Lift to home and health

Pedro Cendeño Lora knew something was wrong when he was too tired to keep going to work.

The native of the Dominican Republic had lived in the United States since 1995, quite happily. But he was about to get an unhappy lesson about the American healthcare system.

By the time his lethargy was attributed to kidney failure in late 2006, he was out of work, and struggling to hang on in his rooming house in Dorchester. Doctors told him he needed a transplant.

But he couldn't work because of his health, and he couldn't qualify for a transplant while he was in danger of losing his home.

Yet there he was last week, in his basement apartment off Geneva Avenue, celebrating his unlikely good fortune with his younger brother, Victor, and a group of friends. Through the grace of God, he said, he was doing well.

"America saved me," he said, via a translator.

Saving Cendeño became a mission of the Boston Health Care for the Homeless Program and Boston Medical Center.

Cendeño, 47, was running out of time when the groups came together earlier this year to find a way to save him. Aside from the problem of finding a donor, he had a precarious housing situation that was also a barrier to qualifying for a transplant.

The donor problem turned out to be the easier one to address: His brother, Victor, 36, was working in the tourism industry in Puerto Rico when the call came that his brother needed him.

"I felt that if my brother needed help, I needed to help him," Victor said last week, via a translator. Now living in Lynn, he is to return to Puerto Rico soon.

Recovery requires a stable environment. Health Care for the Homeless helped Cendeño catch up on his rent so he would have a home to recuperate in.

Before the surgery, the brothers checked into the Barbara McInnis House, which provides nursing care for homeless people. They stayed there for a week preparing for the transplant surgery, and for about a month after. Transplant patients are uncommon there, because candidates for the procedure are required to have a stable living arrangement.

"This was my first transplant experience," said Maggie Beiser, Cendeño's nurse practitioner at McInnis House. "We have many patients who, if not marginally housed or homeless, would make excellent transplant patients."

The transplant was performed by Dr. Matthew Nuhn last September at Boston Medical Center, and Cendeño says he is now almost back to full strength.

That two institutions had to come together to save his life says something about the fragile safety net that poor people confront in the face of catastrophic illness. Cendeño could easily have fallen right through.

Health Care for the Homeless is an organization constantly raising money to help people who are forgotten by many others. I have spent time with its volunteers, who take a van from the Pine Street Inn, seek out homeless people, and try to provide them with the care they need - or to cajole them to go to emergency rooms or clinics. But that system works a lot better for minor maladies than for the replacement of major organs.

Cendeño seemed upbeat last week about his prospects for recovery. "I'm good," he said. "It's in God's hands now."

He sleeps now in a bed that until recently belonged to Red Sox slugger David Ortiz. A healthcare executive who bought it at a charity auction contributed it to Health Care for the Homeless, which gave it to him.

Cendeño's story has a happy ending, though it might easily have been otherwise. He said he has no timetable for finding work, but he doesn't seem worried about it. A near-death experience can put everything in perspective. His brother is leaving the country, but he plans to stay put.

"The United States saved my life," he said.

Adrian Walker is a Globe columnist. He can be reached at walker@globe.com.