What if the biggest advances in organ transplantation weren’t just better drugs, but the ability to keep organs alive and working outside the body

Dr. Antonio Di Carlo traces how mentorship, family experience, and the pure magic of reperfusion drew him into transplant surgery. He describes the still astonishing moment a lifeless kidney on ice suddenly produces urine and explains why the technical side of transplant has changed far less than the immunology and preservation science around it.

He walks through the transformative impact of normothermic machine perfusion (especially for livers), emerging gene profiling and cell free DNA tools that may soon predict rejection, and the rapid progress in genetically modified pig organs. The conversation then turns to how he frames transplant discussions with patients, a memorable pancreas kidney recipient whose life was restored, the surprising fitness of many octogenarian candidates, and why a thoughtfully written textbook still offers a “mind frame” that AI cannot replace.

Top 3 Takeaways

• Normothermic machine perfusion has moved organs from ice bucket urgency to assessed, functioning grafts that can wait while the surgical team rests, dramatically improving outcomes, especially for the liver.
• Xenotransplantation is no longer science fiction: genetically modified pig kidneys have approached one year of human survival, and primate data suggest multi year rejection free function is possible.
• Chronological age is a poor proxy for transplant candidacy; functional status and “protoplasm” matter far more, as illustrated by motorcycle riding and company running octogenarians who have successfully received organs.

About the Guest

Dr. Antonio Di Carlo is a professor of surgery with 25 years’ experience in adult and pediatric abdominal organ transplantation. Board certified in general and transplant surgery, he holds an MD from McGill University, a leadership certificate from Harvard T.H. Chan School of Public Health, and an MBA in Healthcare Administration from Temple University’s Fox School of Business. He has authored chapters in the book Care of the Older Adult.

Connect with Dr. Di Carlo

LinkedIn: Antonio DiCarlo MD

About the Host

Dr. Peter Crane is a board certified physician, educator, and storyteller with a heart for service and a calling to spotlight doctors who make a difference, in their communities, in medicine, and in the lives they touch.

Through Doctors Making a Difference, he brings you into intimate conversations with physicians who have overcome challenges, redefined success, and found purpose in and beyond the clinic. His goal is simple: to help more doctors stay in medicine by showing them what's possible.

About the Show:

Doctors Making a Difference is more than a podcast; it's a movement to highlight the good, the gritty, and the deeply human side of medicine. In every episode, physicians share stories of challenge, purpose, and connection so more doctors can stay in medicine and leave it better than they found it.

visit: doctorsmakingadifference.com

LMC Series Note:

Living with Metastatic Cancer (LMC) explores the science, decisions, and day to day realities of life with advanced disease, through candid physician patient conversations.

The Doctors Making a Difference Podcast is for informational purposes only and does not substitute for medical, legal, or professional advice. Always consult appropriate experts regarding your unique circumstances.

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