Within weeks, though, Angelica’s world came crashing down.

“I started getting swelling in my ankles, losing a bunch of weight and just generally not feeling very good,” Ponce said. “I went in for a blood test and knew quickly something was wrong.”

It was a major flare-up of ANCA vasculitis, the autoimmune disease she had been diagnosed with in her teens but had been in remission for several years. Doctors now told her she had more than 60% damage to her kidneys and there was nothing they could do to reverse it. She would need to begin dialysis and, eventually, would require a kidney transplant.  

“It is very unusual for people in their 20s to go into renal failure. Typically, kidney failure is related to diabetes and high blood pressure in patients in their 50s and older,” said Tsuyoshi Todo, MD, a kidney transplant surgeon at Cedars-Sinai. “In Angelica’s case, she was a college athlete and as healthy as they could come. It was very unfortunate she had her kidneys shut down due to her autoimmune disorder.”

Ponce didn’t want to be on dialysis for her wedding, so she put planning on hold and began searching for a kidney donor.

She didn’t have to look very far. Angelica’s younger sister, Miranda Ponce, immediately volunteered to get tested to see if one of her kidneys might be a good match.

When the test results came back, the sisters were a perfect six out of six match.

“That six out of six number indicates the number of matches that Miranda’s body shares in common with Angelica’s body,” said Justin Steggerda, MD, kidney transplant surgeon at Cedars-Sinai who served as the surgeon for Miranda Ponce. “This means Angelica’s body is less likely to react adversely to the transplant and less likely to form some sort of immune response that may later on lead to problems.”

Miranda Ponce said she didn’t hesitate when she found out she was the perfect living donor for her sister.

“I was happy that I had such a good match so that she could have the longest, healthiest years with the best kidney for her,” Miranda Ponce said. “And I knew it would be comforting for us, to go through this whole process together.”

The Ponce sisters went through their kidney transplant surgery at Cedars-Sinai in November 2025. They spent the next few weeks recovering together at their parents’ home in Bellflower, California.

“Anytime a living donor transplant is between siblings or family members, it’s always a really special occasion,” Steggerda said. “In this case, it facilitated Angelica being off dialysis, and I think that’s a really special story.”

Todo said that Angelica’s determination and positive outlook fueled her recovery.

“[Angelica] was determined to not walk down the aisle while she had a dialysis catheter hanging out of her chest,” Todo said. “And the fact that her sister stepped up to help her with a kidney donation for the biggest day of her life is very touching.”

April marks the recognition of Donate Life Month, which promotes awareness about organ donation and honors those who gave the gift of life. To acknowledge this occasion, the Ponce sisters will participate in the annual Donate Life flag raising ceremony at Cedars-Sinai on Wednesday, April 1.

“This month means so much to me, personally. This has become our story now, and being a transplant patient, I feel like I have a voice to raise awareness,” Angelica Ponce said. “By donating a kidney, you give someone their life back, and I feel like my sister gave me my life back because of this.”

With Angelica’s health challenges in the rearview mirror, the Ponce sisters are looking forward to brighter days to come, including Angelica’s wedding in 2027. Miranda will be her sister’s maid of honor.

“This will be my first time being in a wedding so I'm extremely excited,” Miranda Ponce said. “My biggest goal after the transplant was for her to get that wedding and to hopefully one day be a mother and give me nieces and nephews. That’s my biggest dream, honestly, just to be an aunt. So yeah, I'm really excited.”

Read more from Cedars-Sinai Stories and Insights: After Lung Transplant, a Return to Running

For nearly two years, the Cedars-Sinai Kidney Transplant Program has been performing living-donor nephrectomies—the surgical procedure of removing a kidney from the donor—fully robotically, but, until now, the recipient procedure had not been robot-assisted.

“The stakes are quite a bit higher when it comes to putting a kidney in,” said Justin Steggerda, MD, who performed the Comprehensive Transplant Center’s first fully robotic kidney transplant. “The risk of bleeding increases because you’re not just cutting and stapling vessels but actually opening them up and sewing them together to get the transplanted kidney positioned well to where it can be reperfused and maintain good blood flow.” 

Cedars-Sinai is one of only a handful of institutions in the United States to have performed a fully robotic kidney transplant, placing it on the leading edge of transplant innovation.

Steggerda recently spoke with the Cedars-Sinai Newsroom about robotic kidney transplantation and who can benefit from the minimally invasive surgery.

