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

Irene Kim, MD, director of the Cedars-Sinai Comprehensive Transplant Center, partially credits the increase in liver transplants to the use of machine perfusion, a technology that circulates oxygen-rich, nutrient-rich, blood-based solution through donor organs until transplantation. Machine perfusion reduces graft dysfunction, allowing organs to be viable longer and improving physicians’ assessments of the organs ahead of transplantation—all of which has served to increase donor organ availability, Kim said.

A willingness to take on the most complex cases also helped drive the increase in lung transplants, according to Kim, as Cedars-Sinai is known for accepting high-risk cases that had been previously turned away by other institutions.

“We are committed to staying on the leading edge of transplant technology to ensure the best results for our patients, with survival outcomes that continue to meet or exceed the national average,” Kim said. “The more organs we can transplant, the more patients can receive a second chance at life. It’s a privilege to not only help these patients, but also to honor the donors who gave the ultimate gift of life.”

According to published data from the Organ Procurement and Transplantation Network (OPTN), 49,065 transplants occurred in the U.S. in 2025—more than in any other year. With records continuing to be set year over year, the OPTN has set an ambitious nationwide goal of 60,000 deceased donor transplants annually by the end of 2026.

New Records in Liver and Lung Transplants, Living Kidney Donors

The Department of Cardiac Surgery in the Smidt Heart Institute is the largest heart transplant center by volume in California, with clinical and surgical teams performing 114 adult heart transplants in 2025. The team, led by Joanna Chikwe, MD, chair of the Department of Cardiac Surgery, Fardad Esmailian, MD, surgical director of the Heart Transplant Program, and Jon Kobashigawa, MD, director of the Heart Transplant Program in the Department of Cardiology, has maintained an average of more than 100 heart transplants each year for the last 13 years, a current record in the U.S.

Surgical Director Dominick Megna, MD, and Medical Director Reinaldo Rampolla, MD, led the lung transplant team to perform 93 lung transplants in 2025—the most ever at Cedars-Sinai—surpassing its previous record of 88 in 2024. The Lung Transplant Program in the Smidt Heart Institute at Cedars-Sinai continues to be the largest by volume in California and, in 2025, earned a place as a top 10 center by volume in the U.S.

The Liver Transplant Program also reached new milestones. The team, led by Kim, as surgical director, and Alexander Kuo, MD, professor of Medicine and medical director of the Liver Transplant Program, performed 145 liver transplants in 2025, exceeding the 2024 record of 136 transplants.

The Kidney Transplant Program team, led by Stanley Jordan, MD, medical director of the Comprehensive Transplant Center’s Human Leukocyte Antigen and Transplant Immunology Laboratory, and Tsuyoshi Todo, MD, surgical director, completed 324 transplants in 2025, including one pancreas-kidney transplant.

Notably, the team performed 80 living donor kidney transplants in 2025, setting a record for the number of living donor kidney transplants performed at Cedars-Sinai, with a more than 15% increase over the previously held record volume of 69 in 2013. This program, led by Steven Wisel, MD, and Reiad Najjar, MD, has transformed into a completely robotic surgical program.

“These achievements are a testament to the hardworking team at the Cedars-Sinai Comprehensive Transplant Center,” said Kim, the Esther and Mark Schulman Chair in Surgery and Transplantation Medicine. “But none of these lifesaving procedures would be possible without the altruism of organ donors and their families. We are tremendously grateful to those who give the gift of life through organ donation.”

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

Jordan, the director of Nephrology and medical director of the Cedars-Sinai Kidney Transplant Program, is widely admired for pioneering immunomodulatory therapies—treatments that regulate or suppress the body’s immune system so that it does not reject a transplanted donor organ. Jordan, also the director of Cedars-Sinai’s Human Leukocyte Antigen and Transplant Immunology Laboratory, led the development of therapies aimed at overcoming blood type incompatibility between donors and recipients. 

“Dr. Jordan’s groundbreaking contributions to transplant immunology have fundamentally changed the field and improved the lives of countless patients,” said Irene Kim, MD, director of the Comprehensive Transplant Center at Cedars-Sinai. “This well-deserved honor acknowledges Dr. Jordan’s significant scientific contributions to solid organ transplantation. We are fortunate that such a world-renowned scientific leader represents our transplant center and our institution.”

Jordan is an expert in plasmapheresis, a procedure he pioneered at Cedars-Sinai to reduce transplant rejection by removing harmful antibodies from the blood of kidney transplant recipients. When combined with other therapies, this protocol can enable organ transplantation in a patient who may otherwise have been ineligible.

Jordan also developed intravenous immunoglobulin (IVIG) therapy, which adds helpful antibodies to a transplant patient’s blood—calming the immune system to lower the chance of organ rejection without suppressing the entire immune system.

“I am deeply honored and grateful to receive this special recognition from the American Society of Transplantation,” Jordan said. “It is reflective of the many remarkable people who have shaped my journey—mentors, leaders and my dedicated colleagues at Cedars-Sinai, whose commitment to improving transplant outcomes continues to inspire me. At the heart of it all, our greatest reward is helping patients reclaim their lives. Receiving this award is icing on the cake.”

Jordan decided to become a doctor at 5 years old, when he was hospitalized with polio for four months. Temporarily paralyzed below the waist and surrounded by others ill with the virus, he was cared for by an especially kind medical intern and compassionate doctors and nurses.

“That’s what I want to do,” he remembers thinking at the time. “That’s who I want to be like.”

Two decades later, while completing his immunology fellowship at Scripps Clinic in La Jolla, California, Jordan had a chance encounter with local virologist and researcher Jonas Salk, MD—the inventor of the polio vaccine.

“What an inspiration,” Jordan said, “to go from being in the cauldron of death and human suffering caused by polio to meeting the person who had a positive impact on so many lives by eradicating the virus.”

Meeting Salk bolstered Jordan’s desire to devote his career to clinical care and translational research.

In 1990, Jordan’s research led to Cedars-Sinai performing the first successful kidney transplant from a nonmatching donor after the recipient was treated with one of the antirejection techniques Jordan developed.

Jordan went on to create the Transplant Immunotherapy Program at Cedars-Sinai in 2004. Today the medical center is known for transplant patient care and research and is an international referral center for transplant patients who need antirejection therapies.

