HOLLYWOOD, Fla. (AP) _ A lawyer who began kidney dialysis 18 years ago because he had good medical insurance and was considered a worthy risk for treatment eventually became a crusader for others less fortunate.

But now 48-year-old Paul Feinsmith finds himself in need.

On Tuesday, he was in Pittsburgh awaiting a liver and kidney transplant, his only hope against liver cancer. But Medicare, the federal insurance program that pays medical costs for people with advanced kidney disease, excludes coverage of liver transplants.

So after years of working on others' behalf, Feinsmith has to raise money for himself.

''As ill as he is, and has been for years, he still has been responsible, almost single-handedly, for intervening with Congress to prevent cuts from (kidney) programs,'' said Spero Moutsatsos, project director for the End Stage Renal Disease Network of Florida in Tampa.

Feinsmith has served as president of the American Association of Kidney Patients and was the first president of the National Kidney Foundation of Florida.

''If you were white, middle-class, married and insured, you got on dialysis. If not, you died,'' he said recently at his Hollywood home, above the noise of a dialysis machine during one of his three weekly treatments.

Dialysis gave Feinsmith a chance at a full life. It has allowed him to watch two teen-age children grow and go on to college at Duke University and Ithaca College. He also has a daughter, 4, with his second wife, Alicia.

Although Medicare usually pays for kidney transplants, the agency originally denied compensation to Feinsmith because he needed a double transplant of his liver and kidneys.

Feinsmith conducted a tireless telephone campaign and enlisted the aid of political and medical allies to convince Medicare to pay about $80,000 for the kidney transplant.

But rather than exult, Feinsmith was enraged.

''It's outrageous,'' he said ''If it weren't for me and the people I know ... some poor shnook who didn't have connections wouldn't get this.''

But that wasn't the only battle Feinsmith faced.

He needed a $100,000 downpayment to be considered a liver transplant candidate at the University of Pittsburgh, where he was evaluated. The operation ultimately could cost more than $200,000, plus extra expenses for transportation, lodging and medication.

Feinsmith and his father, Sydney, a retired North Miami Beach cantor, have raised almost $200,000. An undisclosed amount came from ''an angel, out of the blue,'' who anonymously left a large check at a North Miami Beach pizza parlor, Feinsmith said.

He also has gained support from doctors nationwide, said his doctor, Allan Jacob.

''He's unique, he's not just another individual with a difficult medical problem,'' Jacob said. ''In the area of public policy and dialysis, he's an expert. Every major nationally reknowned nephrologist on patient and government issues has rallied around him.''