Francis, of Warren, and his brother, David, originally of Warren but now living in South Carolina, are back to their lives and recovering well after David donated a “huge” kidney to Francis in April.

Francis was born with Down Syndrome. He was also born with two kidneys, but “one was dwarfed and never functioned,” David said.

When the other started to fail, there was really only one option.

“They said he needed a kidney — he wasn’t a good candidate for dialysis,” David said.

Times Observer photo by Brian Ferry Francis Molinaro (left) of Warren and his brother, David, of South Carolina, get together at the gazebo at Betts Park on July 1 about two months after one of David's kidneys was transplanted into Francis.

Searches for donors generally begin with family, and Francis — one of nine siblings — has a big family. “They took three of us to start,” David said. “During the tissue typing, I was the first.”

And there was no reason to keep looking.

“I was a six out of six match,” he said. “Most siblings are three out of six.”

The search was over. Next came the preparations.

In November, doctors examined David to make sure everything — other than the kidney match — was good to go.

“I’ve never been looked over so good,” David said.

COVID-19 played a role.

The surgery “was delayed a couple times,” David said. And, “they insisted Francis get the vaccine.”

Also, Francis was not allowed to have visitors. At the same time, he was not allowed to be alone — someone had to be on-hand to make important decisions. “His sister, Alice Fadale (of Warren) stayed in the hospital 24/7,” David said.

Once he was fully vaccinated, the procedure was scheduled. Francis said the brothers were in the same department at Allegheny General Hospital for the surgeries.

“We saw each other very briefly” before David’s surgery began, David said. “Toward the end of the donor surgery, they start the recipient surgery.”

His surgery took longer than anticipated; the four-hour procedure extended to six, with doctors ensuring they were getting just the images they wanted throughout.

“Francis did very well,” his sister, Arlene Molinaro said. “He never complained of anything.”

He said he didn’t appreciate the staples the doctors used to put him back together, but he was feeling good, and thankful.

Francis pointed to his right side, showing where his brother’s kidney is now part of him. “Right here,” he said. “Huge.”

David’s kidney was larger than average and Francis is not a big man, so the kidney was not a perfect fit. But it’s working.

“Rejection can happen up to five years,” he said. “He’s doing well with it now.”

“I was released the next day,” David said. “They kept Fran in for five days for monitoring.”

“Fran was lucky,” he said. “He has a great support system — eight brothers and sisters, his dad, uncles, and cousins. A lot of people don’t have that kind of support.”

And he had one who was a perfect match and was more than willing to help.

“It was a very easy decision,” David said of giving his kidney to Francis. “It wasn’t hard at all. You gotta think of the alternative.”

The recovery is going well, but it takes time.

“He’s on a lot of meds,” David said. “His tests are like a teeter-totter – up and down all the time.”

“We’re taking it one day at a time,” he said.

“That’s right, Zekey!” Francis said, using David’s gamer tag.