Rejected from medical school, he hoped that networking with some prominent local transplant surgeons might give him another shot at admission.

Instead, Nathan, who runs Philadelphia's Gift of Life Donor Program, wound up a world traveler and a prominent leader in the world of organ transplantation. Now in his 31st year at the organ program, he is president of the International Society of Organ Donation and Procurement.

In 1978, Nathan became the third employee of what was then the Delaware Valley Transplant Program. He now oversees 100 employees who cover a region in eastern Pennsylvania, South Jersey and Delaware that he says produces the largest number of organ donors in the world - about 450.

In 2005, he moved Gift of Life into a spotless, 76,000-square-foot building in Philadelphia that has three operating rooms. The organization trains transplant workers from around the world. His newest project is raising funds for a $7.5 million house for the families of out-of-town transplant patients.

Nathan's father, who died when Nathan was 9, ran a dry-cleaning business. His mother worked for minimum wage in a clothing store. Thirteen years after Nathan started working in transplant, his sister got a liver transplant. She died in 2003.

He married for the first time at 50, having devoted, he now says, almost all of his early life to work. He met his wife after a friend surreptitiously placed a singles ad about him in WHYY's magazine. As a concession to her, he now tries to keep his workdays to 11 hours or so.

Question: You started out pre-med. What happened to that?

Answer: I didn't get accepted to medical school. Came to Philadelphia. Worked at Wistar Institute in research. Went back to grad school. Thought that I would do that, and then go to med school. . . . And then answered an ad in the paper for this job called transplant coordinator, and offered to work for free . . . because they didn't want to hire me. They thought I was too young and immature.

Q: So you worked for free?

A: No, I offered. And the guy who was my boss was like, "This guy had the right attitude."

Q: Why were you interested in this job?

A: Two reasons. One is I had heard about the concept of a person being a kidney coordinator from a friend of mine who had heard about a job in Washington. The second thing is all the surgeons were on the boards of the medical schools. So I thought, "Well, I interview here, I work here for a year or two, go to medical school." Never applied again. . . .

Q: Why not?

A: Because [the job] combined the things that I love, which is being on the cutting edge of medicine, working with people who are committed and are passionate about what they do. And I got to use my, I guess you'd say, my personality and social skills in working with families and working with health-care workers. . . . The neat thing about this job, still today, is that, within hours, you turn tragedy into someone's new life. And what other job has that? And so that's a pretty powerful thing that attracted me and still keeps me pumped up.

Q: It is noticeable that you're still pumped up.

A: I'm getting shivers just talking about it. . . .

Q: Why do you think this area has so many organ donors?

A: I think the . . . relationships that we've developed with the hospitals and the health-care workers is key. Them allowing us . . .to work collaboratively with them in approaching families is really a crucial thing. . . . Second is that we were one of the first to do a comprehensive law that mandates the call to us, starting in 1994. We were also one of the first to put [organ donor] on our driver's license and make it a legal consent for organ donation.

Q: What percentage of people put donor on their driver's license?