They mark the anniversary with a message, a brief text or short phone call every Aug. 16. A reminder that two brothers born 15 months apart share more than DNA. They share a kidney. 

Noel Elliott reached out first last year, texting: “Happy 23rd anniversary come back kid!” Sean Elliott replied: “Thanks to my hero big brother! Today I’m living an incredible life, you gave me that.” 

Wednesday marks another milestone. It’s been 24 years since Noel gave Sean a kidney, a 160-gram gift that led to history, inspired organ donations and saved who knows how many lives. When Sean awoke after surgery on Aug. 16, 1999, a part of Noel was inside him. An organ the size of a fist transformed two brothers, its impact spreading across the U.S.

Sean went from near-dead to soaring San Antonio Spur. On March 14, 2000, Sean threw down a one-handed dunk in the Alamodome, becoming the first pro athlete to return to a major sport after a kidney transplant. Noel went from anonymous stock clerk to acclaimed role model. The National Kidney Foundation honored him with a “Gift of Life Award.” Sean became the foundation’s spokesperson and elevated kidney disease awareness. One year later, the U.S. Department of Health and Human Services reported the largest increase on record for organ donations from the living, 16%. 

“The Elliotts are both an inspiration and have made a great impact on our mission,” says Troy Zimmerman, special projects director for the National Kidney Foundation.

Today, Sean looks like he stepped off the cover of Men’s Health magazine. He’s 55 but could pass for 35. Boyish grin. Youthful features. He feels the aches and pain of age and 12 bruising NBA seasons, but he says his kidney function is strong and he eats meals prepared by his wife Claudia, a dietician. During National Kidney Month, Sean advocates for medical exams with statistics that stun: Kidney disease affects an estimated 37 million people in the U.S. — but 33 million don’t know they have it. Fourteen people die every day, waiting for a transplant. 

At 6-foot-5, Noel is 3 inches shorter than Sean and carries more weight. At 56, Noel leads a simple life, attending church and working to provide for his family. He drives an 18-wheeler for a cement company in Tucson, Arizona. “I’d love to get to San Antonio and visit Sean,” he said. “But we’ve got two kids in college and one just graduated.” 

Hooping brothers

Forty years ago, two brothers spent the last month of summer playing pickup ball. The elder, Noel, had a year and an inch or two on the younger. A healthier body, too. Sean tore the ACL in his left knee as a high school freshman. A doctor told him he’d never play again. After surgery, Sean kept playing and re-injured the knee twice. His mother told doctors Sean would not quit hooping, so he was fitted with a knee brace. In the fall of  1983, Sean and Noel returned to Cholla High School, but this time, for the first time, as varsity teammates. Little brother had talked big brother into playing. “You’re better than most of those guys,” Sean told him. “You should try out.” 

The Cholla Chargers won a lot of games, and Sean emerged as a star. But the season wasn’t exactly a dream. From grade school through high school (and beyond), Noel was plagued with nightmares. In one, he was protecting Sean from a classmate, wielding a big stick. In another, he was pulling Sean to safety from a swimming pool. In a third, he was trying to rescue Sean from a spiritual being. “I was yelling at it and trying to get it away from Sean,” Noel recalls. “It was so jarring, I literally woke up screaming.” 

The brother-in-distress dreams made no sense until Sean faced a real life emergency. After the 1992-93 NBA season, Sean learned he had minimal change disease, a disorder that damages tiny blood vessels in the kidneys. Under medical monitoring, he played through the disease for six seasons. He made his second All-Star team in 1996 and helped the Spurs win an NBA championship in 1999.

After the celebration, an ultrasound revealed Sean had a rare and more serious disease: focal segmental glomerulosclerosis, or FSGS. The prognosis: Get a kidney transplant or die. Without hesitation, Noel offered one and he turned out to be a perfect match. Consider the odds: There are approximately 90,000 kidney patients on a transplant list, according to the National Kidney Foundation. The average wait time for a first transplant is 3.6 years. Sean got one in five months. Relatives, the most likely donors due to genetic similarities, often balk at donation due to fear, the pain of recovery or the expense of missing several weeks of work. Noel had another reason to decline. He was a newlywed. He married in May and went under the knife in August. As for those bad dreams, sometime before Noel said, “I do,” the nightmares stopped.