Jordan has received numerous honors in addition to the Lifetime Achievement Award, including the prestigious 2020 Medawar Prize from The Transplantation Society.

“It’s a great feeling to know that I’ve done something good with my life,” Jordan said after accepting the Lifetime Achievement Award. “I wake up every morning excited to go to work and gratified that we are helping make more people’s lives better. I never could have imagined a life like this.”

Read more on the Cedars-Sinai Blog: Making Kidney Transplants Possible for More Patients

After a successful kidney-pancreas transplant at the Cedars-Sinai Comprehensive Transplant Center, Janine Roberson was thrilled to finally get the doctor’s OK to eat solid foods. But when a dietitian arrived at her hospital bed and asked which dessert she wanted with her first meal, Roberson raised a brow.

“I can have dessert?” she asked. “Without insulin?”

Now 37, Roberson had lived with Type 1 diabetes nearly all her life—she was diagnosed at 7. The chronic disease eventually caused stage 5 kidney failure—her kidneys were so damaged they barely functioned, leading to years of dialysis treatment.

But today, 10 months after her transplant by Cedars-Sinai surgeons Todd Brennan, MD, MS, and Steven Wisel, MD, Roberson’s quality of life is better than ever. She no longer has diabetes.

And those are only two of her reasons for celebrating.

On June 13, Roberson graduated with an associate degree from El Camino College in Torrance, California. She came back to the Comprehensive Transplant Center that morning to see Brennan, Wisel and other transplant team members, give them hugs and tell them thank you.

“I went through this journey by myself—my family and many of my friends live far away,” Roberson said. “My doctors and nurses were my support network, and they made it possible for me to graduate.”

Graduation was just another indication of Roberson’s fortitude, according to the Cedars-Sinai team.

“Janine has remarkable resiliency, as demonstrated by the many obstacles she has overcome,” said Brennan, professor of Surgery. “Resiliency made her a strong candidate for successful double organ transplantation, helped ensure a quick recovery, and is now helping her achieve her goals.”

Wisel agreed, praising Roberson for properly managing her diabetes and staying positive amid many ups and downs.

“Janine is a perfect example of the true benefits of pancreas transplantation,” said Wisel, surgical director of Pancreas Transplantation. “It is not just freedom from insulin injections—but a new lease on life. She has quickly learned to thrive as a kidney-pancreas recipient, and we look forward to supporting her through her successes.”

Excited and Emotional

The decision in 2021 to go back to college helped Roberson, a former graphic designer, through one of the more challenging times of her life.

She had been on medical disability when, while undergoing peritoneal dialysis—a procedure that uses the abdominal lining to filter blood—at home, alone, she decided to pursue a new career.

She is working toward a double major in child development and psychology to become a child life specialist, helping children with chronic illnesses and serving as a mentor for their parents. It’s something Roberson and her family had needed—she remembers much isolation and fear as she grew up managing diabetes, although those challenging times made her a stronger adult.

Once she decided to go back to school, Roberson was especially reminded of her inner strength.

“There were so many medical appointments, health issues, classes, working part time, and doing an internship, and I handled it all on my own,” she said. “So many times, I wanted to give up. Some may think, this is just community college on the path to a four-year degree, but for me, this graduation is a huge milestone. I’m excited and very emotional.”

Ups and Downs

Roberson was on the transplant waitlist six months—a shorter time than is common for many organ transplants because fewer people are waiting for a pancreas.

On July 4, 2024, she got a call to come to Cedars-Sinai right away: A deceased donor’s organs were available for transplantation. It was just before her birthday.

“I was so excited—I just knew it was my birthday gift from God,” she said.

However, Roberson’s dreams were dashed when the team learned the pancreas wasn’t viable. The following month, the transplant team called her again. Another donor’s organs were available.

“I was afraid to get my hopes up,” Roberson said. “When Dr. Brennan came into my hospital room, I asked, ‘Is this really happening?’ He said, ‘It is happening,’ and I started to cry.”

On Aug. 22, she was wheeled into the operating room for one of only five kidney-pancreas transplants performed at the medical center in 2024. After 12 days recovering in the hospital, she was allowed to go home. New milestones were marked a few months later: a hike in a local canyon and, perhaps most memorable, seeing a member of her favorite K-pop band, BTS, perform in concert. She held up a big sign that said, “I got a new kidney to be here!”

New Goals

There’s much more to accomplish, Roberson said. She plans to write a thank-you letter to the organ donor’s family, but she wants to give them time to heal. She also wants to experience more milestones she can share.

“I want them to know how grateful I am, and that I’m a person worthy of their loved one’s gift,” she said.

Roberson also wants to make her dad proud. She dedicated her graduation cap to “Pa,” her best friend and biggest influence in resilience. He passed away a month before her graduation.

“He always wanted to see me healed, and I know he’s excited for me to do new things, live new things and see new things,” she said.

For Roberson, Aug. 22, 2024, was a turning point.

It was the day she began her second life. The day surgeons gave her the opportunity to graduate. The day she chose the chocolate cake.

Read more in Cedars-Sinai Discoveries Magazine: All Eyes on Transplantation

At first, Chris noticed he’d be out of breath while carrying equipment during his son’s Little League games. Eventually the lack of oxygen made it difficult to move and caused his thoughts to blur. His doctors said he desperately needed another transplant, but surgeons at 15 centers had rejected his case, saying it was too complex.

It was October 2023 when Chris and wife Liz prepared to call the Smidt Heart Institute at Cedars-Sinai after meeting with the lung transplant team there. They braced for another compassionate—but emphatic—no. Instead, what they heard was that the team would take his case.

“They were willing to give me more time with my family,” Chris, now 48, said.

Chris and Liz gathered their kids in the living room and they hugged as they shared the news. The family would be temporarily relocating to Los Angeles to begin the process of getting Chris on the organ transplant list.

“When you read his story on paper, you can be taken aback by what's a very risky endeavor,” said Dominick Megna, MD, surgical director of the Lung Transplant Program at Cedars-Sinai. “When you actually meet Chris, you see something totally different. You see a guy who's willing to fight, who has resilience and drive in him and a loving wife willing to support him.”

