Paula Schneider and Lydia Fernandez became fast friends on their first day at Dominican Academy, a Catholic high school for girls on the Upper East Side of Manhattan, in September 2010. Schneider and her fraternal twin sister, Helene, had transferred from public school and knew no one. “At lunch, they were sitting alone in the cafeteria,” recalls Fernandez. “They looked cool, so I decided to keep them company.” Fernandez and Schneider bonded instantly over their love of the TV show Glee and soon became inseparable. On weekends, they hung out at Schneider’s apartment in Manhattan or at Fernandez’s house on Long Island.

After graduating in 2014, Schneider enrolled at the College of Idaho while Fernandez stayed close to home at Stony Brook University. Yet a life-threatening health crisis would bring the pair closer than they ever could have imagined. During her first year of college, Schneider developed severe gastrointestinal problems. She was diagnosed with ulcerative colitis, an autoimmune disease that causes the immune system to attack the colon. Weeks later, she was found to have a second autoimmune disease: primary sclerosing cholangitis, or PSC, a rare, progressive disorder that damages the liver, impairing its ability to filter blood and support digestion.

When anti-inflammatory drugs failed to control her ulcerative colitis, Schneider was referred to David P. Hudesman, MD, director of the Inflammatory Bowel Disease Center at NYU Langone Health. He prescribed a biologic, a drug made from living cells engineered to target specific disease-causing proteins or cells, which eased her symptoms. Meanwhile, Schneider started on medications to mitigate the effects of her PSC.

Still, her health continued to decline. Soon after she finished college, imaging revealed that she had cirrhosis, which is advanced scarring of the liver. Doctors told her that she would eventually need a liver transplant. “I thought, ‘Oh God, what do I do?’” she recalls. “I was terrified.”

Although she’d always been reluctant to discuss her health problems, Schneider confided to Fernandez one day at a coffee shop. “If you ever need an organ,” her friend responded, “I’m here for you.”

By 2021, the situation had become more than hypothetical. Schneider’s ulcerative colitis worsened, requiring the surgical removal of her large intestine and the creation of an ileostomy to excrete waste. Then her PSC went into overdrive, causing toxins to accumulate throughout her body. She developed severe itching and crippling fatigue.

Schneider was accepted by NYU Langone’s Liver Transplant Program. However, she wasn’t placed on the waitlist for an organ, because she scored too low on the model for end-stage liver disease (MELD) scale, commonly used to assess the severity of the disease. “With PSC, there’s often a discordance between a person’s MELD score and how sick they truly are,” explains AnnMarie Liapakis, MD, medical director of NYU Langone’s Living Donor Liver Transplant Program.

In August 2022, Schneider was reevaluated and approved for the waitlist. Still, her prospects for survival remained uncertain, given the nationwide shortage of organs from deceased donors. Each year, about 2,000 patients die while awaiting a liver transplant.

Living donor liver transplantation is a valuable option for increasing the supply. The liver regenerates rapidly, enabling healthy people to donate a portion of the organ with no lasting impact on their own health. These transplants have better outcomes than deceased donor transplants because the organ tends to be in better condition. Donors can also designate their organ for a specific recipient, eliminating the wait and allowing the transplant operation to be scheduled at the donor’s and recipient’s convenience.

Schneider’s sister, Helene, posted a plea for potential donors on social media. Within an hour, Fernandez texted Schneider to report that she had submitted the application form—something she had been planning ever since their initial conversation years earlier. “When you love somebody, you show up for them in whatever way you can,” says Fernandez.

NYU Langone’s Liver Transplant Program ranks among the top 5 nationally and No. 1 in New York State, based on short wait times for a transplant and a high patient survival rate, according to the Scientific Registry of Transplant Recipients. The program is among the few that provide a comprehensive range of support services for donors as well as recipients, including health, psychological, and financial counseling. “We have a dedicated team of surgeons, hepatologists, and specialized nurses who work together to achieve the best possible outcomes with organs from both living and deceased donors,” says Karim J. Halazun, MD, surgical director of the Adult Liver Transplant Program and section chief of hepatobiliary surgery. “Our goal is not just to save patients’ lives but to transform their quality of life.”

The eight-hour surgery took place on November 30, 2022. At 6 a.m., the two friends met in a preoperative area at Tisch Hospital, accompanied by Schneider’s mom, Fernandez’s parents, and Fernandez’s fiancée, Jack O’Dwyer. After they shared a hug, Schneider was wheeled into an operating room and Fernandez walked into the one next door.

Fernandez’s hepatectomy was led by Adam Griesemer, MD, surgical director of the Living Donor Liver Transplant Program. To remove the left lobe of her liver, he used a combination of minimally invasive and open techniques that avoided the need to cut through her abdominal muscles. This approach enables athletic patients like Fernandez, an avid runner, to resume activities sooner. In the adjoining OR, Dr. Halazun carefully removed Schneider’s diseased liver. Then, as Dr. Halazun implanted the donor organ into Schneider’s abdominal cavity, Dr. Griesemer closed Fernandez’s incision. Finally, the two surgeons partnered to complete Schneider’s surgery.

Fernandez went home after four days in the hospital. Within a month, her liver had regenerated, and by eight weeks, she had returned to her job as a cosmetic chemist and to distance running. A year after the surgery, in November 2023, she completed her second New York City Marathon—a race that Dr. Griesemer also entered, inspired by Fernandez’s determination. “She crushed my time,” he says with a laugh. “It was like we were running on different roads.”

For Schneider, the road to recovery was bumpier. A week after the transplant, she developed the first of a series of bowel obstructions, likely due to swelling in old scar tissue. Six months later, she had revision surgery on her ileostomy. Following the procedure, she felt better than she had in years and was able to return to her work in nonprofit finance.

When Fernandez and O’Dwyer married in October 2024, Schneider served as Fernandez’s maid of honor; when Schneider married her fiancé, Sam Carlson, in December 2025, Fernandez and her wife celebrated with them. At 30, both remain in good health, a state that neither takes for granted. “It took Lydia, my family, my wonderful doctors at NYU Langone, and a whole community to get me through this,” says Schneider. “I wouldn’t be here without them.”