Most organ donations occur after the donor has died. But a growing number of people are receiving organs from living donors. In fact, 47 Americans have actually done that good deed twice, reports The Wall Street Journal, which shared the stories of three such donors in a recent article.

According to the United Network for Organ Sharing, the majority of living donors who donate twice typically donate a kidney and part of their liver. Only 47 people have donated more than one organ to two different people over the past 25 years. An additional 17 have donated two different organs to the same recipient on different dates.

Why do they do it?

Ephraim Simon, a 51-year-old rabbi in Teaneck, New Jersey, first donated a kidney in 2009 to a father of 10 children. A few years later, he heard about living liver donation and started looking for someone in need. A number of hospitals turned him down for a second surgery, until the Cleveland Clinic accepted him. He donated a part of his liver to a Long Island father of three last December.

“The reward of bringing a father back to his children, of a husband back to his wife, that reward is infinitely greater than any risk I took,” said Simon. It took him three to four months to fully recover from each surgery.

Nathan Hauser, a 39-year-old director at a consulting firm and volunteer firefighter and EMT in Germantown, Maryland, donated his organs to strangers, choosing not to meet them before the surgery. He decided to go through with donation after seeing a commercial about living kidney donors and logging onto a website that matched potential donors with recipients. His first surgery, a kidney donation, took place in 2008. His second, a liver transplant occurred in 2013. Like Simon, he was turned down by a number of hospitals before he found one that allowed him to undergo a second surgery. He says he donated because of a strong belief that people should look out for one another.

The third donor profiled in the Wall Streeet Journal article is Sean Gome, a 54-year-old information technology manager whose organ donations went to family members. In 2003, he donated a kidney to his father-in-law. In 2017, he was approached by a cousin who needed a liver transplant. Ten months later, the University of California, San Francisco performed the transplant. Gome says he was almost too old for the second donation, so he ran every day to make sure he was healthy enough to go through with the surgery.

Those interested in becoming a living donor, at least once, are always evaluated by a social worker and sometimes a psychologist or psychiatrist, who carefully considers why a person might want to go through with the surgery. Usually, living donors have a history of donating blood or community service.

Doctors say they are more willing to accept first- or second-time donors today because surgeries have become a lot less risky. In fact, no national policy prohibits anyone from donating a second organ.

To learn more about living organ donation, click here.