When Liz met Chris in high school Spanish class, she thought he was funny. Soon they were going to the movies together and talking on the phone for hours.

Chris told Liz not to fall in love with him. That’s because at 8 days old, Chris had been diagnosed with cystic fibrosis, a disease that causes the lungs to create an excess of thick, sticky mucus that clogs airways.

“I warned her it’d be a life of doctors’ appointments,” Chris said.

They dated anyway, often hanging out with friends and family in their Houston suburb, and Liz would visit Chris during his frequent hospitalizations.

“He's always been an incredibly generous, authentic and intelligent person,” Liz said. “I knew from a young age that he was the person I wanted to spend my life with.”

They married when Liz was 20 and Chris 22. After many difficult conversations, Chris and Liz chose to have children through in vitro fertilization after bloodwork confirmed Liz was not a carrier of the genetic mutations that cause cystic fibrosis. Both parents must carry the altered cystic fibrosis gene for a child to inherit the condition. 

The family eventually moved to Arizona, where the arid climate allowed Chris to breathe easier than the Houston humidity.

Exercise helps keep the lung mucus at bay and Chris was diligent about daily workouts. Despite this, his lungs required constant care, so much so that Liz created a play area in his hospital rooms for their children. When Chris’ condition forced him to leave his job as a physical therapist, he learned to do personal investing from home.

A double lung transplant in 2015 made it possible for Chris to see both of his children finish elementary school, his son enter middle school and his daughter start high school.

When those lungs started to lose function because of chronic rejection, Chris knew a second transplant would be more challenging. Scar tissue from previous surgeries can interfere with the reattachment of new organs. Chris also had been diagnosed with superior vena cava syndrome, a condition in which one of the body’s main veins has a blockage and cannot circulate blood properly.

“Because of this syndrome, he had poor venous access and an increase in collateral circulation to his right chest, which would increase his risk of bleeding during surgery,” said Reinaldo Rampolla, MD, medical director of the Lung Transplant Program.

Another complicating factor was that after his first transplant Chris had developed a debilitating condition called post-transplant lymphoproliferative disease, a reaction to the many drugs he took to prevent his body from rejecting the first transplant. Although he had been in remission from the disease, physicians were aware that he was at risk.

By the time a donor match was made for Chris in March 2024, he had already been intubated because he couldn’t breathe on his own. Megna and transplant surgeon Pedro Catarino, MD, working with a team of other surgeons, anesthesiologists, surgical technicians and operating room nurses, dissected scar tissue and prepared Chris’ blood vessels to attach to the new lungs. A heart-lung machine called ECMO, or extracorporeal membrane oxygenation, kept Chris alive during the eight-hour operation. Chris became one of 88 patients who received a lung transplant at Cedars-Sinai in 2024.

Today, he’s back in Arizona, lifting weights five days a week, playing baseball with his 13-year-old son, and helping his 16-year-old daughter prepare for college.

“We expect Chris to have a great long-term outcome,” Megna said.

Rampolla is treating Chris with low doses of immunosuppressive drugs to avoid the toxicity that made him sick after his first transplant. Chris travels to Cedars-Sinai for checkups every three months, but these visits will be less frequent as he adapts to his new organs.

Improved surgical techniques and immunotherapy treatments are making it possible for more people to qualify for a transplant. But more than 100,000 people are waiting for an organ in the United States, according to the United Network for Organ Sharing.

Liz gives talks in her community about signing up to be an organ donor. “It’s a horrible thing to think about, but it can be comforting knowing that if something terrible happens to you, you could give life to someone else,” she said.

For Chris, his goals keep changing. He once hoped to be well enough to walk his daughter into kindergarten. He currently looks forward to seeing both children finish college and begin their adult lives.

“Organ donation means everything,” Chris said. “If someone hadn't been generous enough to donate their lungs, my children would have grown up fatherless a long time ago.”

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

That’s what she’s been doing since she was 22, when she was diagnosed with dilated cardiomyopathy, a rare disease that causes the heart muscle to weaken and, eventually, stop pumping blood.

After college graduation, Epps-Manuel began her career in special education. She grew up with a brother with special needs, and Epps-Manuel believed she had found her calling. But one day in 2010, during her first job as a teaching assistant, she came home feeling like she had just run a marathon. She couldn’t catch her breath. An emergency physician discovered her heart was enlarged, and the next day, a cardiologist diagnosed Epps-Manuel with dilated cardiomyopathy.

Just three years earlier, the former intramural college volleyball player had given birth to a healthy boy, and she had never had health issues. No one in her family was known to have a heart condition.

Epps-Manuel’s type of dilated cardiomyopathy is idiopathic, meaning the cause is unknown.

“It was very hard mentally,” she said. “I started having issues with palpitations and had to start wearing an external defibrillator. It was just one thing after another.”

To give herself more flexibility, Epps-Manuel left her elementary school job, moved in with her parents and started a ministry and service center for people with cognitive disabilities.

A few years after she was diagnosed, surgeons at Baylor University Medical Center in Texas implanted a left ventricular assist device (LVAD) to help Epps-Manuel’s heart pump blood. Less than two years later, she received a second LVAD after the first one caused a major blood clot in the cannula of the device’s pump.

In December 2014, Epps-Manuel received a long-awaited heart transplant in Texas, which was followed by difficulties. Medications she took to keep her body from rejecting her new heart so severely injured a kidney that she had to undergo a kidney transplant in 2022. Ten years after the heart transplant, her heart also started to fail. That’s when her Texas doctors referred her to the Smidt Heart Institute at Cedars-Sinai. Tyler Gunn, MD, assistant professor of Cardiac Surgery, led the team of physicians, nurses and operating room staff who performed the transplant.

“When I first met Destany in April 2024 she was very sick, but she was physically fit and had a lot of life ahead of her,” Gunn said.

Epps-Manuel’s case pushed the limits of what surgeons can do.

“With each additional redo surgery, different parts of the heart, tissues and bone fuse together and it becomes much more technically challenging to operate,” Gunn said. “These surgical considerations are why centers from across the nation refer their most difficult cases to Cedars-Sinai.”

Although Epps-Manuel has spent much of her adult life facing life-or-death situations, waiting for her second heart transplant made her feel especially hopeless. She credits the support program led by Rebecca Hedrick, MD, director of Consultation Liaison Services in the Department of Psychiatry and Behavioral Neurosciences, with helping her through her sickest period. The program taught her coping tactics such meditation and helped her use virtual reality to calm her mind. 

“You have to feel your feelings, but you can't stay there,” she said. “You have to have a mindset to fight.”

Epps-Manuel’s second heart transplant took place in October 2024 during a nine-hour operation at the Smidt Heart Institute. A life-support machine called cardiopulmonary bypass temporarily did the work of Epps-Manuel’s heart and lungs. It took surgeons two hours to carefully dissect the bands of scar tissue around the old heart and remove it, a process that typically takes 30 minutes.

Another challenge the Smidt Heart Institute faced was that Epps-Manuel had developed antibodies to the first transplant, so there was a high risk that any future donor heart would be quickly rejected.

Jon Kobashigawa, MD, director of the Heart Transplant Program at Cedars-Sinai and a world expert in preventing and treating organ rejection, managed Epps-Manuel’s care pre- and post- transplant. He created an aggressive immunotherapy plan to stop her body from rejecting the new heart.

Epps-Manuel and her mother lived in Los Angeles for months while she waited for her transplant and recovered afterward. She missed being able to tour colleges with her son, but she is now healthy enough to travel back and forth between her home in Cedar Hill, Texas, and Cedars-Sinai, where she continues to receive desensitization therapy for donor antibodies. She’s excited to volunteer with her ministry again and watch her son compete in senior-year football and track.

“Destany has an incredible, upbeat attitude, which contributes to her recovery,” Kobashigawa said. “She is a joy to care for and continues to inspire our collective team.”

Read more on the Cedars-Sinai Blog--Heart Disease: When to Get a Second Opinion

Cedars-Sinai, part of a national multicenter consortium, will be responsible for developing protocols for the procurement and preservation of donor tissue as well as the eye transplant surgeries themselves. The Cedars-Sinai effort is being led by Curtis L. Cetrulo Jr., MD, vice chair of Research in the Jim and Eleanor Randall Department of Surgery and director of the Division of Plastic Surgery at Cedars-Sinai.

“Vision loss affects over 7 million Americans and this award represents an opportunity to really move the needle in our treatment of blindness. With this funding, I’m confident we can make progress toward eye transplantation,” Cetrulo said. “As the only clinically active vascularized composite allotransplantation program approved for face and eye transplantation on the West Coast, we are in a unique position to design the protocols that will allow for successful optic nerve connection and regeneration. We will also be addressing preservation of the donor eye tissue in transit to safeguard the optic nerve and retina, which are very sensitive to periods of decreased blood flow.”

Cedars-Sinai joins several partners, including the University of Colorado Anschutz Medical Campus, the effort’s primary award recipient. The other partners are Johns Hopkins University, University of Wisconsin, Indiana University, University of Southern California, the National Eye Institute and the Foundation for Fighting Blindness. The ARPA-H funding for the project totals up to $46 million, with up to $6 million dedicated to Cedars-Sinai’s clinical surgical efforts.

ARPA-H is a federal agency established to advance high-potential, high-impact biomedical and health research that cannot be readily accomplished through traditional research or commercial activity. 

In its clinical transplantation practice, Cedars-Sinai will employ the robotic Symani Surgical System, which was recently acquired by the hospital. Currently, Cedars-Sinai is the only institution on the West Coast utilizing this new and highly specialized robotic microsurgery technology, which scales down the surgeon’s movements significantly for extreme precision.

“This is just another example of how the Department of Surgery at Cedars-Sinai strives to be at the forefront of the most innovative and life-changing procedures,” said Cristina Ferrone, MD, chair of the Department of Surgery at Cedars-Sinai and the Linda and Jim Lippman Chair in Surgical Oncology. “The work our team is doing on this project has the potential to transform clinical practice and impact the lives of millions of people around the globe.”

Cedars-Sinai is a leader in treating eye disease with novel approaches. Previously, Clive Svendsen, PhD, professor of Biomedical Sciences and Medicine and executive director of the Cedars-Sinai Board of Governors Regenerative Medicine Institute, received a $10.5 million grant from the California Institute for Regenerative Medicine (CIRM) to launch a clinical trial testing treatments for retinitis pigmentosa, an inherited eye disease with no known cure.

Read more from the Cedars-Sinai Blog: Pioneering Advances in Surgery

“I’ve always said, we’re like one coat of paint,” Thomas said. “Even our parents often couldn’t tell who was who when talking to us on the phone.”

Now, the sisters share more than just their DNA—they share a kidney. They also share an uncommon transplant experience, said Irene Kim, MD, the Esther and Mark Schulman Chair in Surgery and Transplantation Medicine and director of the Cedars-Sinai Comprehensive Transplant Center.

“It’s a rare event to transplant a patient with a genetically identical organ because it requires having an identical twin,” Kim said. “This is only the second time in my career that this has happened.”

The twins’ transplant story began in October 2021, when Thomas was diagnosed with multiple myeloma, a rare blood cancer that affects plasma cells. The disease caused her to go into kidney failure and damaged the C1 vertebra in her spine, putting her in a neck brace for more than six months. The next few years included a litany of medical procedures for Thomas, including chemotherapy, neck surgery and even a bone marrow transplant. Her twin was by her side every step of the way.

While Thomas’ cancer is now in remission, her kidney function never returned to normal. A transplant was the next step to keep her from requiring IV fluids or dialysis for the rest of her life. Rodman didn’t hesitate to volunteer to donate one of her own kidneys.

“We never even had to have a conversation about it,” Rodman said. “I knew I couldn’t go on with my life with my sister not being able to have a better quality of life. It was just the right thing to do.”

There were concerns, however, that the immunosuppressant medications typically required for transplant patients to keep their body from rejecting a transplanted organ could cause a recurrence of Thomas’ multiple myeloma. But through testing, Thomas and Rodman learned they were a match across all markers and were more than 99% identical, meaning Thomas could avoid the antirejection drugs that could have caused her cancer to return.  

“Transplantation requires immunosuppression to trick our immune systems into believing that the organ we’re transplanting is not foreign so that our body’s natural immune defense doesn’t attack or reject it, and that immunosuppression can have a lot of side effects of its own,” Kim said. “That we can avoid immunosuppression altogether for Linda by transplanting a kidney that is genetically identical to hers is really exciting and remarkable.”

Kim explained this is an uncommon occurrence in the transplant world not only because demographically, there are just fewer identical twins, but also because doctors must consider the reason a transplant is required. If a transplant is necessary due to a genetic predisposition for kidney disease, giving up a kidney could put the donor at risk down the line. In Thomas’ case, her multiple myeloma was nongenetic.

“Living donor transplants are always an emotional event filled with stress and gratitude, but the bond Linda and Karen share as identical twin sisters is palpable,” Kim said. “It was just such an honor from a transplant surgeon’s perspective to be part of that.”

The pair underwent successful kidney donation and transplant procedures at Cedars-Sinai Medical Center in mid-October. The transplanted kidney began working immediately and Thomas was able to have her dialysis port removed shortly after surgery because it was no longer needed.

Thomas and Rodman spent the remainder of the month and most of November recovering together in Los Angeles so they could be close to the hospital for their many follow-up appointments. As they regained their strength following surgery, they often would spend afternoons visiting local beaches to walk together on the sand.

“The beach is our happy place,” Rodman said.

“I’m just so grateful to have been able to go through this with my sister. If it had been the other way around, it would have absolutely been the same,” Thomas said. “I would do anything for my sister.”

As they look to the future, they’re excited for more big milestones with their families. Rodman recently learned she’ll be a first-time grandmother next spring. They also look forward to more camping trips to the beach and the opportunity to travel.

“We’re only 56 years old,” Rodman said. “We have places to go. We have things to do. We have more life to live.”

Read more from Cedars-Sinai Discoveries Magazine—OR Talk: Triple Organ Transplant

The international study was published in the peer-reviewed Journal of Hepatology.

“Our study found that we can treat advanced-stage liver cancer patients with immunotherapy and shrink their tumors, effectively turning them into early-stage patients and making them candidates for liver transplantation,” said Ju Dong Yang, MD, medical director of the Liver Cancer Program at Cedars-Sinai Cancer and senior author of the study.

Liver cancer causes no symptoms in the early stages, so many patients aren’t diagnosed until a later stage, said Yang, who is also an associate professor of Medicine at Cedars-Sinai.

“Immunotherapy has transformed care for many cancer types, including advanced-stage liver cancer,” said Dan Theodorescu, MD, PhD, director of Cedars-Sinai Cancer and the PHASE ONE Foundation Distinguished Chair. “But for these patients, liver transplant still seemed out of reach because bolstering the body’s immune system increases the risk of organ rejection.”

Yang said that clinicians believed that a gap between the end of immunotherapy treatment and liver transplant might allow the immune system to return to normal and reduce this risk, but that no large-scale studies had looked at this question.

Yang and fellow investigators reviewed published data on 91 liver cancer patients from Europe, Asia and North America who had received immunotherapy before having a liver transplant, noting rates of transplant rejection, cancer recurrence and overall survival.

“We collected every case that has been published and obtained additional clinical information on each patient,” Yang said. “Based on this, we concluded that with a 90-day gap between the last dose of immunotherapy and liver transplant, the risk of organ rejection is no greater than if the patient had never received immunotherapy.”

Additional studies to confirm these findings are already in the works, and Yang said that based on this evidence, clinicians should feel more comfortable considering organ transplant for advanced liver cancer patients after “downstaging” their cancer with immunotherapy treatment—as long as they observe a 90-day waiting period first.

“This allows time for the immune system to return to normal, and also to monitor the patient to make sure their cancer doesn’t begin to progress after immunotherapy treatment,” Yang said.

Yee Hui Yeo, MD, a Cedars-Sinai gastroenterology fellow, is also a study author.

Additional authors: Mohammad Saeid Rezaee-Zavareh, Tielong Wang, Zhiyong Guo, Parissa Tabrizian, Stephen C. Ward, Fatma Barakat, Tarek I. Hassanein, Dave Shravan, Ajmera Veeral, Sherrie Bhoori, Vincenzo Mazzaferro, David M.H. Chascsa, Margaret C. Liu, Elizabeth S. Aby, John R. Lake, Miguel Sogbe, Bruno Sangro, Maen Abdelrahim, Abdullah Esmail, Andreas Schmiderer, Yasmina Chouik, Mark Rudolph, Davendra Sohal, Heloise Giudicelli, Manon Allaire, Mehmet Akce, Jessica Guadagno, Clara Y. Tow, Hatef Massoumi, Paolo De Simone, Elise Kang, Robyn D. Gartrell, Mercedes Martinez, Ricardo Paz-Fumagalli, Beau B. Toskich, Nguyen H. Tran, Gabriela Azevedo Solino, Dra Mariana Poltronieri Pacheco, Richard S. Kalman, Vatche G. Agopian, Neil Mehta, Neehar D. Parikh, Amit G. Singal.

Funding: Dr. Yang`s research is supported by NCI K08 CA259534. Dr. Singal’s research is supported by NCI R01.  

Follow Cedars-Sinai Academic Medicine on LinkedIn for more on the latest clinical research from Cedars-Sinai. 

The phone rang 30 minutes later.  

“When I picked up the phone, I thought it would be family or friends calling to wish us a happy new year,” Schulz said. “Instead, it was someone from the Smidt Heart Institute at Cedars-Sinai saying they had a heart match for me and asking how soon I could get there.”

Those early moments of 2024 catapulted a chaotic yet beautiful series of events that led to Schulz’s new heart—which was implanted on Jan. 1.

Schulz first sought help at Cedars-Sinai in October 2019. The congestive heart failure he had been diagnosed with several years earlier had become advanced and his heart was giving out.

“At that point, I was so sick that the first hospital I went to said they couldn’t treat me, and they were telling my wife to contact family to say goodbye,” Schulz said. “Thankfully, my wife wouldn’t accept that as an answer and told them to call other hospitals. Several others also rejected me, but eventually, Cedars-Sinai said yes.”

“When Mr. Schulz arrived at Cedars-Sinai, he was critically ill,” said Dominic Emerson, MD, associate surgical director of Heart Transplant and Mechanical Circulatory Support in the Smidt Heart Institute. “We needed to stabilize him quickly to save his life.”

The first course of treatment for Schulz was extracorporeal membrane oxygenation, or ECMO—an often lifesaving treatment where blood is pumped outside of a patient’s body to a portable heart-lung machine, giving the patient’s own organs a rest.

After a period on ECMO, Schulz was stable enough for Emerson and team to surgically place a left ventricular assist device, also known as an LVAD. An LVAD is a mechanical device implanted inside the chest that helps the heart pump oxygen-rich blood to the rest of the body. For Schulz, it would serve as a bridge to transplant, said Lawrence Czer, MD, medical director of the Heart Transplant Program in the Smidt Heart Institute.

“LVAD placement is a major open-heart surgery, and some patients experience a prolonged recovery, but Mr. Schulz was a model patient following the procedure,” Czer said. “He followed all our recovery instructions including walking, watching his nutrition, keeping detailed records, and coming to clinic weekly at first. As a result, he recovered quite well with no complications.”

Several months later, in August 2020, Schulz was placed on the heart transplant list—and the wait began.

“This was early in the COVID-19 pandemic, and it was a really difficult time for my family and especially for my three children,” Schulz said.

While he did well with his LVAD, Schulz said he still felt limited. “My youngest son, who was 6 at the time, wanted me to play with him, and I just wasn’t physically able to do as much as we both wanted.”

But the New Year’s Day phone call changed everything. He arrived at Cedars-Sinai with his family a few hours later, ready to receive the medical center’s first transplanted heart of 2024. Emerson was the transplant surgeon on call when Schulz came into the hospital for his procedure.

“Because we can’t predict when a donor match will be available and when transplants will happen, as surgeons, we don’t always get the opportunity to perform transplants on patients we’ve previously worked with,” Emerson said. “But it’s fantastic when we do. It’s very rewarding to be part of the patient’s entire care arc.”

Schulz said even some of the same nurses who helped him through his recovery in 2019 cared for him following his transplant.

“I am so grateful to the team at Cedars-Sinai for the care I received during both of my experiences,” Schulz said. “The compassion they showed not only to myself, but to my wife and my family, was excellent.”

Now a few months post-transplant, Schulz says he is feeling great. When asked if he made any New Year’s resolutions for himself when he received his new heart, he said he is looking forward to more family trips with his wife and their three kids. Schulz is also excited to feel strong enough to play soccer with his youngest son, Sebastian—something he hasn’t been able to do for many years.

April is Donate Life Month, which promotes awareness about organ, eye and tissue donation and honors those who gave the gift of life. As he experiences this new lease on life, Schulz also shares his gratitude to his donor and the donor’s family.

“I understand this is an incredible gift I’ve been given, and it wouldn’t have been possible without my donor and their family,” Schulz said. “It’s not something I will take for granted. I’m grateful every day.”

Read more from Cedars-Sinai Discoveries Magazine: Heartfelt Support

For the fourth consecutive year, the

Allogeneic transplants use blood stem cells from donors’ bone marrow to treat patients with blood and bone marrow diseases. The Cedars-Sinai team performs more than 40 such transplants each year.

Among the 178 U.S. centers included in the report, Cedars-Sinai is one of only 12 that exceed national survival expectations for allogeneic transplants. Its one-year survival rate is 85.8%. Expected survival rates for similar patients receiving transplants at other U.S. centers are between 68.8% and 83.1%.

“Our success in hematopoietic stem cell transplantation is a testament to an outstanding team of dedicated people who work seamlessly together toward one goal—giving the patient the best possible experience and outcome,” said John Chute, MD, director of the Division of Hematology and Cellular Therapy at Cedars-Sinai. “It is an honor to be among the top allogeneic transplant centers in the country. It’s an even greater honor to see patients year after year at their follow-up visits, back to living the life they did before they became ill.”

The Cedars-Sinai Newsroom recently sat down with Ronald Paquette, MD, clinical director of the Stem Cell and Bone Marrow Transplant Program and director of Myeloid Malignancies at Cedars-Sinai Cancer, to discuss bone marrow transplantation.  

Tell us about marrow transplants and why they are performed.

Bone marrow is the soft tissue inside your bones, and it contains stem cells that make the body’s main blood cells. Marrow transplantation is used to treat diseases of the bone marrow and blood—cancers like leukemia, lymphoma and myeloma. It involves replacing unhealthy blood cells with healthy ones. Before transplant, patients undergo chemotherapy with or without radiation to destroy abnormal cells and suppress the patient’s immune system to prevent rejection of the donor cells.

When would an allogeneic transplant be performed?

We most often use allogeneic transplant to treat acute leukemia because it offers patients the best chance of a cure. It involves transferring healthy stem cells from a donor to a patient, as opposed to using stem cells from the patient’s own body—which is called autologous transplantation. The donor is most commonly someone related to the patient, but they don’t have to be a relative.

What makes for a successful allogeneic transplant?

Our preferred donors are young relatives, most commonly children, of the patient. Modern transplant methods allow us to use related donors who share only half of the tissue proteins of the patient. Close to 85% of our transplants are performed using such half-matched donors. In the past only fully matched transplants could be considered. A biological child of the patient will always be a half-match donor, and that can help get the patient to transplant more quickly and with excellent success rates. Also, the younger stem cells of children can provide greater benefit than older cells from another family member, such as a sibling. Once we’ve identified a half-match donor, we can typically get someone to transplant in about six weeks versus three months for an unrelated donor.

What does Cedars-Sinai do to exceed national survival expectations?

We’ve been able to reduce the risk of graft-versus-host disease by using high-dosage chemotherapy after transplant. This is an approach that we adopted at Cedars-Sinai about seven years ago with great success. We also work to ensure patients are in the best possible remission before transplant so that their risk of relapse is less. We try to minimize treatment-related toxicity because if patients are too worn down at the time of transplant, they’re going to have a higher risk of complications. We’ve also been able to extend transplantation to older patients, up to age 75. Historically, the risks have been high for this group, but thanks to our work to hone safe and effective regimens, we’ve had good success.

The unique and valuable experience at every level of our transplant team is remarkable. Our physicians, transplant coordinators, nurse practitioners, dedicated nursing staff, oncology pharmacists, psychosocial specialists, quality assurance nurses and administrative staff all work together to improve patient outcomes and satisfaction. We’ve found a formula that works, and we continue to stay up to date on the most innovative treatments for our patients.

