experience and it's also an amazing feeling to be part of something bigger than yourself," said Ron Downing.
"So yes, at first I hesitated, but after a second, I think about it and pray about it and with my husbands encouragement," Veronica Downing started nodding, "now I'm glad I made that decision."
The Downing's will likely never know exactly where Ron's kidney went and where Veronica's came from.
All they know is that they have each other for a little longer; and they're happy four other pairs of people can say the same.
Doctors say paired exchanges are the next big breakthrough in Kidney Transplantation. The program has been around for a while, but word is starting to get out about it.
Doctors say receiving a living kidney improves life expectancy much more than one from someone who's deceased.
They also say Paired Exchange isn't for everyone, that it takes a lot of physical and mental strength to make happen.