ER visit led to rare liver transplant for stage IV colon cancer

A routine emergency room visit for dehydration turned into a diagnosis that changed Amy Piccioli’s life. The 39-year-old Los Angeles accountant and mother of three went to the hospital in May 2024 after a stomach bug swept through her family, and a CT scan unexpectedly found a mass in her colon and multiple lesions in her liver.

A biopsy confirmed stage IV colorectal cancer. Piccioli had no symptoms at all, no bowel changes, no family history and no warning signs that would have pointed to an advanced cancer hiding in plain sight. Her case underscored a difficult reality for doctors: colorectal cancer can spread before it causes obvious trouble, especially in younger adults who may not yet be in routine screening programs.

Treatment began quickly. Chemotherapy started in June 2024, and immunotherapy was added in July after genetic testing suggested it could help shrink the tumors. By the time her cancer had responded enough to make surgery possible, Piccioli traveled to Chicago in September 2025 for evaluation at Northwestern Medicine, where a multidisciplinary team considered her for a living-donor liver transplant.

Northwestern Medicine said the transplant was performed in December 2025, making Piccioli the first person at the hospital to receive a living-donor transplant for metastatic colon cancer. By March 2026, she said she had been told she had no evidence of disease. Northwestern’s CLEAR program, short for Colorectal Metastasis to Liver Extraction with Auxiliary Transplant and Delayed Resection, is among the only U.S. programs offering liver transplants for carefully selected colorectal cancer patients whose disease has spread to the liver.

The case arrives amid a broader national warning. The American Cancer Society’s 2026 estimates call for 158,850 new colorectal cancer cases and 55,230 deaths in the United States this year. The disease is the second most common cancer-related cause of death in the country and ranks first among adults younger than 50. The Centers for Disease Control and Prevention says average-risk adults should begin screening at 45, a threshold that leaves a vulnerable gap for younger patients whose cancers can advance before detection.

Experts have long noted that about half of colorectal cancer patients will develop metastases, most often to the liver, and that chemotherapy alone has historically delivered poor long-term survival once the disease cannot be removed surgically. Piccioli’s case shows why transplant-oncology programs are gaining attention: for a narrow group of patients, a late-stage diagnosis no longer has to close off every treatment path.