People called him the most famous kidney donor in America, but Noel did not understand the fuss. When he arrived for Sean’s first game after the transplant, TV cameras filmed him walking into the Alamodome. When 26,708 people began chanting his name, he could not comprehend why. “It was surreal,” he says. “It was crazy. I mean, I’m just Sean’s brother.” 

The Elliotts grew up as best friends, sharing a bedroom. They hooped together, got into mischief together, did everything together. An organ donation represented a tightening bond of brotherhood. But there was something more. Noel wanted to put his Christianity into practice. “My faith,” he says, “gives me a perspective that this life is not for us to do whatever we want, but to live sacrificially.” 

(from left) Brothers Noel, Bobby and Sean Elliott in April 2023. Credit: Courtesy / Elliott Family

‘It’s a wonder I’m here’

No one knew if Sean would play again. Spurs Coach Gregg Popovich didn’t expect him to. Spurs point guard Avery Johnson didn’t want him to. Johnson, in fact, told Sean he never wanted to see him in uniform again. So what did Sean do? He plotted a comeback at age 32.  When not broadcasting games for the Spurs, he lifted weights, took yoga classes and ran wind sprints. During a workout in a cold gym in Indiana, Sean got sick. His lungs began to hurt. He spiked a fever. “I thought I was going through [organ] rejection,” he says. Sean returned to San Antonio and spent several days in the hospital with pneumonia. Says Sean, “The team doctor said, ‘If you had come in a day later, you would be leaving out the back door.’ Which means the morgue. It’s a wonder I’m here.”

Sean recalls his near-death story after I share my own. I walked into the emergency room on Jan. 8, struggling to breathe. Twenty two days later, I awoke from a coma. From the foot of my bed at North Central Baptist Hospital, a doctor said, “You are a living miracle.” Unable to speak with a tracheostomy tube in my throat, I blinked in bewilderment. I was told I’d arrived with pneumonia, which turned into septic shock. Then my liver and kidneys failed. At one point, my wife wondered if I needed a kidney transplant. She had been born with three. “I’ll give him one of mine,” Judy thought. A transplant wasn’t needed, but I was placed on dialysis. A greater danger lurked. A surgeon nicked a lung while draining it for fluid. I bled and coded. A doctor explained: “It’s as if you stepped into a ring with three world heavyweight boxing champions and came out alive.” 

“You’re lucky,” Sean says. “You’re so lucky.”

And Sean? He played at an elite level with a kidney disease threatening his life. As the Spurs tore through the 1999 playoffs, his body sounded alarms. The symptoms that led to the FSGS diagnosis flared: fatigue, swelling, frequent urination. Before games, he could feel water in his legs. After games, his level of creatinine, a measure of kidney function, spiked. A normal creatinine level for men is 0.7 to 1.3. After Sean sank his famous three-pointer to beat Portland on Memorial Day, his creatinine level jumped over 7.0. After the Spurs beat the New York Knicks to win the NBA championship, Sean’s creatinine level soared to 9.6.

“I can’t imagine how he was running and jumping with all that swelling in his legs,” says Dr. Chris Glanton, a nephrologist and chief medical officer at Peterson Health in Kerrville. “For him to compete at such a high level, in pressure-packed games, with those kinds of numbers, that’s amazing.”

Sean Elliott of the San Antonio Spurs follows through on his game-winning three point shot against the Portland Trail Blazers in the final seconds of game two of the Western Conference Finals on Memorial Day, 1999.
Sean Elliott follows through on his game-winning 3-point shot against the Portland Trail Blazers in the final seconds of Game 2 of the Western Conference Finals on Memorial Day 1999. Credit: ROBERT SULLIVAN / AFP via Getty Images

Miracle: That’s the Biblical term used to describe Sean’s off-balance, tippy-toe 3-pointer over the long, outstretched arm of Rasheed Wallace on Memorial Day. The word also fits his life. His basketball career was supposed to be over before he played his first junior varsity game. A torn ACL. Two more injuries to the same knee. No way, doctors said, he’d step on the court again. As a sports writer for the now defunct Tucson Citizen in 1983, I arrived early to cover a varsity game between basketball rivals Cholla and Pueblo. Sean was on the junior varsity team. The Pueblo coach, Barry O’Rourke, and I chatted as the JV game drew to a close. “Anybody on the floor I should watch for next year?” I asked. O’Rourke replied, “That kid with the leg brace. He’s going to be special.”

