By GREGORY ZELLER //
Long Island’s first-ever triple transplant surgery is in the books.
Surgeons at the Northwell Health Transplant Institute have performed a successful three-organ transplant on 47-year-old Queens resident Sergio Cestoni, swapping out his heart, liver and kidney in one grueling 14-hour procedure.
Cestoni checked into Manhasset’s North Shore University Hospital Nov. 5 after a cardiology appointment revealed his heart was struggling to pump blood through his body. Cestoni was initially diagnosed with ischemic cardiomyopathy (reduced blood flow to the heart caused by coronary artery disease or a heart attack) in 2018, and by last November had already been on heart- and kidney-transplant waiting lists for two years.
At NSUH, doctors determined that his dire condition was being complicated by eroding liver function – a nasty case of cirrhosis (advanced scarring of the liver) attributed to his malfunctioning heart.
The overload of awful diagnoses left the relatively young patient “surprised and scared.”
Deane Smith III: Teamwork.
“When they told me there was no other option except transplant,” Cestoni noted, “I admit that I lost hope.”
But hope did not lose Cestoni.
His “miraculous second chance,” according to Northwell Health, emerged when three organs from the same deceased donor – appropriate in size, age and function – came back a match. Quickly, a complex operation was planned and scheduled, and on Feb. 8, Cestoni went under the knife at NSUH’s state-of-the-art Petrocelli Surgical Pavilion.
Thirteen surgeons and two separate OR nursing teams – a cardiac team for the heart transplant and an abdominal team for the liver and kidney work – united for the marathon 14-hour procedure, an unprecedented cross-discipline synchronization featuring “a lot of people used to worrying about only what they need to do,” according to Deane Smith III, Northwell’s surgical director for heart transplantation and mechanical circulatory support.
“The advantage for us is that we function as a Transplant Institute,” added Smith, who presided over the heart-transplant portion. “We’re prepared for this – we know what we need to do and have talked about it ahead of time.
“Once the transplant is ready to happen, we’ve already done it in our heads.”
Nabil Dagher: Complex confirmation.
Following Smith were liver/kidney/pancreas-transplant specialist Nabil Dagher, who headed up the liver-replacement team, and general surgeon Ahmed Fahmy, who transplanted the kidney.
Within days of the record-setting procedure, Mr. Cestoni was up and about and – for the first time in a year – able to urinate without the aid of dialysis. He was discharged March 7 and to continue convalescing at home.
“I felt like I came back to life,” the patient noted. “I have an opportunity to live again and do things better.”
With 48,000-plus solid organ transplants recorded at 250 U.S. hospitals in 2024, according to the United Network for Organ Sharing, transplants – while always risky – are fairly commonplace.
But fewer than 60 triple-transplant procedures have been performed domestically over the last four decades – and Cestoni’s medical miracle marks a “great milestone” in the surgical annals of Northwell Health, according to Dagher.
“It signifies that the most complex operations can happen here and happen here well,” noted the transplant specialist, who is also senior vice president and director of the Northwell Health Transplant Institute. “Very few programs can do this.”