Read more on the Cedars-Sinai Blog: What's It Like to Donate Bone Marrow?

Known for leading-edge therapies and taking on the most complex patients, Cedars-Sinai transplant teams also completed a triple organ transplant in 2023, performing a successful heart, liver and kidney transplant during a 20-hour surgery.

“Genuine compassion, commitment and teamwork enable us to perform these lifesaving operations,” said Irene Kim, MD, the Esther and Mark Schulman Chair in Surgery and Transplantation Medicine and director of the Cedars-Sinai Comprehensive Transplant Center. “We are so fortunate to be able to offer our patients lifesaving treatments through donors’ gifts of life.”

There currently are more than 100,000 people in the U.S. on the organ transplant waiting list, according to the United Network for Organ Sharing, the nonprofit organization that manages the U.S. organ transplant system. About 20,000 of those are in California.

In 2023, Cedars-Sinai was the ninth-largest transplant center by volume in the U.S., according to current published data from the Organ Procurement & Transplantation Network.

The Comprehensive Transplant Center and Smidt Heart Institute reported excellent patient outcomes, with one-year survival after transplantation at 91% or greater and lung, liver and kidney survival exceeding the national average.

The Kidney Transplant Program team, led by Stanley Jordan, MD, medical director of the Comprehensive Transplant Center’s Human Leukocyte Antigen and Transplant Immunology Laboratory, demonstrated the largest leap. The team performed 336 kidney transplants in 2023, including 15 pediatric transplants. The previous record was 298.

The liver transplant team, led by Nicholas Nissen, MD, surgical director of the Liver Transplant Program and director of Hepatobiliary and Pancreatic Surgery, and Alexander Kuo, MD, professor of Medicine and medical director of the Liver Transplant Program, performed 104 liver transplants in 2023. The 2022 figure was 102.

The Department of Cardiac Surgery in the Smidt Heart Institute is home to one of the largest thoracic organ transplant programs in the U.S. Led by Jon Kobashigawa, MD, director of Advanced Heart Disease and the Heart Transplant Program in the Smidt Heart Institute, and Fardad Esmailian, MD, surgical director of the Heart Transplant Program, the team performed 130 adult heart transplants and two heart-lung transplants in 2023.

The lung transplant team, led by surgical director Dominick Megna, MD, and medical director Reinaldo Rampolla, MD, also reached a new milestone in 2023 with 80 lungs transplanted, placing the program among the top 10 of U.S. lung transplant programs.

The Cedars-Sinai multidisciplinary transplant teams include physicians, nurses, social workers, pharmacists, physician assistants, dietitians, technicians, perfusionists, researchers, administrative professionals and others committed to successful organ transplants.

“So many people work together to create these lifesaving programs, and the contributions of our donors, family and friends who support our transplant team are profound,” Kim said. “They step in to help our patients and their caregivers make it through a transplant, help each other when things get busy and offer our patients and team members emotional and physical support when needed. That is truly inspiring.” 

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

Sams’ note is for the family of the 21-year-old man whose heart, liver and kidney are living on in his body, the result of a 20-hour triple transplant he underwent at Cedars-Sinai in May.

How do you adequately thank a family for a gift borne of such generosity and sadness? Sams is still processing his good fortune to receive three organs at once and wonders how the donor’s family is managing their own feelings.

“It makes me emotional when I think about how these three organs have changed my life,” Sams said. “I prayed every day for a miracle when I was waiting for a transplant. I knew what I was up against, and that the wait would be tough.

“I got my miracle. But I feel sad that this young man’s family had to go through what they went through in order for that to happen.”

Sams became only the 46th person in the U.S. to receive a heart, liver and kidney transplant since the United Network for Organ Sharing, the government agency that tracks organ transplants, started tracking in 1987.

His transplant was Cedars-Sinai’s first successful triple transplantation. The hospital is among the top centers in the U.S. for multi-organ transplants. Cedars-Sinai has completed more than 600 transplants in 2023—the most ever in its history.

For 10 years, Sams had been living with sarcoidosis, a rare inflammatory disease that caused a buildup of scar tissue on his heart and left him unable to work or even walk. Over time, he required multiple visits every week to his doctors to monitor his condition, drain built-up fluids from his body and administer dialysis treatments.

But his health took a turn for the worse early this year when his heart, liver and kidneys began to fail.

“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.

Sams was in the hospital for two months before a matching heart, liver and kidney were available for transplantation.

Sams’ surgeons—Tyler Gunn, MD, director of the Extracorporeal Membrane Oxygenation Program; Nicholas Nissen, MD, surgical director of the Liver Transplant Program; and kidney surgeon Justin Steggerda, MD—worked together with their teams of up to 15 other providers at a time to transplant the organs. The highly orchestrated procedure required close alignment among the teams and detailed planning.

“The coordination started long before we even got to the operating room,” Steggerda said. “It started with our program coordinators and our respected nursing staff, who made sure that a donated organ was acceptable, identified the best time to do the procurement and organized 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, Sams’ heart transplant happened first, followed by the liver and, finally, the kidney.

Nissen said that multi-organ transplants like this exemplify transplant teams’ ability to work together under pressure.

“It’s the ultimate example of medical teamwork,” he said. “Literally every team member has to work with every other team member for this to go right. There are three different teams that are making this happen, so for this to be successful, it takes an absolutely coordinated effort.”

Fast-forward six months, and today, Sams is feeling “wonderful.”

He’s keeping in mind his physicians’ advice: The more he moves, the better and faster his recovery. And so, he walks more than a mile three times a week and makes sure to get in cardio exercise and plenty of stretching. There’s no huffing and puffing as he climbs the stairs at Los Angeles Trade-Technical College, where he’s taking classes with the goal of earning a degree in sports psychology.

“I thank the Cedars-Sinai transplant team for having everything down to a science,” Sams said. “I have so much to be thankful for, from all my doctors and nurses to everybody who helped me along the way. And I’m thankful for life—to be as sick as I was and then to come out of it 10 years later with no health problems—it’s the miracle that I prayed for.”