Sean stood about 6-foot-3 at the time. The next year, he grew to 6-5, made first-team All-City and attracted some college interest. He kept growing, signed with the University of Arizona, grew to 6-8, broke the Pac-10 career scoring record set by Lew Alcindor (Kareem Abdul-Jabbar) and was named College Player of the Year in 1989.

Four years later, he felt the settling weight of water retention and lethargy. “I woke up one day and my eyes and face were so swollen,” he says, “I had trouble opening my eyes.” 

To treat minimal change disease, doctors placed him on high doses of prednisone, a steroid. Traded to the Detroit Pistons in 1993, Sean did not respond well. “I gained about 15 to 20 pounds of fat,” he says. “I couldn’t shed the weight. When I got off prednisone, I had body aches and didn’t feel like myself. That was one more hurdle to overcome.” 

When Sean was traded back to the Spurs in 1994, he hid the kidney disorder from teammates. Most adults with minimal change disease achieve remission. Sean expected the same: “I thought, ‘Any day now, I might get better and it will go away.’” It got worse. Deep into the Spurs’ 1999 playoff run, doctors were checking Sean’s blood pressure before and after games. “I was concerned,” he says. “I thought this might be my last go-around. But this was something I’d worked so hard for. I was just kind of single-minded. I put blinders on.” 

The Spurs won the NBA championship in five games. Sean hoisted a trophy and sprayed champagne. Noel celebrated in Tucson with his wife Kathy, his mother Odiemae, older brother Bobby and aunts and uncles. Two months later, Noel gave a kidney to save Sean’s life.

The comeback

When everyone thought Sean would retire to the broadcast booth, he decided to rejoin the team. On Jan. 11, 2000, he slipped on a jersey and, without asking permission, jumped into one-on-one drills. As Popovich attended to other players, Sean hustled up and down the court until an assistant coach noticed and kicked him out. Although cleared by doctors, Sean was barred from practice until he passed a conditioning test, running the length of the 94-foot court 10 times in less than one minute. After a one minute rest, he had to repeat the run five times. He failed on his first few attempts before passing. “I still don’t know how I did it,” he says.

Seven months after the transplant, Sean made headlines. In his first game back, he played 12 minutes and scored two points against Atlanta. As the final seconds ticked off the Spurs’ 94-79 victory, the Alamodome crowd chanted, “We want Sean! We want Sean!” Everybody wanted Sean. He was invited to the 2000 U.S. Transplant Games. Fans approached him in every NBA arena, asking questions, seeking autographs. The media asked for interviews. Nonprofits wanted him to record public service announcements.

The one year anniversary of the transplant arrived. Then the second. The brothers exchanged warm messages. In 2001, Sean retired to the broadcast booth, physically spent. “Your body takes a beating,” he says. “I have all kinds of maladies now. The back goes out once or twice a year. I can’t stand up straight. I slipped about three weeks ago on vacation. I did something to my hip. My wife said, ‘Geez, babe, you look like an old man.’” 

The old man looks almost as long and lean as he did in silver and black. The joints might ache and creak and he may carry a few more pounds. But Sean has more muscle and appears fit. 

Being married to a dietician helps. Claudia turned Sean from junk to healthy eating. “It took a little bit of time,” she says. “But I tell my clients it’s possible to change your spouse’s eating habits. When I met Sean, he was still eating at Taco Cabana and Burger King. Hitting the drive-thrus.”

As a new anniversary approaches, the clock ticks on a 24-year-old organ. A transplanted kidney from a living donor lasts, on average, 15 to 25 years. There are exceptions. Glanton has a patient whose transplanted kidney remains strong after 32 years. Ohio State University tracked a recipient who received one 45 years ago. The National Kidney Foundation featured a recipient with a 46-year-old transplanted kidney. Having seen the impossible unfold time and again, Sean expects one more miracle. “I plan for this kidney,” he says, “to last forever.”

Ken Rodriguez is a San Antonio native and award-winning journalist.