Zachary C. Dietch, MD, Transplant Surgeon at Northwestern Medicine

In this episode of the Becker's Healthcare Podcast, Elizabeth Gregerson interviews Dr. Zachary C. Deitch, a transplant surgeon at Northwestern Medicine, about a groundbreaking case involving liver transplantation for a patient with unresectable colorectal liver metastases. The patient, a young mother in her early forties, was diagnosed with stage IV colorectal cancer with extensive bilobar liver metastases that could not be surgically removed. Despite historically poor prognoses—five-year survival rates of only 10–20%—Dr. Deitch and his team successfully performed a living donor liver transplant, resulting in the patient’s full recovery and no evidence of disease. The discussion highlights how integrating transplant surgeons early into multidisciplinary tumor boards, alongside oncologists and surgical specialists, is critical for identifying eligible patients. Dr. Deitch emphasizes the need for clinical champions, coordinated protocols, and specialized financial navigation to overcome insurance hurdles, as reimbursement remains a major operational challenge. He also underscores the growing potential of this treatment, noting increasing patient interest across the U.S. and internationally, and calls for broader awareness and systemic integration to expand access. Key takeaways include the importance of early interdisciplinary collaboration in treating advanced colorectal cancer, the necessity of dedicated transplant oncology programs with integrated tumor boards, and the critical role of financial and administrative support in securing insurance approvals. Health system leaders are advised to invest in cross-specialty coordination and education to identify patients who may benefit from transplant as a viable option. The episode concludes with a hopeful outlook: while not a high-volume procedure, liver transplantation for select colorectal liver metastases is poised to become a standard-of-care treatment, offering life-extending and potentially curative outcomes for a subset of patients who previously had few options.