One man’s selfless act has started a chain reaction today, resulting in nine people receiving the kidney transplants they need. In one of the nation’s first single city collaboration transplant efforts done over a 36-hour period, 18 people from the San Francisco Bay Area are currently being operated on in a marathon surgery to help one another.

The man, who kick-started the reaction comes from California Pacific Medical Center, and he is known as an altruistic donor. He had been wanting to donate his kidney and found the perfect opportunity when a patient in need of a kidney was not a match with their relative. It was because of his kindness that the man inspired this relative to donate their kidney anyway, to another person in need. This chain of donors continued, tallying 18 total, nine receiving and nine giving.

"He's doing a wonderful thing. I think he felt the need to show gratitude in some way and this is how he's doing it and he's helping multiple people now," transplant surgeon Dr. Andrew Posselt told ABC 7.

Posselt also noted that this system is very fragile, and that every person is essential to the process. "The chain can break at any place, so if one donor is ineligible or if one gets sick, the whole thing falls apart," he said.

But this has yet to be the case. So far, doctors have already finished 10 of 18 surgeries at both the University of California and California Pacific Medical Center, where the organs are being transported via courier.

Posselt concluded by saying that anyone could do what this man did and help save a significant amount of lives. "A healthy person giving one kidney up is not going to hurt their health and it's not going to shorten their lifespan. It's a very safe thing."