Living Donor Transplantation: Innovation, Precision, and Compassion

Francisca’s case was medically complex, which complicated the diagnosis and increased the potential risks associated with transplantation. This intersection of autoimmune and metabolic liver diseases made her treatment particularly difficult, requiring careful coordination and deep expertise from the liver transplant team at UI Health.

One condition, Primary Biliary Cirrhosis (PBC), is a chronic autoimmune disease that causes the body’s immune system to mistakenly attack the small bile ducts within the liver. Over time, this progresses to inflammation, scarring, and ultimately liver failure.

Francisca was also diagnosed with Autoimmune Liver Disease — another condition where the immune system attacks liver cells directly, causing chronic inflammation, which can lead to fibrosis and cirrhosis. This overlap was accelerated by Francisca’s third diagnosis: Non-Alcoholic Fatty Liver Disease (NAFLD) — a progressive form of non-alcoholic fatty liver disease associated with fat buildup and inflammation. Unlike alcoholic liver disease, NAFLD occurs in individuals who drink little to no alcohol and is often linked to metabolic conditions.

Francisca’s condition affected nearly every part of her daily life. She experienced constant itching, her hands sometimes trembled, and she dealt with swelling in her legs and abdomen that made it hard to move comfortably. On the hottest days, she still felt cold — a sign of how much her body was struggling to regulate itself.

When Francisca and her daughter were referred to the liver transplant team at UI Health, the opportunity for a living donor transplantation became a possibility. “When UIC explained the procedure and all the benefits of donating part of your liver, it really helped put my mind at ease,” Julia said.

Julia appreciated not only the thoroughness of the transplant team but also their honesty and accessibility for any lingering questions regarding the procedure. Lisa Mariano, liver transplant team nursing manager, walked Julia and her mother through every step, discussing details of the procedure and percentages of potential risks during the surgery. “I felt supported every step of the way,” Julia said. “I knew I could text Lisa or the other nurses at any time, especially if I had any questions. We had family that had questions about the condition and procedure, too.”

After weeks of blood work, CT and MRI scans, and liver health evaluations, Lisa informed Julia that she was an excellent candidate to donate to her mother.

“Patients awaiting organ transplantation live in a chronically decompensated state,” Lisa said. “They do not feel well. The gift of living donation offers an expedited road to restored health.”

“UIC was the first program in the region to apply robotic surgery to transplantation,” Dr. Spaggiari said. “We are afforded the opportunity to tackle complex cases, such as Julia and Francisca’s, because of these technological capabilities.”

Calculating the graft-to-recipient weight ratio assisted Dr. Spaggiari in understanding how much of Julia’s liver can be safely removed and how much Francisca needs to ensure normal liver function after the transplant, since the liver has the unique ability to regenerate itself.

Through minimally invasive incisions, Dr. Spaggiari and the team were able to carefully remove the part of Julia’s liver, then implant the segment in Francisca for re-anastomosing arteries and bile ducts with precision and safety.

This is all part of UI Health’s unwavering dedication to providing patient-centered care in innovative and new ways by reducing surgical trauma, decreasing recovery periods, and delivering safer outcomes for both donors and recipients.

As a police officer for the Northern Illinois University Police Department, Julia knew her recovery needed to be complete before returning to such a physically and mentally demanding role. Her healing was steady, marked by mild discomfort as her body adjusted. “There was some pain at first, but little by little every day, I noticed it was hurting less,” she said. Francisca’s recovery, too, came with ups and downs—but both women leaned on each other and the support of the UI Health transplant team. “I not only feel better,” Francisca continued, “I see life in a better way now.”

Their strong relationship only grew stronger following their procedure and recovery. “Our relationship remains as it always had,” Julia said. “But there is a certain bond now, knowing that a piece of me is in her, and she is getting better because of that.”

UI Health continues to raise the bar for donor and recipient care, hoping to inspire more people to consider becoming living donors. “In the last decade, UIC has applied minimally invasive, robotic-assisted surgery to all different types of abdominal transplants,” Dr. Spaggiari said. “We have become a referral center for other institutions to train in robotic transplantation.”

Visit to learn more about UI Health’s Living Donor Transplant Program or call 312.413.4035.