Matthew Botchler is issuing an emergency appeal to anyone moved by his plight: He needs a kidney and would like a stranger to give him one.
It is a bold and desperate request, a 911 to a good Samaritan who might provide him with what he calls "the gift of life." And it is one he must do on his own because state and national procurement organizations cannot ethically seek organs from the living.
"I first found out in July of last year that I would need a transplant," said Botchler, 37, who lives in Selden. "I was told at that time that my kidneys were functioning at only 13 percent and that I was in kidney failure."
His medical problems have led to a highly unusual situation. The transplant team at Mount Sinai Hospital in Manhattan has advised him that because of his long and unique medical history, a kidney from a living donor will work best.
The catch: Botchler will have to find the live donor himself. It is a bioethical dilemma as well as a personal one, he said.
His parents, sister, fiancee and small circle of friends have all been tested as possible donors, who must have the same blood type as Botchler. None match.
Botchler has been battling medical problems since birth. He was born with a rare condition known as exstrophy of the bladder, which means the muscular urinary sac not only developed outside the pelvic region, but was so small it had to be removed when he was a child.
A physician in France who had heard about him offered to perform that operation, also rerouting urinary function through the large intestine. That operation worked well throughout most of his life.
"Two years ago I had Stage I colon cancer," Botchler said of a malignancy marked by two abnormal growths in his large intestine.
Botchler, a New York City employee who inspects manholes, said doctors at Johns Hopkins Hospital in Baltimore, where the cancer surgery was performed, told him they believe the surgery by the French doctor put undue pressure on sensitive intestinal tissue and led to the malignancy.
They conducted yet another surgery using artificial tubing as extensions to his kidneys. But his battles with kidney stones and a host of other chronic kidney problems, he said, sent the organs' function precipitously downhill.
Julia Rivera, spokeswoman for the New York Donor Network, said the state is one of the worst for kidney patients, whether they need living donor or cadaver organs.
"We probably have one of the longest waits in the country because we have about 10 percent of the national waiting list," Rivera said.
"Every 15 hours, someone in New York dies waiting for an organ," Rivera said Monday, adding that most of the people in need of organs statewide are awaiting kidneys.
Nationally, nearly 100,000 people need kidneys but there are never enough living and cadaver organs to meet the demand, Rivera said.
Some experts, however, say there are ways of circumventing the lopsided math.
"There are sometimes pairs of donors and recipients where potentially people in a similar situation can switch donors," said Joel Newman, spokesman for the United Network for Organ Sharing -- UNOS -- the national nonprofit that oversees cadaver organ procurement. UNOS also has a panel that writes policy on living donor transplantation.
Newman said exchanges of this kind -- sometimes involving donors and recipients in different states -- have occurred successfully for years. Botchler's potential donors don't match him but one may match someone else -- and he may match that person's donor.
Botchler has set up a Facebook page for those who want to contact him and learn more about his story -- Matt's Kidney Kampaign.
His fiancee, Megan McIver, 31, also of Selden, can't talk about Botchler's medical condition without weeping.
She said Botchler's cancer operation two years ago makes it difficult for him to sleep lying down, and that he must remain upright in a recliner. Her hope is for him to receive a transplant to alleviate small discomforts as well as the looming problem that threatens his life.
"I would give him a kidney if I could," she said. "I was pretty upset when I found out I wasn't a match."