We consider a well-studied online random graph model for kidney exchange, where nodes representing patient-donor pairs arrive over time, and the probability of a directed edge is p. We assume existence of a single altruistic donor, who serves as a start node in this graph for a directed path of donations. The algorithmic problem is to select which donations to perform, and when, to minimize the amount of time that patients must wait before receiving a kidney. We advance our understanding of this setting by (1) providing efficient (in fact, linear-time) algorithms with optimal O(1/p) expected waiting time, (2) showing that some of these algorithms in fact provide guarantees to all patients of O(1/p) waiting time {em with high probability}, (3) simplifying previous analysis of this problem, and (4) extending results to the case of multiple altruistic donors.