At 14, Marie Marquardt was diagnosed with lupus, a chronic inflammatory disease in which the body's immune system attacks its own tissues and organs. She used crutches and a wheelchair in high school and was taught mainly by tutors. By 19, she was in renal failure; she traveled an hour to and from dialysis three times a week while living in college dorms. At 21, Marquardt -still in college - underwent her first kidney transplant.

She was told the kidney, which was from a deceased donor, would likely function for about seven years before her body rejected it. But she (and the kidney) beat the odds: it lasted 21 years. Marquardt finished college, worked as a Certified Public Accountant, married, gave birth to a son and adopted a daughter.

About 15 years post-transplant, Marquardt learned that the mother of the organ donor wanted to meet her.

"I was scared," recalls Marquardt. "I thought, my life is going great - why would I want to open up this Pandora's Box?" So she did not.

"As I look back on it now, I was selfish. It wasn't until I became a mother myself that it haunted me," she says. But by then, the donor's mother had moved, leaving no forwarding address.

Subtle awareness of changes

About eight years ago, Marquardt began noticing "little things" that signaled her body was rejecting the donated organ. "The kidney was just tired," she says. "I knew it was dying a slow death."

Her doctors gave Marquardt only a one percent chance for another successful transplant because she had become "sensitized" - meaning her body had harmful antibodies that would attack foreign tissue. These antibodies develop through previous exposure to foreign tissue, such as through transplants. Marquardt's situation was exacerbated by the unusually long time since she had her first transplanted organ.

She went back on dialysis - this time overnight, for 12 hours at a time, so she could have treatments at home instead of at a dialysis center. After several months, Marquardt says, "I decided: I can't live this way, hooked up to a cable 12 hours a day." She searched online for clinical trials, ultimately self-referring herself to the Mayo Clinic for a special procedure called a positive cross-match transplant, using living donors. Unexpectedly, a volunteer donor came forward: her husband's boss's wife.

Marquardt was grateful, but given the degrees of separation, she felt she had to ask: Why?

"She told me her mother passed away when she was young. She said: 'I look at you and your kids, and I don't want them to grow up without their mother,'" says Marquardt, her voice cracking with emotion.

The transplant, seven years ago, was followed by several days in intensive care when Marquardt's blood didn't clot. She and her husband made the decision to move from Alaska to Minnesota, where she could be close to Mayo for monitoring.

An ambassador for donation

Last year, as her son graduated from high school, Marquardt pondered: 'What's my passion?' She thought anew of the mother of her first kidney donor, who later wanted to meet. She couldn't change the past, but she could still give back. Marquardt reached out to LifeSource, the regional nonprofit that manages the organ and tissue donation process, supports donor families and educates the public. Now she's among the organization's ambassadors, who share their stories with student drivers and at information booths and otherwise spread the word about the importance of organ donation.

The message has found fertile ground in Minnesota, where 63 percent of adults are registered as donors, compared to 54 percent nationwide, according to Susan Mau Larson, director of partner and community relations at LifeSource.

"Minnesotans are very generous," says Larson, noting that the state's residents also have high rates of donating to charity and voting. In addition, the state has enacted laws bolstering organ donation awareness and registration. For example, driver education classes must include information on organ donation. This year, Minnesota became the first state to let people register as donors upon obtaining or renewing hunting and fishing licenses.

It's anticipated that the new law might boost donor registration among men. Women are slightly more likely than men to register, according to Larson.

Currently about 120,000 Americans are awaiting a transplant, including some 2,900 Minnesotans. Kidneys are the most common organ transplanted.

Marquardt, at 50, continues to keep tabs on her body, monitoring its signals. "There's a very slow [kidney] rejection going on," she said in mid-June. "It's not acute - it's a minor chronic rejection - so I'm not alarmed by it." She knows at some point she'll have another decision to make about how to proceed.

In the meantime, she's living her life, keenly aware of and grateful for the gifts her body has received. When she meets donor families at events and hears their stories, Marquardt says, "I start physically shaking and burst into tears - because I know they have changed someone's life."

Say yes

LifeSource helps with more than organ donation. Both of Marie Marquardt's knees and hip joints have been replaced, because of required and prolonged steroid use that affects joints. She needed to re-replace a knee with donated bone and knee tissue. "Without this donation I would not be walking today."

According to LifeSource:
• One donor can save and heal up to 60 lives through organ, eye and tissue transplant.
• In cases where a deceased person had expressed no preference on donation and surviving families make the decision, about half the time families say no.
•You can say yes by registering to be a donor at: