Transplant Surgery

Dr. Jeffrey B. Matthews

John Fung, MD, PhD
Professor of Surgery
Chief, Section of Transplant Surgery
Co-Director, Transplant Institute
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From left to right: Liver cancer survivor Nicole Leon, surgeon Talia Baker, MD, baby Baker Leon and Larry Leon.

Given six months to live, woman gets a chance at life thanks to Liver Tumor Program

For two years, Nicole Leon worked out six days a week, sweating endlessly on an indoor bike trying to lose weight that wouldn’t go away. In October 2016, after visiting her local emergency room with a bout of food poisoning, she discovered the problem. She had a large mass on her liver—a lesion, or hepatic adenoma—that turned out to be the size of a football.

At age 32, the seemingly healthy and happy Leon was quickly referred for testing, and the news wasn’t good: A biopsy of the tumor came back as hepatocellular cancer.

“It was shocking,” recounted Leon, who was living in Chicago and enjoying a busy social life and successful career in human resources. “They said it was so large it had gone over the hepatic artery and that it was inoperable.”

She was told she had six months to live. “The doctors didn’t know when or why the tumor had started growing, and they suggested I go into palliative care.” That answer wasn’t acceptable to Leon, who flew across the country for a second opinion. This time she was told she had several tumors that couldn’t be surgically removed.

In January 2017, Leon was referred by a friend to the University of Chicago Medicine’s newly opened Liver Tumor Program. Led by Medical Director Anjana Pillai, MD, and transplant and hepatobiliary surgeon Talia B. Baker, MD, the program offers patients with liver tumors the opportunity to see a multidisciplinary group of specialists who are focused solely on the care of patients with liver disease.

Leon met with both Dr. Pillai and Dr. Baker, who told her surgical removal was possible. Baker recommended to Leon’s previous doctor a one-time treatment called radiation embolization to reduce the tumor’s size. “She was the only one in the world willing to operate on me and give me another chance at life,” Leon said.

“We were hopeful that we could do this,” Dr. Baker recounted. “I’ve operated often after liver-directed radiation therapy, and we know that if the liver and the tumor responded well to the treatment, the more likely it is for us to successfully remove the entire tumor.”

In February 2017, Dr. Baker did an extended hepatectomy, a procedure to remove all of the football-sized tumor and more than 80 percent of the liver. This left about 20 percent of Leon’s liver to regenerate.

The surgery was a success, and today Leon has close to 100 percent of her liver volume back and perfectly normal liver function.

Dr. Baker credits the effective approach to Leon’s care to the collaboration made possible through UChicago Medicine’s Liver Tumor Program. Hepatobiliary and transplant surgeons, medical liver specialists (called hepatologists), medical oncologists and interventional radiologists together offer personalized care pathways for patients. Additionally, the team can determine which liver cancer patients may potentially benefit from a liver transplant.

“This type of program is rare,” Dr. Pillai said. “It’s how we should be treating many of these cancers—in a multidisciplinary fashion—and more centers are leaning towards it.”

The program also has a research coordinator who can enroll patients in clinical trials and a tumor clinic nurse who helps patients navigate scheduling appointments. The navigator makes sure the treatment plan goes into action, coordinates treatment and communication among physicians, and acts as the point person for the patient.

Two months after her surgery, in April 2017, Leon became engaged to Larry Leon, who was by her side before, during and after the procedure. In August 2018, the two were married. And this past summer, on June 30, their baby boy was born in an uncomplicated but carefully monitored pregnancy. The couple named him Baker.

Nicole and Baker Leon

“Dr. Baker saved my life and allowed me to have a second chance—to get married and start a family and move on.”

Nicole Leon

“Dr. Baker saved my life and allowed me to have a second chance—to get married and start a family and move on,” said Leon. “Baker is our miracle baby. We didn’t even know if I’d be able to get pregnant, and I’m forever grateful to Dr. Baker and her team and UChicago Medicine for taking on my case and allowing me to live.”

