Spotlight On: Giselle Guerra, Executive Director, Miami Transplant Institute

Key points:

• • Miami Transplant Institute is advancing transplant care through robotics, AI, and complex multi-organ procedures.
• • Leaders are pushing to expand living donation by breaking myths around donor safety and recovery.
• • MTI combines innovation with personalized, culturally aware care to improve patient outcomes.

May 2026 — As medical director of the living kidney donor program at the Miami Transplant Institute (MTI), a joint enterprise between UHealth—University of Miami Health System and Jackson Health System, Giselle Guerra leads a specialized program at one of the nation’s most ambitious transplant centers, one that routinely takes on complex, multi-organ cases that other places decline. Guerra spoke with Invest: about MTI’s focus on living donation, robotic surgery, artificial intelligence, and xenotransplantation. “There are significant myths and misconceptions about what it means to be a living donor. The reality is that you can live a full, healthy, productive life after donating,” Guerra said.

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What is the core mission of the Miami Transplant Institute, and what makes your approach distinct?

Our main mission is to help those in greatest need. These are individuals who have gone into organ failure and require a replacement. Our primary goal is straightforward: no one should die waiting on the list. Unfortunately, the list continues to grow, so our job is to provide the best care, safely and efficiently, while minimizing wait times as much as possible to give patients the best long-term quality of life.

What sets us apart is the Institute model itself. Years ago, we made a deliberate decision to build a true institute — not just a program — because it provides the right infrastructure at both the human resource and financial scale, and it unites two major institutions: UHealth with the University of Miami and Jackson Health System. That foundation allows us to take on the most complex cases. Other transplant centers may handle a kidney, a liver, or even a heart. We take it further, accepting patients who need more than one organ transplant simultaneously. That requires a fully integrated, multidisciplinary care system and resources drawn from across the healthcare network.

How does MTI manage the full care continuum, from referral through recovery?

It truly is a team approach, and it requires buy-in from both the healthcare infrastructure and the broader community. When patients are referred to us, we involve referring physicians from the beginning, not only to ensure patients arrive at the right time for us to intervene effectively, but also to engage those physicians in post-transplant management. Our goal is for patients to return to the community as productive members of society. There is no point in a successful transplant if the patient remains in the hospital and deteriorates. We want our patients to go back to work, be with their families, and give back to the community that helped them.

Internally, the multidisciplinary collaboration is just as critical. As a transplant nephrologist, I may find myself supporting a heart failure patient who goes into kidney failure following a heart transplant. Every discipline plays a role. And beyond physicians, this work cannot happen without the right nurses, operating room staff, case managers, pharmacists, and nutritionists. When we talk about a transplant institute, we are talking about every division and every ancillary team working together.

Living donation is a major focus for you. What are the key challenges and opportunities in expanding this life-saving pathway?

The single most important thing we must advocate for is education. There are significant myths and misconceptions about what it means to be a living donor. The reality is that you can live a full, healthy, productive life after donating. Recovery from surgery is manageable. At MTI, we can perform donor procedures robotically, and patients go home in under 24 hours. Most feel back to normal within two weeks, and I often have to remind them to take it easy because they recover so well. I advise against strenuous activity for eight weeks, but physiologically, everything returns to normal. I have donors who run marathons, compete in Ironman races, and have gone on to have children, including twins.

The impact of living donation extends far beyond a single recipient. Through national paired exchange programs, a single donor can set off a chain — we have participated in chains that result in up to 16 individuals receiving transplants. Living donor kidneys also last twice as long as deceased donor organs, and in the case of liver donation, a living donor can mean the difference between life and death for a patient who might not survive the wait.

How is technology reshaping transplant medicine, and where is MTI today in that evolution?

We are already well into this transformation — it is not a future story, it is happening now. For the past five years, all donor nephrectomies at MTI have been performed robotically. We also perform robotic kidney and kidney-pancreas transplants. The precision robotics affords is remarkable. Looking ahead, I expect we will expand into tele-robotic surgery, collaborating with other centers to extend this level of skill to patients and programs that don’t yet have access to it.

Artificial intelligence is another significant frontier. I see a strong opportunity to develop algorithms that better match donors with recipients, building pathways through AI to get the right organs to the right individuals as quickly as possible. And then there is xenotransplantation, which we are actively pushing to the forefront. Given the persistent organ shortage nationally and globally, transplanting organs from other species represents a genuine near-term opportunity. 3D printing has also entered the conversation in transplant circles, though it is not as immediately actionable as the areas I just mentioned.

What are MTI’s top priorities over the next three to five years?

Innovation remains central. We must stay on the cutting edge to provide the best care. But I am equally focused on something that technology alone cannot deliver: the personal touch. Medicine requires humanity. It demands compassion and empathy. In a world increasingly driven by speed, social media, and instant answers, we cannot lose sight of that. Whoever is able to integrate advanced technology with genuinely personalized patient care will take medicine to an entirely new level. As an institute, we can never lose sight of why we are here, which is for the patients.

Miami is one of the most diverse cities in the country. How does that shape the way MTI delivers care?

This is something I feel strongly about, and it is particularly relevant in South Florida. Miami’s multicultural population brings with it a range of distinct medical needs, cultural values, and deeply held beliefs, especially around organ donation. We work with a large Hispanic population, a significant Haitian population, and increasingly, patients arriving from around the world. Understanding and respecting those cultural perspectives is not secondary to care — it is part of care.

With organ donation in particular, different communities hold strong feelings, and there are deeply embedded myths that vary by culture. When I work with a transplant recipient, I actively encourage them to bring their entire family — their grandmother, their parents, their siblings — to the conversation. If the family matriarch understands and supports the process, everyone follows. That buy-in can translate directly into living donors and, ultimately, better outcomes for the patient. We are not just treating an individual. We are treating their entire support system, and here in Miami’s mecca of diversity, we can never afford to forget that.

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