Because Mr Ruzzamenti was not a match for Mr Terry, staff at the National Kidney Registry set up a series of connected transplant operations which put together people willing to donate with those who needed kidneys.
Chain 124, as the linked procedures were called, was carried out in a series of operations which took place between August 15 and December 20 last year.
All but one of the patients involved have now come forward to discuss their role in the record-breaking series of transplants.
They include a man from Michigan who agreed to donate for his ex-girlfriend despite their bitter break-up for the sake of their two-year-old daughter. Husbands donated for wives, children for parents, a nephew for an uncle and a mother-in-law for her daughter's son.
The kidneys travelled across the United States, from coast to coast, in specially iced cardboard boxes fitted with GPS tracking devices on commercial airlines.
It was not possible for the recipients to travel, meaning that the operations could not be done simultaneously.
That meant trust had to be placed in the donors, amid fears that some might pull out of the deal once their relative had received a kidney.
John A Clark from Sarasota, Florida, told how his wife, Rebecca, faced a 68 day wait for a kidney after he had donated his own organ earlier in the chain.
"I believe in karma," he told The New York Times, which told the story of the transplants. "And that would have been some really bad karma [if someone had reneged]. There was somebody out there who needed my kidney."
In the end, all of the donors kept their side of the bargain.
Mr Ruzzamenti became inspired to donate after bumping into a stranger in a supermarket who told him she had recently given a kidney to a relative. He went ahead with the procedure even after his wife threatened to leave him.
There are around 400,000 Americans with kidney failure who currently undergo daily dialysis, and 4,500 die each year while waiting for a transplant.