He is also eager to get back into coaching youth baseball and giving back to the community. He’s even hoping to start his own nonprofit to help dialysis patients.

But first, he wants to finish the most important thank-you note he’s ever written, for the most meaningful gift he’s ever received.

“I’m hoping and praying that the donor’s family would like to meet me one day,” Sams said. “It can be hard for people who need an organ to get one, let alone three—and it would mean the world to me to know more about the person who made that possible.”

Read more on the Cedars-Sinai Blog: Being Patient | The Delicate Timing of Organ Transplantation

In that time, she’s earned a finisher’s medal from the New York City Marathon, which she ran to raise funds and awareness for organ donation; kept busy with a full-time job and volunteer work; moved to a new state; and continued to thrive.

“I’m very lucky—I’m doing amazingly well,” Galan said. “No issues, no problems—just living life to the fullest. I am so grateful.”

She credits her Cedars-Sinai care team for her good outcome.

“They took such good care of me,” she said. “I wouldn’t have gone anywhere else.”

In October 1998, at 36 years old, Galan was ready to give up on life. She had battled lupus since her teen years, and complications from the autoimmune disease had left her with congestive heart failure, multiple liver stones and narrowing of her liver. Barely able to move, she was living with her parents and had been in the intensive care unit for nearly three months before the family got the news they had been waiting on for years: A heart and liver were available for Galan.

Less than two weeks after her combined transplant surgery, Galan was home from the hospital—and for the next 20 years, she thrived.

But by 2017, Galan was in kidney failure—which can occur as a side effect of longterm immunosuppression. She had been on dialysis for nearly two years when she learned she had been matched with a living donor for a new kidney.

“The new kidney went in, I was working from my hospital room the very next day, and I’ve never looked back,” Galan said. “My attitude has always been, just let me live.”

Every year, she sends the kidney donor, whom she has met in person, a thank-you note.

“She saved my life,” Galan said. “Because of her, I’m still here.”

Today, there are more than 100,000 people in the U.S. on the organ transplant waiting list, according to the United Network for Organ Sharing, the nonprofit organization that manages the U.S. organ transplant system. About 23,000 of those waiting are in California.

This past year was the busiest yet for the Cedars-Sinai Comprehensive Transplant Center and the Smidt Heart Institute. In 2023, Cedars-Sinai has completed more than 600 transplants—the most ever in its history.

The medical center also is among the top centers in the U.S. for multi-organ transplants. In July, the transplant team performed the hospital’s first successful triple transplantation during a 20-hour surgery.

It’s also known for state-of-the-art care and advanced therapies when it comes to complex transplantation cases.

“Cedars-Sinai is an extremely specialized medical center where other hospitals send their most complex patients with end-organ disease,” said Irene Kim, MD, director of the Cedars-Sinai Comprehensive Transplant Center, the Esther and Mark Schulman Chair in Surgery and Transplantation Medicine, and the surgeon who performed Galan’s kidney transplant. “Through the generous gift of life from organ donors, our transplant programs offer patients hope for an opportunity at recovery.”

Galan is outspoken about the need for more organ donors. And to patients on the organ waitlist, her message is that there is no better medicine than optimism.

“People should know there is success in organ transplant and that we are living longer,” Galan said. “Look at how long I’ve lasted, thanks to my Cedars-Sinai team and the generosity of donors. If I can encourage even one person to check that little organ donor box on their driver’s license, I will know I’ve done a good thing with my life.”

During the holiday season of giving and receiving, Galan is especially reflective.

“Donating an organ is the greatest gift you can give.”

Read more on the Cedars-Sinai Blog: Being Patient: The Delicate Timing of Organ Transplantation

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

The kidney/pancreas transplant team completed 317 transplant surgeries (316 kidney and one dual kidney-pancreas), topping its previous record of 290 transplant surgeries (279 kidney, 10 kidney-pancreas and one pancreas) in fiscal year 2021, according to statistics compiled by the United Network for Organ Sharing (UNOS), the nonprofit organization that manages the U.S. organ transplant system. Fifteen of the 2023 transplants were pediatric kidney transplants, the most the center ever has completed in one year.  

“Organ transplantation requires close coordination and trust from a large team of professionals who truly care about patients,” said Irene Kim, MD, the Esther and Mark Schulman Chair in Surgery and Transplantation Medicine, director of the Cedars-Sinai Comprehensive Transplant Center and surgical director of the Kidney Transplant Program. “Physicians, nurses and coordinators, social workers, dietitians, administrative professionals and so many more all work together to make it happen. Most importantly, organ transplantation would not be possible without the lifesaving gifts of organ donors.”

Surgeons in the Department of Cardiac Surgery performed 202 thoracic organ transplants during fiscal year 2023. The team's 126 heart transplants during fiscal year 2023 is a significant increase over the previous year’s total of 105. Surgeons also performed more lung transplants during fiscal year 2023, with 76 transplants compared to 72 during fiscal year 2022.

“We are proud to offer state-of-the-art care to all our heart and lung transplant patients, who are often referred by other transplant centers for advanced therapies, such as innovative, minimally invasive lung transplants that help our patients get back to a better quality of life sooner," said Joanna Chikwe, MD, chair of the Department of Cardiac Surgery.

Liver transplant surgeons, led by Nicholas Nissen, MD, director of Hepatobiliary and Pancreatic Surgery, and Alexander Kuo, MD, professor of Medicine and medical director of the Liver Transplant Program, performed 97 transplants, nearly as many as the prior fiscal year.

Although Cedars-Sinai’s transplant volumes are impressive, they don’t tell the complete story, Kim said.

“Cedars-Sinai is a national leader in performing complicated transplant surgeries,” she said. “We take on some of the most complex cases, often referred to us from other medical centers.”

These include highly sensitized patients, who have high levels of antibodies in their blood, making their bodies more likely to reject organs.

Cedars-Sinai’s Stanley Jordan, MD, director of the Comprehensive Transplant Center’s Human Leukocyte Antigen and Transplant Immunology Laboratory and professor of Medicine, is a pioneer in the development of desensitization therapies, which remove prohibitive anti-HLA antibodies from the blood and enable those patients with these antibodies to receive a lifesaving transplant.

Read more in Discoveries: Meet Transplant Surgery Trailblazer Irene Kim, MD