At a follow-up appointment this past August, Nicole Leon, who’s now approaching three years cancer-free, brought Dr. Baker in to meet his namesake and Dr. Pillai.

“I’m grateful that I was able to touch Nicole’s life,” said Dr. Baker. “I’m touched and honored.”

Baby Baker Leon rests comfortably in the arms of his namesake, surgeon Talia Baker, MD.

Originally published on November 20, 2019. Written by Anne Stein.
faculty listing

Professor of Surgery
Yolanda T. Becker, MD, Professor of Surgery; Director, Kidney and Pancreas Program
Rolf Barth, MD, Professor of Surgery
Anita S. Chong, PhD, Professor of Surgery; Committee on Molecular Metabolism and Nutrition
John Fung, MD, PhD, Professor of Surgery; Chief, Section of Transplant Surgery; Co-Director, Transplant Institute
J. Michael Millis, MD, Professor of Surgery; Vice Chair, Global Surgery

Associate Professor of Surgery
Talia B. Baker, MD, Associate Professor of Surgery; Surgical Director, Liver Tumor Program; Director, Living Donor Liver Transplant Program; Surgical Director and Program Director, Liver Transplant Program
Piotr Witkowski, MD, PhD, Associate Professor of Surgery; Director, Pancreatic and Islet Transplant Program

Assistant Professor of Surgery
Diego di Sabato, MD, Assistant Professor of Surgery; Co-Director, Living Donor Liver Transplant Program

Research Associate Professor of Surgery
Dengping Yin, MD, PhD, Research Associate Professor of Surgery; Director, Animal Microsurgery Center

Clinical Associate
Rosario Perez Gutierrez, MD, Clinical Associate

faculty honors

Yolanda T. Becker, MD, was named a Senior Faculty Scholar at the Bucksbaum Institute for Clinical Excellence.

Yolanda T. Becker, MD,John Fung, MD, PhD, and J. Michael Millis, MD, were named 2020 Top Doctors by Chicago magazine.

select publications

Ahmed O, Salaskar AL, Zangan S, Pillai A, Baker T. Transsplenic portal vein recanalization and direct intrahepatic portosystemic shunt placement to optimize liver transplantation. CVIR Endovascular. 3(1):5, 2020 Jan 08. UI: 32026045.

Bachul PJ, Gołębiewska JE, Basto L, Gołąb K, Anteby R, Wang LJ, Tibudan M, Thomas C, Fendler W, Lucander A, Grybowski DJ, L, Wang L, Dębska-Ślizień A, Fung J, Witkowski P. BETA-2 Score Is an Early Predictor of Graft Decline and Loss of Insulin Independence After Pancreatic Islet Allotransplantation. Am J Transplant 2019, Oct 9.

Bachul PJ, Grybowski DJ, Anteby R, Basto L, Perea L, Gołąb K, Wang LJ, Tibudan M, Prez Gutierrez A, Komorniczak M, Nagpal S, Lucander A, Fung J, Matthews JM, Witkowski P. Total pancreatectomy with islet autotransplantation in diabetic and prediabetic patients with intractable chronic pancreatitis. J Pancreatology, 2020, in press.

Jain D, Rahab A, Young JS, Yin D, Nadasdy T, Chong AS, Pelletier RP. 2020. Reversing established donor-specific antibody responses and antibody-mediated rejection with bortezomib and belatacept in mice and kidney transplant recipients. Am J Transpl. 2020 Apr 3. doi: 10.1111/ajt.15881. [Epub ahead of print].

Kaldas FM, Rocca JP, Bhati CS, Duan N, Evenson AR, Tan HP, Redfield RR, di Sabato DM, Yoshida A, Abt PL, Geevarghese SK. (2019). The Abdominal Transplant Surgery Workforce: Current state and future trends. Clinical Transplantation. 33(10), [e13659]. doi: 10.1111/ctr.13659.

