In a first-of-its-kind surgery for Long Island, the Northwell Health Transplant Institute performed a successful three-organ transplant of a Queens man who was in various stages of heart, liver and kidney failure.
Sergio Arias Cestoni, 47, of Hollis, Queens, was admitted to North Shore University Hospital (NSUH) on November 5, 2024, after a cardiology visit revealed that his heart was straining to circulate blood throughout the body. Mr. Cestoni was diagnosed with ischemic cardiomyopathy in 2018. By the time surgeons at the Sandra Atlas Bass Heart Hospital installed an Impella pump in his left ventricle to mechanically restore circulation, a man who once did heavy lifting for a living was only able to walk a few blocks before exhaustion.
Mr. Cestoni, who had been on the heart and kidney transplant waiting lists for two years, now saw his liver function erode from the impact of cirrhosis as well, something doctors attributed to heart issues combined with diabetes. The Queens man said he began to doubt he’d ever leave the hospital.
“I was surprised and scared,” said Mr. Cestoni, who is married. “When they told me there was no other option except transplant – I admit that I lost hope.”
A miraculous second chance emerged when three organs from the same deceased donor matched – appropriate in size, age and function – so a complex surgery involving dozens of medical staff both inside the operating room (OR) and beyond was put into motion on February 8, 2025. Over 14 grueling hours at specialty-built Petrocelli Surgical Pavilion, 13 surgeons working in three shifts, along with two different OR nursing teams – cardiac for the heart and abdominal for the liver and kidney – delivered on that medical miracle.
“We’re coordinating across disciplines with a lot of people used to worrying about only what they need to do,” said Deane Smith III, MD, surgical director for heart transplantation and mechanical circulatory support at Northwell. “The advantage for us is that we function as a Transplant Institute. 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.”
Dr. Smith oversaw the heart transplant, followed by Nabil Dagher, MD, and his liver team and then Ahmed Fahmy, MD, transplanted the kidney. Mr. Cestoni’s care team included Samit Shah, MD, a heart failure cardiologist; Nitzan Roth, MD, a transplant hepatologist; and Vinay Nair, DO, a nephrologist and medical director of kidney transplantation.
The Northwell Transplant Institute has performed 165 heart, 1,313 kidney and 339 liver transplants since each program’s inception. NSUH, which has 756 licensed beds and treats more than 90,000 patients each year, is the only hospital on Long Island that offers heart, lung, liver and kidney transplantation services, opening access to thousands of New Yorkers who otherwise would have to go into Manhattan for care.
A record 48,000 solid organ transplants took place at 250 transplant hospitals across the United States in 2024, including 373 at Northwell alone, according to the United Network for Organ Sharing. However, fewer than 60 triple transplant surgeries have occurred in the U.S. since 1987.
“It’s a great milestone and signifies that the most complex operations can happen here and happen here well,” said Dr. Dagher, senior vice president and director of the Northwell Transplant Institute. “Very few programs can do this. Patients can expect excellent outcomes.”
Within days, Mr. Cestoni was feeling better. He was up and moving. And he was able to urinate without the aid of dialysis for the first time in a year. Mr. Cestoni went home to continue his recovery on March 7. Hope has returned and the future suddenly is full of possibilities.
“I felt like I came back to life,” said Mr. Cestoni. “I have an opportunity to live again and do things better.”
For more information about the Northwell Transplant Institute, go to: https://transplant.northwell.edu/
About Northwell Health
Northwell Health is New York State’s largest health care provider and private employer, with 21 hospitals, about 900 outpatient facilities and more than 12,000 affiliated physicians. We care for over two million people annually in the New York metro area and beyond, thanks to philanthropic support from our communities. Our 87,000 employees – 18,900 nurses and 4,900 employed doctors, including members of Northwell Health Physician Partners – are working to change health care for the better. We’re making breakthroughs in medicine at the Feinstein Institutes for Medical Research. We're training the next generation of medical professionals at the visionary Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and the Hofstra Northwell School of Nursing and Physician Assistant Studies. For information on our more than 100 medical specialties, visit Northwell.edu and follow us @NorthwellHealth on Facebook, X, Instagram and LinkedIn.