Outstanding Clinical Programs

Pictured: Patient, Mark Evertt and family

Liver Transplants Give Cancer Patients a Second Chance at Life

The gold standard treatment for liver metastasis is surgery. At the renowned UR Medicine Transplant Surgery Division, our highly skilled team is dedicated to liver surgery, including complex liver resections, with a focus on patients with cancer.

“Liver transplant for advanced colorectal metastasis is not experimental,” says Roberto Hernandez-Alejandro, M.D., Professor of Surgery and Chief, Transplant Surgery Division. “It’s another way of removing the cancer in specific patients.” As one of the first two centers in the nation to offer liver transplants for select patients with advanced colorectal liver metastasis, the Division provides a life-saving treatment option that gives these patients a better chance of beating their cancer and ultimately a second chance at life.

Upon receipt of a patient’s medical records, imaging and test results, the team at our Transplant Surgery Division provides personalized recommendations and a strategy for care. “Patients who have liver cancer and meet certain criteria may be eligible for a transplant, even if they do not have liver failure,” adds Dr. Hernandez-Alejandro. “Whatever a patient’s surgical needs, we offer the expertise necessary to handle the most challenging cases.”

Treating Patient from Near and Far

Diagnosed in March 2020 with Stage IV colon cancer that had spread to his liver, Mark Everett, then 43 years of age, had been given only two months to live without treatment and two years with chemotherapy. After nearly 18 months of undergoing treatment, he had no evidence of disease remaining outside his liver. Now he was a candidate for a living-donor liver transplant – and he found a donor after more than a dozen people volunteered.

Mark and his family decided to make the cross-country trip from their home in Washington state to UR Medicine for a life-changing – and saving – surgery. However, even though he met strict clinical criteria for the procedure, Mark’s insurance company denied the surgery twice, considering it experimental. He appealed the denials and finally a determination was made by a liver transplant surgeon who deemed the procedure medically necessary based on medical evidence and the absence of any alternative treatment. Mark would be approved for surgery.

Based on data, Dr. Hernandez-Alejandro’s team has been successful in overcoming insurance denials in eight cases, after what he calls, “huge battles.” UR Medicine financial transplant administrators spend hours speaking with patients and insurance companies, writing letters, sending evidence from literature proving the effectiveness of liver transplants and sharing outcomes from other patients. “For patients who meet the criteria and have the surgery, the five-year survival rates can increase from 5% with chemotherapy alone to 70% or 80%,” explains Dr. Hernandez-Alejandro. Mark underwent his hard-won liver transplant surgery in August 2021 and is doing well. His wife Megan says the surgery is an answer to prayer. “I see it as a new beginning,” she adds. “And a new future that we just didn’t know we had.”

Looking Forward to Reaching More Milestones

Kathleen Lyons, a pediatric physical therapist and mother of two from Chicago, IL, was also diagnosed with Stage IV colon cancer that had spread to her liver. She had been accepted for the life-saving liver transplant procedure by our Division – and a former college roommate made the selfless decision to donate part of her own liver to save her friend’s life. Both women went through extensive testing, which showed them to be a perfect match for the transplant. Everything was set until Katheen received the crushing news that her insurer declined the proposed surgery, then rejected her doctor’s appeal. “Instead of receiving a surgery that would have helped make me cancer-free, I returned to chemotherapy,” says Kathleen.

Once again, Dr. Hernandez-Alejandro and the transplant team pushed back forcefully, like they have done for other patients. He says insurers initially balked at providing coverage for his other transplant patients but reconsidered after peer-topeer discussions with him. However, Kathleen’s insurer never allowed him to plead his case for her. “Unfortunately, liver transplantation is in the early stages in the U.S.,” states Dr. Hernandez-Alejandro. “And transplantation for unresectable liver metastasis is the best option for the most favorable outcome.” Katheen reapplied for the surgery, which she had in May 2021. “My main concern is my daughters, really my only concern,” she says. “Every milestone I can get to, I’m appreciative of.”

The Possibility of Having More Time Is Precious

According to Michael Kasperbauer, his wife Scarlet is strong and the type of person most people would aspire to be. After having major surgery to remove her colon and lymph nodes, cancer was also found throughout Scarlet’s liver. She endured a 5-1/2 year battle and non-stop chemotherapy prior to seeing specialists at Sloan Kettering Cancer Center, who said they, “didn’t think they could help her.” However, one of the specialists told Scarlet and her husband, who reside in Chapin, SC, that there was something new being offered for patients with liver metastasis – liver transplantation.

After learning about Dr. Hernandez-Alejandro at UR Medicine in Rochester, NY, Michael immediately reached out to him and promptly received a callback. “This doctor checked all the boxes,” says Scarlet, who was thrilled to find out she was a candidate for the surgery. “A liver transplant would be an opportunity to have a future, to see my son grow up,” she adds. “The possibility of having more time is precious – it’s a second chance to live and love family.”

Kristen Cannon says she wasn’t surprised when her husband Chaz decided to be a donor for Scarlet because, “he’s always giving of himself.” After determining that Chaz, who is from Lexington, SC, was a match, both families prepared for the living-donor liver transplant surgery, which took place in October 2019. “Dr. Hernandez-Alejandro, Dr. Tomiyama and their team were very attentive and I know I was in the best hands,” says Scarlet. When speaking about Chaz, Michael adds that it, “takes a lot for a person to stand up and do something of this magnitude for someone else.” The surgery and recovery went well for both Scarlet and Chaz, who says he, “feels really good.” Scarlet, too, feels great. “My follow-up labs and testing don’t even look like I had a liver transplant,” she exclaims with joy. “I’m like a new person, physically, mentally and emotionally.”