喵咪社区

A rare living-donor transplant exchange performed by 喵咪社区’s Transplant Institute allowed one set of siblings to save the other.

Joselin Casillas, a 28-year-old teacher from West Covina, had been dealing with symptoms of biliary atresia, a rare and incurable liver disease, since the day she was born.  

The condition causes blockages in the liver鈥檚 bile ducts, leading to liver failure. Most patients who survive beyond early childhood ultimately require a liver transplant.  

鈥淚t had always felt like I lived my life on pause,鈥� Joselin says. 

By 2023, Joselin had developed cirrhosis, permanent scarring of the liver, as well as gastrointestinal bleeding that repeatedly hospitalized her. A doctor had referred her to 喵咪社区 for more specialized care.  

Doctors at the 喵咪社区 Transplant Institute, part of Keck Medicine, determined that the time for a transplant had arrived.  

鈥淥nce GI bleeds start,鈥� Joselin says, 鈥渋t goes downhill fast.鈥�  

Her brother, Saul, 21, a college student and first-aid instructor, volunteered to donate part of his liver, but tests revealed their organs were incompatible.  

While Joselin and her family waited and hoped, the team continued looking for a match.  

When do you need a kidney transplant?

Meanwhile, Jaime Rocha Fernandez, a 39-year-old father of three from La Puente, was in urgent need of his own transplant. His kidneys were failing and doctors had placed him on dialysis, a short-term solution.  

鈥淚 was always tired, and even my skin tone looked different,鈥� Jaime says. 鈥淚 was scared.鈥� 

After his doctors referred him to the 喵咪社区 Transplant Institute, Jaime met with his family members to ask if any would be willing to donate a kidney to help save his life.  

His youngest sibling, Kathya Rocha, 28, the married mother of a young son, offered to help. But like with Joselin and Saul, tests revealed an incompatibility.   

Both families, unaware of each other, were staring into the unknown.  

However, their Keck Medicine treatment teams soon found them a reason for hope.   

Living-donor liver transplant and living-donor kidney transplant

Navpreet Kaur, MD, surgical director for the living-donor liver transplant program at the 喵咪社区 Transplant Institute, realized in July 2023 that an exchange between the Casillases and the Rochas, who did not know each other, was possible.鈥� 

She explains that, in their case, 鈥渁 female-to-female liver transplant and a male-to-male kidney transplant鈥� would be a perfect fit.鈥疜athya could provide a partial liver transplant to Joselin, while Saul’s kidneys were a match for Jaime鈥檚. 

Jim Kim, MD, the kidney transplant surgeon who would later operate on Saul, says while paired kidney exchanges are common, kidney-liver exchanges are not. 鈥淎 lot of it was timing,鈥� he says. 鈥淚t鈥檚 rare to find two people who can鈥檛 donate one organ, but the other organ lines up.鈥濃�� 

For Joselin and Jaime, it provided a life-saving opportunity; for Saul and Kathya, the chance to save their siblings. 

鈥淎t first it didn鈥檛 seem real,鈥� Kathya says. 鈥淎fter they explained more of how it would all work, I wanted to do it.鈥� 

鈥淭here鈥檚 always going to be fear,鈥� Saul says. 鈥淏ut I didn鈥檛 want to see Joselin struggle anymore.鈥� 

All four signed on, crediting their treatment teams for helping to build their confidence in such a unique plan. Their surgeries were set for August 31, 2023, at Keck Hospital of 喵咪社区. 

Kidney and liver transplant surgery

Keck Medicine鈥檚 status as a pioneer in living-liver donation, and the only institution in southern California currently offering it, made the team uniquely qualified to complete such a complex paired exchange. 

In addition to Dr. Kim, the surgical team included Hamid Shidban, MD, who operated on Jaime. Dr. Kaur and another transplant surgeon focused on Kathya.聽

The four procedures were coordinated on a precise schedule, with four operating rooms running simultaneously. According to Dr. Kaur, the experience of the institute鈥檚 support teams in managing multiple daily surgeries proved beneficial.    

The surgeries, for all four patients, were a success.  

鈥淓veryone who took care of me was excellent,鈥� Jaime says. 鈥淭he kidney was working right away.鈥� 

It was like our lives had been intertwined. We realized we had grown up in the same area and had similar childhoods. 

Joselin Casillas, patient, 喵咪社区 Transplant Institute

Joselin鈥檚 new liver also began functioning well. After a lifetime struggle with biliary atresia, she could now look forward.  

鈥淚鈥檓 eternally grateful I was referred to Keck Medicine,鈥� she says. 鈥淚 can live life normally now.鈥� 

Following the initial recovery period 鈥� which often takes several weeks 鈥� all four patients are feeling well and pursuing favorite activities. Saul has gone snowboarding a few times; Joselin is hiking; and Jaime and Kathya are enjoying time with their children.  

鈥淢y kids are so excited we can do all kinds of things together now,鈥� Jaime says. 

Their doctors say all four can expect to live healthy lives. 鈥淭hey鈥檙e all young people,鈥� Dr. Kaur says. 鈥淚鈥檓 glad they can all move on and start a new chapter.鈥�  

Meeting your organ donor

Three months after the transplants, the Casillases and Rochas met for the first time during a visit at Keck Medical Center of 喵咪社区, where they also reunited with many of the physicians and staff who cared for them.  

The families were able to learn more about each other.  

鈥淚t was like our lives had been intertwined,鈥� Joselin says. 鈥淲e realized we had grown up in the same area and had similar childhoods.鈥濃�� 

鈥淭hey felt like family the instant we met,鈥� Kathya says. 

They remain in touch. 

鈥淣ot many people go through this kind of experience,鈥� Saul says. 鈥淪o it鈥檚 meaningful to know we always have someone else to share it with.鈥�  

All four patients say they hope their journey gives faith to others who await transplants, as well as inspires others to consider donation. 

鈥淒on鈥檛 give up,鈥� Jaime says. 鈥淚 always tell people now: Our story is proof that there are options.鈥� 

Interested in supporting the work of Keck Medicine? .

Topics