He enjoyed a prosperous career, but over time, kidney function declined: 50 percent capacity, then 20. He began dialysis. The long-term outlook was bleak. Life expectancy without a transplant is typically 5-10 years.
A compatible donor was identified last winter, but a few days after surgery, the new kidney faltered. Simms was shattered. The average wait for someone with his condition is four years.
He followed a disciplined regimen to continue living to the fullest: undergoing dialysis three days a week, monitoring fluids, limiting sodium, maintaining a smart diet, exercising. He founded an indoor cycling studio, which has two locations in the Boston suburbs and is seeking to expand to Washington.
And then one day this fall, Simms received a call from MedStar Georgetown University Hospital, which handled his first transplant. A donor had come forward. It was not a direct match, meaning a transplant was not possible. But it would initiate a paired donation, a process that matches multiple donors with suitable recipients to help more ailing people receive transplants.
In other words, if a compatible individual were identified in the Kidney Transplant Registry, the kidney provided by Simms's "donor" would go to someone else in need and Simms, in turn, would receive a new one. It's a chain, typically started by a person for altruistic reasons. "Paying it forward" is how UCLA Medical Center, the busiest kidney transplant center in the country, describes the path.
Despite the promising development, Simms said, "I didn't get my hopes up because I didn't know how long I would have to wait" for a match.
Unbeknownst to him, Simms's registered donor was his ex-girlfriend, Katri Hunter. They were a couple for six years, bought a row house together blocks from RFK Stadium. When Simms signed with the Revolution ahead of the 2012 season, they began a long-distance relationship. Time apart and Simms's declining health took a toll. After the season, they broke up. They remained on good terms: occasional phone calls or texts, social events with mutual friends.
Hunter, Simms said, had been the driving force behind his first transplant, using social media, email blasts and their wide circle of friends to seek a donor. The campaign worked, though, ultimately, the transplant did not because of suspected clotting in the donated kidney.
Hunter, too, had been tested but wasn't a direct match. Last spring, though, Georgetown hospital reached out to ask if she would be willing to enter the national registry. She agreed. She was listed as Simms's donor. She didn't tell anyone, not even her family, in case Simms received a direct donation or life circumstances changed at either end.
In recent months, the hospital asked her to undergo a series of tests, physical and psychological. "So I had an idea they would ask me to donate," she said. "I was expecting that call."
That call came right before Thanksgiving. Through the registry, Georgetown had located a match for Simms. The date was set. As Simms's "donor," Hunter would give her kidney on the same day that he received his, both at Georgetown. Simms's would come from the Midwest, hers would go to a recipient in the Baltimore area.
Simms had received a similar call, that a match had been located and he had a donor. No other details were shared.
The hospital contact asked Hunter, "Does Clyde know? Because you guys are going to run into each other at the transplant center" in the days leading to surgery, she recalled.
Simms and Hunter do not speak regularly, so when one calls the other, it's usually important. Hunter called him.
"Is there something you want to tell me?" Hunter asked.
"Georgetown called. They have a kidney for me," Simms told her.
"I know," she said.
"Because I'm the one" who facilitated the chain.
Simms said he was "shocked" and couldn't process the information right away. When his mind cleared, they spoke again the next day.
"After I thought about it, I was happy it was her," he said. "She is the one person who saw me in all of the phases. She has seen me at my worst. For her to be the one, something felt right about it. It just felt right. In a way, it all made sense."
Said Hunter: "It's crazy, but it's not."
She said she remained "very rational" through the entire process and did not let emotions cloud her judgment.
"I didn't want him to feel he owes me in any way," Hunter said. "I'm not the warm, fluffy type. That's not what it's about for me."
If, in the end, Simms had received a kidney through a different path, she said she would have remained in the national registry.
"When you see someone so young go through it over a long period of time," she said, citing her experience with Simms, "you want to help."
For Simms's first transplant last year, one of the donors in the chain was a friend of theirs. "To see what she experienced," Hunter said, "it helped humanize it."
By sharing her own experience, Hunter said she hopes to encourage others to become donors. "In the big picture, the [registry] chain is so amazing."
On Dec. 9, Hunter had her kidney removed early in the morning. Simms received his new kidney, via the anonymous Indiana donor, late in the day. In recovery, they were one floor apart. They texted. The next day, Hunter visited Simms. At her side "to make sure I didn't pass out in the elevator," Hunter said was Megan Olsen, wife of Ben Olsen, United's head coach and Simms's former teammate.
Although she and Simms are no longer together, Hunter has remained in United's circles: She is tight with athletic trainer Brian Goodstein's wife, Judy; has rented rooms in her house to players; and, as a real estate agent, helped new goalkeepers coach Zach Thornton find a home in the city last year.
After a two-night stay, Hunter was released from the hospital. Donors are typically sore but need only a couple weeks before resuming normal activity.
Simms got out three days later. He is staying with relatives in Manassas, Va. He'll return home to Boston in a few weeks. His parents are visiting from North Carolina. His twin sisters, who live in the District, have been at his side. Outings are refreshing but exhausting. Someday, he hopes to learn the identity of the Indiana donor and thank him or her.
Last Thursday, Simms and Hunter met at a Washington cafe. Christmas was a week away. His most important present had arrived early.
"Yeah," he said, "the best."