A CT scan at Pulido’s community hospital revealed a large tumor on Pulido’s right ovary—roughly the size of a small basketball. Surgeons removed the cancerous mass, only to discover a smaller tumor on the left ovary, which was removed three months later. Believing the worst was behind her, Pulido returned to work.

But her sense of normalcy was short-lived. Within a month, sharp pains returned.

“I was getting the worst shoulder pain I could get on my left side,” Pulido said. “I went back to the emergency room, and they did another CT scan. Then they saw another tumor. It was much bigger than the first one.”

The doctors diagnosed Pulido—just 22 years old— with a rare condition known as growing teratoma syndrome. The condition occurs when tumor tissue continues to grow rapidly and uncontrollably, pressing on vital organs like the heart and lungs.

The third and largest tumor, about 14 centimeters, was located near Pulido’s liver. Doctors recommended chemotherapy to shrink the tumor, but it failed, and the mass kept growing at an alarming rate. The tumor had progressed so much in size that it was pressing up against her right lung, shifting her heart to the far-left side, essentially under Pulido’s armpit.

By May 2024, the tumor had reached 27 centimeters, weighed more than 40 pounds, and left her wheelchair-bound and dependent on oxygen.

Opting for High-Stakes Surgery Despite the Risks

When chemotherapy failed, surgically removing the tumor was the inevitable choice. After multiple surgery delays and six failed attempts to put Pulido under anesthesia, her original care team halted the procedure altogether.

“The doctors came out of the surgery and told my mom they couldn’t move forward with the surgery because I couldn’t go under anesthesia without flatlining,” Pulido said. “They said the next best step for me would be hospice care.”

Still, Pulido and her family refused to give up.

In their last push for hope, her family sought several opinions from various institutions, but ultimately chose to seek care from Cristina Ferrone, MD, chair of the Jim and Eleanor Randall Department of Surgery at Cedars-Sinai.

Ferrone quickly assembled a team of experienced anesthesiologists and 13 surgeons from various specialties, including cardiothoracic and liver transplant teams, to perform the complex surgery.

“The tumor was so large and heavy, and it involved such essential blood vessels that if you injure them, it would be very, very difficult to repair them. And an injury like that could quickly lead to death on the operating room table,” Ferrone said.

Yet, Pulido was willing to take her chances.

“The only one that could decide if I do go or stay on that surgery table would be God,” Pulido said. “And I just had really high hopes and faith that I was going to make it through.”

Awake on the Operating Table

The surgical team included Tyler Gunn, MD, an assistant professor of Cardiac Surgery at Smidt Heart Institute at Cedars-Sinai. During the first half of the surgery, Gunn performed a critical procedure called preoperative extracorporeal membrane oxygenation, or ECMO, using only local anesthesia while Pulido was still awake in order to keep her respiration and heartbeat stable and to stop her from flatlining.

“When someone goes to sleep for surgery, their muscle tone decreases and the blood flow to the heart can decrease as well. And they can have trouble with their blood pressure, breathing and heart rate,” Gunn said.

Furthermore, as Pulido’s heart was unstable, lying flat on the operating table was not an option. To work around this, the team placed Pulido on an incline for the first half of the surgery.

“In my mind, I just kept saying, ‘You got this, just keep fighting, keep pushing,’” Pulido said.

The long, arduous surgery was a success.

“In the end, we spent over 14 hours operating with all of the different teams working together,” Ferrone said. “It’s a testament to the working environment of Cedars-Sinai. It is an incredibly collaborative institution and patient care comes first, no matter what.”

Within a week after the tumor removal, Pulido’s lungs were able to fully expand, and her heart was back in its rightful place. She was able to breathe on her own for the first time in six months. 

From Wheelchair to Walking Down the Aisle

Amid her harrowing healthcare journey, Pulido found a few uplifting moments, including an important life milestone. Last year, during the halftime show on Super Bowl Sunday, her longtime boyfriend, Jeffrey Chavez, who had stood by her through every challenge, surprised her with a proposal.

“He was always there every day with me, whether it was before work, after work, he was there and visiting me all the time at my mom's house,” Pulido said.

For Ferrone, watching Pulido through her demanding recovery process has been incredibly gratifying.

“When she returned to the clinic a month later, the entire staff and I were amazed. Just six weeks earlier, she had been wheeled in, in a wheelchair. Now she walked through the doors,” Ferrone said. “She's an incredibly strong young woman and has a wonderfully supportive family.”

On June 21, a little over a year after her life-changing surgery, Pulido walked down the aisle and tied the knot with Chavez in front of her close family and friends. While Pulido will need to continue to monitor her health closely, the newlywed is hopeful and looks forward to the next phase of life.  

“I feel really good. I feel like a new person. I see the world differently,” Pulido said. “Every day is a positive day.”

Read more on the Cedars-Sinai Blog: Women in Surgery at Cedars-Sinai.

Destany Epps-Manuel was diagnosed 14 years ago, at 22, with idiopathic dilated cardiomyopathy—a disease in which the heart becomes enlarged, weakened and unable to pump blood effectively. The cause is unclear.

Her local physicians had implanted a left ventricular assist device (LVAD) to help her heart pump blood, but less than two years later Epps-Manuel needed another LVAD. A long-awaited heart transplant followed, but anti-rejection medications damaged her kidney so badly she needed a kidney transplant as well.

Ten years after her initial heart transplant, Epps-Manuel learned her new heart was failing. She would need a second heart transplant.

That was when Epps-Manuel’s Texas physicians referred her to the Smidt Heart Institute, Gunn told FOX 4 reporter Shaun Rabb. 

“So, after all this, over 10 years, she was in the clinic with a failing heart after having three heart surgeries,” he said.

Gunn told Rabb the transplant team operated on Epps-Manuel for more than 10 hours, and the surgery was a success.

“Part of the issues that complicated her case was that with each heart surgery, she developed antibodies that potentially reject her new heart,” he said. “So, we had to do some aggressive therapies that are available to get her desensitized to be able to have a low likelihood of rejecting this new heart.”

Epps-Manuel told Rabb her experience serves as a reminder to always continue moving forward.

“Never wallow in your sadness,” she said. “Whatever that reason is, just make sure you find a reason to keep pushing.”

Click here to watch the complete segment from FOX 4.

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