Unconditional love saves two couples with first-ever robotic kidney pair exchange performed at Miami Transplant Institute

By: Krysten Brenlla

Nearly 30 years ago, Michael Deitado was diagnosed with chronic kidney disease. He knew that one day he’d likely need dialysis, and possibly a kidney transplant – but he never let that fate affect the way he lived.

Michael, 57, loves to travel, woodwork, and never shies away from an adventure. He spent more than two decades as a City of Pembroke Pines firefighter and paramedic.

Ten years ago, he met Maria Astrid Deitado, 51, and the couple instantly fell in love.

“Since the moment I met Astrid, I knew she’d be my wife,” Michael said. “She’s my angel.”

At the start of their relationship, Michael shared details about his health issues, telling Astrid that he was living on limited time.
“He told me that one day he’d probably need a transplant,” Astrid said. “I told him, if you need a kidney – I will give it to you. No questions asked.”

Michael was dependent on medication for most of his adult life to maintain proper function in his diseased kidneys. Despite this, he lived an active and healthy lifestyle, which helped keep the disease under control.

It wasn’t until 2021 that his condition started to take a turn for the worst.

“Within six months, my kidneys were failing to the point where there was nothing more I could do,” Michael said. “My nephrologists told me it was time for a transplant.”

Michael was referred to the Miami Transplant Institute (MTI), an affiliation between Jackson Health System and UHealth – University of Miami Health System, in the hopes of finding the perfect match.

Upon arrival at MTI, the first person to sign up to be Michael’s donor was Astrid. To their surprise, she was a perfect match.
However, after further evaluation of her kidneys, the team found that although Astrid’s kidneys were a perfect match for Michael, they were too small for his body.

While Astrid was not the best match for Michael, the team at MTI had another idea that would lead to two life-saving transplant procedures in one day.

“Even when a family member or friend’s kidney is not a match, a suitable living donor may still be an option with our paired kidney exchange program,” said Giselle Guerra, MD, medical director of the kidney transplant program at MTI. “Through this program, we can match willing donors for one patient with willing donors for another patient, swapping the kidneys and saving two lives at once.”

Much like Michael and Astrid, Fabiana Castro Troya, 35, and her husband, Enrique Gonzalez Abarca, 45, felt love at first sight. Natives of Ecuador, the couple love to spend time with their family, travel, and work in their careers.

In 2020, during a routine check, Fabiana’s doctors found that her creatinine levels, a waste product produced by the muscles that is filtered out by the kidneys, were extremely high – to the point where it was affecting her heart.

She then suffered a pulmonary embolism and was hospitalized, where she required several blood transfusions to survive.
“She was bleeding nonstop and was so swollen; she was unrecognizable,” Enrique said. “The doctors in Ecuador told me it was time to say goodbye, but I wasn’t going to let that happen without a second opinion in the United States.”

During a telehealth appointment with a doctor in the United States, Fabiana was told that she needed a transplant or she could die.

Fabiana was referred to MTI as an international patient. After meeting Dr. Guerra and the kidney transplant team, Fabiana moved to Miami in 2021, where she started treatments to reduce her antibodies – protective proteins produced by your immune system to remove antigens from the body – to become eligible for transplantation. During this time, she kept her kidney functioning through dialysis treatments.

Without Fabiana knowing, Enrique signed up to donate his kidney to her. However, like Astrid and Michael, he was not an eligible match, so he signed up for MTI’s kidney paired exchange program.

The couples finally received the calls they longed for – Astrid was Fabiana’s perfect match, and Enrique was Michael’s perfect match.

After extensive evaluations, Michael, Astrid, Fabiana, and Enrique were ready for the swap. On March 30, 2023, the kidney transplant team at MTI performed a 2-way paired kidney exchange robotically – marking the first time this method was used in a kidney exchange surgery at Jackson Memorial Hospital.

“Robotic surgery is a type of minimally invasive surgery that brings many advantages to the recipient and donor,” said Rodrigo Vianna, MD, PhD, MTI’s director of transplant services and chief of liver, intestinal, and multivisceral transplant. “Post-operatively, the patients recover very fast. This is the first time paired exchange surgeries are performed entirely robotic, which is a huge breakthrough for MTI and for the future of kidney transplantation.”

After just a few days in the hospital, the couples were discharged home, with minimal pain.

Michael, Astrid, Fabiana, and Enrique are all looking forward to returning to a healthy, normal life, filled with love and health.
They’re grateful to the team at MTI for their new chapters in life, but also to each other, for their unconditional love that led to a second chance.

On September 6, five months after their surgeries, the couples reunited with their medical team at MTI, and met for the first time during an emotional press conference at Jackson Memorial Hospital.

“It’s hard for me to express how I feel about what MTI, Astrid, and Enrique did for me. I don’t know how I could ever repay them,” Michael said.

“To Astrid – I am so grateful to her. I had faith in God, and she really changed my life. And, to my husband, I am so grateful to him,” Fabiana said. “This was a labor of love.”

Rodrigo Vianna, MD


Giselle Guerra, MD