In 2010, Andrew had been living with primary sclerosing cholangitis (PSC), a disease that was progressively damaging the bile ducts in his liver. After spending six weeks in a medically induced coma, he received a liver transplant at a Florida hospital in October of that year. Despite experiencing major complications, Andrew recovered and began working at a local blood bank, sharing his story to encourage organ and blood donation.

A Surprise Diagnosis

In 2022, a routine CT scan of his chest area revealed something unexpected: stage 1 lung cancer. “I was completely shocked. I had no symptoms at all, and this was found incidentally,” says Andrew, a non-smoker.

Surgeons removed the cancerous nodule, and Andrew was declared cancer-free. Yet his medical journey was far from complete.

A year later, Andrew began experiencing fluid buildup around his lungs. It wasn’t the cancer returning — it was his transplanted liver beginning to fail.

“When you get cancer after a transplant, you’re really between a rock and a hard place,” says Satish N. Nadig, MD, PhD, transplant surgeon and director of Northwestern Medicine Comprehensive Transplant Center. “When Andrew was diagnosed with lung cancer in Florida, some of his antirejection medications likely had to be reduced to give his immune system a chance to fight the disease, which may have contributed to rejection of his transplanted liver.”

A 2nd Opinion

As Andrew’s health declined, his wife Nicole reached out to transplant centers across the country. Because Andrew had not been cancer-free for three to five years, most centers said no to a second transplant.

While searching for answers online, Nicole came across the story of Gary Gibbon, MD, a California physician who traveled to Northwestern Medicine to receive the first double-lung and liver transplant for advanced lung cancer in the United States.

Inspired, the Wagners traveled to Chicago in October 2024 to see if Northwestern Medicine could help.

They got the answer they were hoping for.

“Andrew was really on the brink when he first got to Chicago. He likely had months to live,” says Andres Duarte, MD, a hepatologist at Northwestern Medicine. “After presenting his case to our multidisciplinary selection committee, we determined that even with immunosuppression, the risk of his lung cancer recurring was very low. Though we knew the surgery would be difficult, as retransplants tend to be, we were excited to offer him this critical chance for survival.”

A Complex Surgery

On December 16, 2024, Andrew underwent the complex liver retransplant at Northwestern Memorial Hospital. Because of scar tissue from previous surgeries, removing his old liver was challenging. Surgeons placed him on bypass to maintain blood flow and used a device called “liver in a box” to keep the new liver healthy outside the body.

“Having access to this wide range of techniques allowed us to navigate Andrew’s transplant effectively,” says Zachary C. Dietch, MD, a transplant surgeon at Northwestern Medicine. “It was an interesting blend of old and new — traditional methods like bypass used alongside the latest advancements in transplant such as ‘liver in a box.’” 

Home Again and Healing

Five months after surgery, Andrew returned home to Florida, where he’s doing well. His new liver is functioning, and he remains cancer-free. He stays active with walking, swimming, biking and weightlifting. Most of all, he enjoys spending time with his family — including his wife, two daughters, two stepdaughters and his granddaughter.

“Receiving the greatest gift of life from the most generous organ donor has given me the opportunity to witness all the future milestones in our daughters’ and granddaughter’s lives,” says Andrew. “Thanks to my donor and my incredible transplant team at Northwestern Medicine, I still get to be a dad and grandfather.” 

Redefining Transplant Eligibility

Northwestern Medicine is one of the few known health systems in the country focused on redefining the criteria for transplant eligibility, especially for patients with lung or colorectal cancer. 

Through innovative programs like DREAM (Double Lung Transplant Registry Aimed for Lung-Limited Malignancies) and CLEAR (Colorectal Metastasis to Liver Extraction with Auxiliary Transplant and Delayed Resection), Northwestern Medicine is expanding access to lifesaving transplants for patients with cancer.

“It’s a very exciting time for the field of transplantation,” says Dr. Nadig. “What we’ve learned in the past is not necessarily what we’re taking with us into the future. I think it’s time to re-examine what we think we know about transplant indications and become more inclusive of those who have recently faced or who are facing cancer.” 

Learn more about how you can become a living organ donor.