How is robotic transplant surgery helpful to patients?

The primary advantage of a robotic approach is a smaller incision, which means less pain and lower risk of infection. This leads to a faster recovery, faster return to work and reduced reliance on pain medication. These are all big advantages for patient-centered outcomes.

There is a misconception that robots are doing the surgery itself, and that is not true. Robots do not act autonomously. We are controlling them every step of the way, so, in fact, it may be more appropriate to refer to it as robot-assisted surgery. But the advantage of using the robot is that the instruments can be much more dexterous, allowing the procedure to be more minimally invasive.

How does the incision for robotic surgery compare to a traditional procedure?

A kidney is about the size of a human fist, so any incision needs to be at least wide enough to get the organ in. For a robotic procedure, that incision is approximately the length of my palm. In a standard, open procedure, the incision is wider—closer to the length of my entire hand—so you can not only get the kidney in, but you can also see around it and get your instruments in to complete the operation.

What are the risks associated with robotic kidney transplant?

The biggest challenge of a robotic transplant procedure is getting into the abdomen safely and operating around other organs that may be in the way. This is different from a traditional, open procedure. … In a robotic transplant, we must be cognizant of the other organs that may be in our operative field, making the procedure more highly specialized.

Who will benefit most from robotic transplant procedures?

Patients with a body mass index over 35 or 40, are at an increased risk for wound infections, which have been associated with worse kidney transplant outcomes in the long term. By reducing some of those risks, we expect to see better outcomes in that population of patients.

What is next for the robotic transplant program?

Robotic kidney transplant at Cedars-Sinai is a program that we want to continue to grow. It will allow us to expand the number and types of patients that we transplant, with better outcomes. It’s really the future of transplantation in general.

It’s important to note, however, that we are working with a fragile population with end-stage kidney disease, and robotic surgery may not be the right technique for every patient. We will always evaluate every case individually to make sure we personalize the best possible care for each patient. In the short, three-to-five-year view, we hope to be performing up to 40% of these transplant procedures robotically as we continue to drive innovation further and stay on the leading edge of kidney transplantation surgery.

Read more from Cedars-Sinai Stories and Insights: What Is Robotic Surgery? How It Works and When It’s Used

Sams is one of just 46 people in the U.S. to receive a heart, liver and kidney transplant since the United Network for Organ Sharing (UNOS), the government agency that tracks organ transplants, started tracking the procedures in 1987.

A decade ago, Sams was diagnosed with sarcoidosis, a rare inflammatory disease that caused a buildup of scar tissue on his heart. Since then, he’s been unable to work, exercise or even walk at times.

After learning that his heart, liver, and kidney were failing and being hospitalized for two months at Cedars-Sinai Medical Center, Sams received the miraculous news that an organ donor match was available.

“I had to sign off on it, and that was the hardest thing I had to do,” Sams told NBC 4. “It was either go ‘all in’ or ride it out with the bad organs, and I was going to give myself a shot at life.”

The 20-hour surgery was performed by a team of eight Cedars-Sinai doctors, including Nicholas Nissen, MD, director of the Liver Transplant Program; Tyler Gunn, MD, director of the Extracorporeal Membrane Oxygenation Program; and kidney surgeon Justin Steggerda, MD.

“This triple organ transplant was absolutely remarkable,” Nissen told NBC 4. “We expect him to grow to be a wonderful older gentleman.”

Sams is recovering and already back to coaching youth athletics in Baldwin Hills with his son. “I am just thankful for a new day, whether cloudy or sunny. Every day is a good day; every day is my birthday,” he told NBC 4.

Click here to watch the complete segment from NBC 4. Click here to watch the complete segment from ABC 7. 

But today, Sams walks side by side with his son, Valance “Vee” Sams Jr. He’s exercising again, eating healthy, and focused on rebuilding his strength, thanks to a triple organ transplant at Cedars-Sinai.

“I’m feeling good, great, awesome,” he said. “It’s night and day.”

After a successful 20-hour surgery this spring, Sams is one of just 46 people in the U.S. to receive a heart, liver and kidney transplant since the United Network for Organ Sharing (UNOS), the government agency that tracks organ transplants, started tracking in 1987.

“Going through the UNOS database, I can see that prior to Mr. Sams, there were only 45 of these triple organ transplants,” said Tyler Gunn, MD, director of the Extracorporeal Membrane Oxygenation Program and Sams’ heart surgeon. “Since then, the average has been only about 1.5 of these surgeries per year in the U.S., more frequently within the last five years as providers and surgeons get more comfortable with the operations and technology.”

