The pivotal premise upon which all baseball trades are founded is as follows: If you want to get something back, you must give something up.

For eight long years, Jim Duquette's young daughter, Lindsey, has battled a serious kidney disorder with no known cure. And for eight long years, the Duquette family has wondered what it will take to ensure this brave girl will have a chance to live a long and healthy life.

As it turns out, the answer was inside Jim all along.

Lindsey, you see, needed a kidney transplant, and tests revealed Jim to be a match. And so it was that on June 4, the 46-year-old former Mets general manager and his 10-year-old daughter were wheeled into separate operating rooms at Johns Hopkins Medical Center in Baltimore. Doctors removed one of the father's kidneys and placed it in the body of his long-suffering daughter -- a generous gift that Duquette hopes will reap a rewarding return.

Father's Day coverage
Duquette's gift: Healthy daughter
MLB helps prostate cancer fight
Home Run Challenge
Shop the Father's Day collection
Father's Day around MLB
Beach Boys' Father's Day PSA

"There was never any second doubt about it for me," said Duquette, an analyst for MLB.com and MLB Network Radio. "I've got a chance to do this great thing for her, and I'm not going to die from it? It's not even a question."

While some questions remain to be answered regarding Lindsey's adaptation to the organ, this much is clear: For the first time since her medical trauma began when she was just two years old, Lindsey has real hope of beating a debilitating disease, of enjoying a carefree, pain-free childhood.

And to Jim Duquette, that's a more than adequate return for what he's given up.

* * * * *

In 2004, Lindsey was diagnosed with minimal change disease, a kidney disorder that leads to nephrotic syndrome, in which damage to tiny blood vessels affects blood filtration. To put it plainly, protein was spilling into Lindsey's urine, leaving her blood-protein levels life-threateningly low.

The eight years since have been a non-stop nightmare for the Duquettes.

Lindsey has spent time in intensive care. She's endured breathing trouble, blood clots, high blood pressure and high cholesterol. According to the National Kidney Foundation, the majority of children with nephrotic syndrome eventually outgrow it, but Lindsey wasn't so fortunate. In 2008, she was given the more specific diagnosis of focal segmental glomerulosclerosis (FSGS), a disease that usually leads to kidney failure.

Duquette to host NephCure event
  • Jim Duquette's experience with his ailing daughter, Lindsey, inspired him to become a board member for NephCure, a non-profit foundation committed to supporting FSGS and nephrotic syndrome research.
  • On June 24, Duquette will host "Countdown to a Cure," a NephCure fundraising event in Baltimore. Special guests will include former Orioles players Jim Palmer, Rick Dempsey, Dave Johnson, Ron Hansen and Chris Hoiles.
  • Those interested in attending or donating to the cause are encouraged to visit www.countdowntoacure.org or call (571) 355-9808.

For several years, doctors tried to stave off what turned out to be the inevitable with protein and steroid infusions and chemotherapy. At one point, Lindsey was taking 24 medications a day.

Nothing worked.

Finally, in May of last year, with Lindsey entering end-state renal failure, both of her kidneys were removed.

"The thing that the doctors always told you is you keep the native kidneys as long as you could," Duquette said. "They've seen progress in those who can keep it under control by 9, 10, 11 years old. That was always the goal, but that just never happened."

* * * * *

With her kidneys gone, Lindsey was hooked up to a dialysis machine twice a day, including 11 hours at night. It served as a stopgap measure to cleanse her blood of toxins until she could receive a transplant, and doctors wanted her to wait a minimum of six months so that her body could purge all the medications she had been on.

Because the absence of the kidneys stunts growth in children, Lindsey began taking daily human-growth hormone shots. And because the dialysis only functions at a fraction of the percentage of actual kidneys, her skin took on a darker complexion.

"We didn't want her to miss school [following a transplant], so we gave her a full year [on dialysis] to get caught up in school, spend time with friends," Duquette said. "And as the calendar turned to this year, that's when the search started for a transplant."

Jim and his wife, Pam, had several options in that search. They could have waited for a matching donor to emerge. They could have even looked into the possibility of an organ swap, in which somebody in Lindsey's circle of family or friends offers a kidney to the relative of a willing kidney donor who is a match for her.

The baseball executive in Duquette was a little curious about that idea.

"I've done some trades before," he said with a laugh, "but this is so much more complicated than that."

But the Duquettes knew the best option was a direct donation within the family.

"I knew right away," Jim said, "that I wanted to be tested to see if I should go to the next level."

* * * * *

Duquette was a match not only in the rare AB blood type but also in three of the six specific antigen proteins that doctors inspect for compatibility. In April, a full battery of health tests -- CAT scans, MRIs, etc. -- determined him to be healthy enough to handle a transplant. Every time the doctors came back with a thumbs up, Duquette joked that he felt one step closer to immortality.

More than anything, though, Duquette knew he was doing what was best for his daughter, and his paternal instincts didn't allow him to dwell on what he would be going through himself.

"You're so protective of your kids," he said. "If they have a temperature of 102, you're freaking out, saying, 'How am I going to fix this?'"

Jim and Lindsey might have been a match in the blood department, but Lindsey wanted to ensure their connection extended into other, equally important areas. Jim was away at Spring Training for work one day when Lindsey learned that some kidney recipients actually inherit the taste buds of their donors.

"I want to know if you like ice cream," she texted him, "because I want to keep liking ice cream."

Not to worry, he assured her. He had her covered.

Surgery was set, but that didn't stop Duquette from fulfilling an obligation to do the Mets' radio broadcast, filling in for play-by-play man Josh Lewin, just three days earlier.

What he didn't know was that he'd be calling history: Johan Santana pitched the Mets' first no-hitter that night. And given the sport's many superstitions, it somehow seemed significant.

"When you feel like you have the baseball gods on your side," Duquette said with a laugh, "that's got to bode well for surgery. Because they're on the other side so often."

* * * * *

The gods indeed were smiling on the Duquettes, for the surgery was a success. Lindsey's body did not reject the new organ, though she did have to have a separate procedure performed Thursday to address a small blood clot in a ureter. Jim was out of the hospital three days after surgery and is already feeling fine, but Lindsey's recovery will require a summer-long rest period.

Lindsey was nervous going into the transplant surgery, but, throughout her ordeal, both her family and her doctors have been amazed by her upbeat attitude.

"It kind of hurt after," she said of the surgery, "but I feel good."

Already, Lindsey has told her parents that she feels more energetic -- just the way a 10-year-old ought to feel. Her skin tone is back to normal, and she's no longer tethered to the dialysis lifeline. She was scheduled to get out of the hospital on Friday.

"When I go home," she said excitedly, "I get to see my dog."

That would be her nine-month-old cockapoo puppy, Cassie.

"She wants to see the dog more than anything," Duquette said. "More than me!"

Lindsey is not completely in the clear. She'll continue to visit her doctors several days a week to have her blood-protein levels checked. The chances of FSGS attacking her new kidney, Jim said, are 50-50. It's an uneasy situation for the Duquettes, but the new kidney has brought new hope to a situation that once seemed so bleak.

Father's Day is Sunday, and Jim knows the usual gifts -- a new tie or a night out to dinner -- are not necessary.

"All I've cared about through this whole thing is that she's home, she's doing well, and she's healthy," he said. "That would be the best Father's Day gift I could ever get."

And it doesn't matter what he had to give up to get it.