The Kemoeatu family post-transplant surgery. (Photo: Amani Martin)

BALTIMORE — Ma’ake Kemoeatu missed his final collegiate football game because the NCAA suspended him for improperly providing textbooks to his younger brother.

He was a four-year starter at Utah on scholarship and his little brother Tevita was a walk-on. Their parents didn’t have enough money to buy books, so Ma’ake bought them for him and therefore couldn’t play in the Las Vegas Bowl against USC.

But Ma’ake wasn’t trying to cause trouble. The oldest of seven kids, he steps up for his family when they need help.

So when his brother Chris needed a kidney transplant this past August, Ma’ake, a former nose tackle for the Baltimore Ravens, didn’t hesitate when he heard the news. He was going to donate.

When Chris was in eighth grade, he started having kidney pain. Over the years, as he grew into a 6-foot-3, 385-pound lineman for Utah and go on to win two Super Bowls with the Pittsburgh Steelers, the pain got worse.

He played through it. Training camp, regular season practice, games and playoffs. With what was later discovered to be a form of kidney disease. He grew up in a tough family. A family that rarely said ‘I love you’ not because they didn’t have feelings, that’s just how it was.

“I’ve seen him struggle and the last three years of his career, fighting through a lot because of his kidney,” Ma’ake said at a press conference at the University of Maryland Medical Center on Wednesday. “When we found out he needed a transplant, we had to stop our careers because his health was most important to us.”

After the 2011 season, the pain was too much and Chris stopped playing football. Ma’ake ended his career with the Ravens after the 2012 season to be with his brother.

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In early 2013, Chris met with Dr. Matthew Weir, a nephrologist at the University of Maryland School of Medicine. Chris learned then that he had advanced kidney disease and needed a transplant. Ma’ake immediately said he would be the donor. And he was a 99% match.

“The doctor said we could pass as twins to do this surgery,” Ma’ake said. “My dad wanted to do it, and we kind of got into it because I didn’t want him to do it. I’m the oldest of seven kids so it was my responsibility to take care of my younger brothers and sisters.

“If my brother or any of my siblings needed blood, they have to have my blood. If any of my siblings needed a kidney, it would have to be my kidney.”

Ma’ake had to pause for a second as tears welled in his eyes.

“My dad wanted to do it so bad,” he said. “I had to stop him. But the credit goes to my brother because he had so many flare ups. He had to go into training camp and had to fight through the pain and get ready for the season.”

In order to have a successful transplant, both brothers needed to lose weight, which took some time. Chris was unable to workout, so he had to go through dialysis. And he hated it.

“First starting out, I didn’t know how it was going to go because I’m scared of needles,” Chris said. “So going into this was tough.”

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About a year into the process after the weight had been lost, doctors discovered Chris had heart problems and needed surgery. He underwent heart surgery this past June and six weeks later on Aug. 27, they did the kidney transplant.

It was successful and the brothers are doing well. Dr. Stephen Bartlett, who performed the transplant, said Ma’ake’s kidney was the largest he had ever seen.

“It was one-and-a-half times bigger than any other kidney I had ever seen in my life,” Bartlett said. “It was absolutely remarkable.”

Recovery takes six weeks and the brothers are about halfway finished. The doctors said they’re both “functioning beautifully.” They’re living down the street from the hospital for now, but plan to move home to Hawaii once they’ve been cleared.

A return to the NFL is unlikely. Ma’ake has reached out to Cleveland Browns linebacker Paul Kruger, who plays in the league with one kidney, but the brothers want to spend time with family and friends in Hawaii. Chris spent eight years in the NFL and Ma’ake played for 10, and they have businesses and foundations to tend to.

As if the family wasn’t close enough — while the brothers were preparing for surgery, they said different siblings would come from Hawaii to stay with them and cook and clean the house — they say ‘I love you’ more these days.

“We were raised in a tough atmosphere,” Ma’ake said. “But after this, I think we say it.”

Then he turned to his brother Chris and said, “I love you man.”