Sams’ journey began when the sarcoidosis diagnosis necessitated multiple visits each week to his doctors to monitor his condition, drain built-up fluids from his body, and administer dialysis treatments.

“If the heart's not working, it can cause something called congestive hepatopathy in the liver, where the liver just starts not to work very well, and can cause chronic and permanent damage of the liver, and then it can also cause stress on the kidneys as well,” said Irene Kim, MD, director of the Cedars-Sinai Comprehensive Transplant Center and the Esther and Mark Schulman Chair in Surgery and Transplantation Medicine.

In order to make it to all of his medical appointments and keep up with his health, Sams was forced to quit film school, a deeply devastating decision.

His son, Vee, then a teenager, took on the role of nurse, counting out medications and helping his father prepare meals that would keep his health on track.

“I was basically his personal nurse,” Sams Jr. said. “I made sure everything was OK, he wasn’t missing appointments. I made sure his medicines [were] OK, you know, changing his bags for dialysis at the house.”

Sams Sr. gets emotional when talking about how much of a help his son was.

“Since the beginning, he’s been like my nurse, my best friend, my brother,” Sams Sr. said.

Early this year, Sams Sr.’s health took a turn for the worse–he was hospitalized because, despite keeping up with his treatments, his heart, liver and kidneys were failing.

After a two-month hospital stay, Sams received news of a new hope–a matching heart, liver and kidney were available for transplantation.

Sams’ surgeons, Gunn, Nicholas Nissen, MD, and Justin Steggerda, MD, worked together with their teams of up to 15 other providers at a time, in a 20-hour-long operation to transplant the organs. The highly orchestrated procedure required close coordination.

“The coordination starts long before we even get to the operating room,” said Steggerda, Sams’ kidney surgeon. “It starts with our program coordinators and our respected nursing staff, who make sure that a donated organ is acceptable, identify the best time to do the procurement, and organize the logistics of getting all the teams there to get the organs and bring them back safely.”

During multi-organ transplants, surgeons operate based on allowable ischemic time–the amount of time each organ can tolerate being outside the body. Based on this, the heart transplant must happen first, followed by the liver and finally the kidney.

“The first step is the heart transplant, which is actually done in the same technical fashion that a single heart transplant is done: median sternotomy, cardiopulmonary bypass, removal of the old heart, suturing in the new donor heart, then coming off the bypass circuit,” said Gunn. “At that point, it changes. We leave the heart and the chest open, allowing the liver team to do their anastomosis [making connections] as well. And then ultimately the kidney is transplanted, followed by the closure of the chest.”

Nissen, surgical director of the Liver Transplant Program and Sams’ liver surgeon, said that multi-organ transplants like this exemplify transplant teams’ ability to work together under pressure.

“There's probably no better case in surgery or in medicine that exemplifies the concept of teamwork like a multi-organ transplant, because literally every team member has to work with every other team member for this to go right,” Nissen said. “The anesthesiologists work with the surgeons, the surgeons work with the technicians, and there are three different teams that are making this happen, so for this to be successful, it takes an absolutely coordinated effort. And it's the ultimate example of medical teamwork.”

According to transplant center Director Kim, not all medical centers in the U.S. offer organ transplants, and even among those that do, not many offer even dual organ transplants, let alone triple organ transplants.

“At Cedars-Sinai, we are one of the world’s leaders in dual organ transplants,” she said. “While no transplant center is doing triple organ transplants very routinely, our expertise in dual organ transplant management gives us an advantage when performing these complex, multi-organ procedures.”

His doctors say that, with Sams’ careful adherence to his medications and determination to rebuild strength, he should make a full recovery. He’s already back to doing some of the things he loves most–like coaching youth baseball. And much to Sams Sr.’s delight, son Vee is enrolled in film school, inspired by his father.

“The little things are so important,” Sams said. “We take advantage of a lot of little things, but now I know that those little things are where it’s at.”

Sams said he hasn’t yet met the family of the organ donor who saved his life, but if he does get the chance, he’ll tell them how grateful he is.

“I want them to know that I’m very appreciative, and that I’m going to do the best that I can to do a lot of good things,” Sams said. “His memory is still going, through me, and I’m going to do my best to honor it.”

Read more on the Cedars-Sinai Blog: 7 Myths About Organ Donation