Kelly SH, Wu Y, Varadhan AK, Curvino EJ, Chong AS, Collier JH. 2020. Enabling sublingual peptide immunization with molecular self-assemblies. Biomaterials 2020 May;241:119903. doi: 10.1016/j.biomaterials.2020.119903. Epub 2020 Feb 24.

Khiew SH, Jain D, Chen J, Yang J, Yin D, Young JS, Dent A, Sciammas R, Alegre ML, Chong AS. 2020. Transplantation tolerance modifies donor-specific B cell fate to suppress de novo alloreactive B cells. J Clin Invest. 26:132814. doi: 10.1172/JCI132814.

Lara LF, Bellin MD, Ugbarugba E, Nathan JD, Witkowski P, Wijkstrom M, Steel JL, Smith KD, Singh VK, Schwarzenberg SJ, Pruett TL, Naziruddin B, Long-Simpson L, Kirchner VA, Gardner TB, Freeman ML, Dunn TB, Chinnakotla S, Beilman GJ, Adams DB, Morgan KA, Abu-El-Haija MA, Ahmad S, Posselt AM, Hughes MG, Conwell DL. A Study on the Effect of Patient Characteristics, Geographical Utilization, and Patient Outcomes for Total Pancreatectomy Alone and Total Pancreatectomy With Islet Autotransplantation in Patients With Pancreatitis in the United States. Pancreas. 2019 Oct 8.

Lei YM, Chen L, Wang Y, Pirozzolo I, Sepulveda M, Theriault B, Chong AS, Belkaid Y, Alegre ML. 2019. Transplant-restricted Commensal Colonization Accelerates Skin Allograft Rejection. JCI Insight 16;5. pii: 127569. doi: 10.1172/jci.insight.127569.

Maffi P, Lundgren T, Tufveson G, Rafael E, Shaw JAM, Liew A, Saudek F, Witkowski P, Golab K, Bertuzzi F, Gustafsson B, Daffonchio L, Ruffini PA, Piemonti L. REP0211 Targeting CXCR1/2 Does Not Improve Insulin Secretion After Pancreatic Islet Transplantation: A Phase 3, Double-Blind, Randomized, Placebo-Controlled Trial in Type 1 Diabetes. REP0211 Study Group. Diabetes Care. 2020 Apr;43(4):710-718. doi: 10.2337/dc19-1480. Epub 2020 Feb 4.

Miller ML, McIntosh CM, Wang Y, Chen L, Wang P, Lei YM, Daniels MD, Watkins E, Mora Solano C, Chong AS, Alegre ML. 2019. Resilience of T cell-intrinsic dysfunction in transplantation tolerance. Proceedings of the National Academy of Sciences USA 116:23682-23690.

Shudhanshu A, Farr M, Jennings D, Serban G, Uriel N, Sayer G, Vasilescu V, Restaino S, Chong AS, Habal MV. 2020. Desensitizing highly sensitized heart transplant candidates with the combination of belatacept and proteasome inhibition. In press Am J Transpl.

Si Y, Tian Q, Zhao F, Shore L, Kelly SH, Camacho DR, Sperling AI, Collier JH, Chong AS. 2020. Intranasal vaccination with adjuvant-free nanofibers induces in situ lung dendritic cell activation and Th17 responses. In press: Science Advances.

Si Y, Zhao F, Tian Q, Weiskopf D, Sette A, Chong AS, and Montgomery CP. 2020. Inhibition of protective immunity against Staphylococcus aureus infection by MHC-restricted immunodominance is overcome by vaccination. Science Advances 6(14):eaaw7713. doi: 10.1126/sciadv.aaw7713. eCollection 2020 Apr.

Soubrane O, Eguchi S, Uemoto S, Kwon C, Baker T. Minimally Invasive Donor Hepatectomy for Adult Living Donor Liver Transplant: An International Multi-Institutional Evaluation of Safety, Efficacy and Early Outcomes. Annals of Surgery 2020 Mar 27. doi: 10.1097/SLA.0000000000003852.

residents & fellows

View the Transplant Surgery Residents and Fellows here.