A gravely ill New York man whose sister died on the operating table trying to donate her kidney to him had yet another kidney transplant canceled at the last minute.

Dad of four Roberto Medina -- who spent all of Thursday at Montefiore Medical Center prepping for the scheduled surgery -- expected to undergo the life-saving operation sometime after 7:00pm local time after the Bronx hospital and other hospitals agreed to vault him to the top of the kidney recipient list for compassionate reasons.

But close to that time, Medina, 39, and his family were informed that he would not be receiving the kidney because the New York Organ Donor Network did not obtain required approval for the speeded-up donation from two federal organ-donation-oversight bodies.

A downcast Medina said, "There was not a good outcome."

The about-face was the second time since May 23 -- when mom of three Yolanda Medina died while undergoing kidney-harvesting surgery on her brother's behalf -- that Medina entered Montefiore expecting to receive a new kidney only to be thwarted at the last minute.

Helen Irving, president of the New York Organ Donor Network, said, "Unfortunately, the patient in question will not be able to receive an organ as soon as we had hoped. We hope to have all of the approvals in place shortly. I have been impressed by the unity, support and commitment of the transplant community in wishing to pursue this rare request. Our thoughts are with the patient and his family at this difficult time."

It is not known when Medina will get a kidney that is a match for him.

Earlier in the day, he expressed thanks for the expedited surgery.

Montefiore had told him to return to the hospital hours after the prestigious live-donor program was shut down while the hospital and state health officials investigated his 41-year-old sister's death.

Medina said, "They went out of their way. They spoke to all the organizations in the area -- they all agreed the next kidney was for me. Montefiore took the step. I know my sister is here through all this, and she's doing her thing from heaven. She wants to finish what she started -- she's an angel."

Her death was the first of a live donor in more than 40 years of such surgery at Montefiore.

The hospital declined to comment on events Thursday.

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