On a weekend morning in Reno, Nevada, Ashley Cardenas, Transplant Administrator at Renown Health, can walk through the farmer’s market and run into a transplant patient who looks healthier and happier than the last time she saw them. For her, that kind of ordinary encounter is a quiet proof point. She joined Renown just over a year ago to help build a new transplant program – one that is taking root in a state that has long sent patients elsewhere for care. A team that was “green to transplant” a year ago is finding its footing. And, in a field increasingly shaped by scrutiny, regulation, and public mistrust, she is building something she believes the system cannot afford to treat as optional: a culture of quality.
“We’ve come a long way in a short time, but none of the innovation matters if nobody trusts the system,” she said. “Quality is how we restore that trust and move forward.”
The Alliance connection: a home for quality
In the last year and a half, Ashley’s involvement with the Organ Donation and Transplantation Alliance (The Alliance) has deepened, including recognition as one of The Alliance’s 2025 40 Under 40. But the core of her connection is practical: The Alliance provided something she and peers believed the field lacked, a professional home for transplant quality.
At a national conference, she started comparing notes about gaps in education, competencies, and shared standards for quality professionals with Lindsay Smith, director of quality at the Vanderbilt Transplant Center, and Celeste Braley, director of quality and compliance at the UW Health Transplant Center. A poll to the transplant quality community yielded a strong response, and early conversations suggested broad agreement: quality roles vary widely by institution, and many professionals learn through “road rash,” as Ashley put it, rather than structured training.
They approached The Alliance, which had shown a willingness to champion community-driven initiatives. The result is The Alliance’s National Transplant Quality Collaborative, with a steering committee and four early subcommittees: education and training; professional growth; standards and competencies; and event planning.
She also has been a member of The Alliance’s Transplant Quality Corner Workgroup, and chairs the Executive Committee of the Community of Practice of Transplant Administration and Quality Management of the American Society of Transplantation.
A first-responder household, and an early understanding of donation
She grew up in Las Vegas, the daughter of first responders, in a household where organ donation and emergency medicine were familiar topics “I actually can’t remember a time in which I didn’t know about organ donation and what a great gift it was, this sort of thing was dinner table discussion” she said.
That foundation shaped her long before she chose a career path. She always knew she would work in health care. As a teenager, she imagined becoming either a plastic surgeon or a transplant surgeon, before deciding on surgical nursing. The common thread was clear: she wanted to be close to the moments when medicine could restore something that had been lost.
A nationwide nursing shortage redirected her plans. After completing her prerequisites, she faced a two-year waitlist for nursing school. Rather than stall, she pivoted to a degree in global health at Arizona State University. The program blended sociology, anthropology, history and public health, and the systems that shape who gets care and how.
It was a practical pivot, too. She became a mother in her last semester of undergrad and began applying widely for nonprofit work, looking for an organization whose mission aligned with her values. “I’m really heart centered,” she said. “I have to believe in the purpose that I’m serving.”
A friend’s death, and a direct line to purpose
About 10 days before graduation, Ashley received a call that a close high school friend, Matthew Anderson, had died suddenly at age 24 after a major stroke. As she arranged to travel to his funeral, she received another call, this one from Nevada Donor Network, offering an interview for a family services coordinator position.
At the funeral, she mentioned the upcoming interview to Matthew’s mother, who told her that Matthew had donated every major organ. In the midst of grief, donation offered a kind of meaning she could hold onto. “Right there, that became my connect to purpose,” she said.
She interviewed the next day and was offered the job on the spot. The work was consequential and, in a small community, intensely personal. In a year and a half, she found herself supporting donations involving people she knew or people connected to her childhood. She understood the promise of donation, but the emotional proximity of repeated loss took a toll.
A turning point: learning about quality
Then came another kind of inflection point, one that would define the center of her professional identity. Nevada Donor Network went through an audit and Cardenas saw firsthand why quality systems exist. “That’s when it clicked,” she says. “Quality was the pathway for me to make a real difference.”
Quality, she realized, was not just paperwork. It was the foundation for safety, trust, and accountability. It was also a path that might allow her to stay in the mission without burning out on the emotional intensity of donor family work.
She moved into transplant operations, first at the Scripps Center for Transplantation. She was accepted into a master’s program in health law and policy, drawn to the regulatory architecture that shapes how OPOs and transplant programs operate.
A graduate school assignment, the “White Coat Project,” asked her to interview someone who held the job she wanted. She reached out to James Alcorn, then UNOS director of policy, and the conversation led to a job offer. She moved with her young daughter to Richmond, Virginia, to become a policy analyst and liaison for the Liver and Intestinal Committee.
She landed in the middle of one of the field’s most contentious policy debates, working on liver redistricting. The content was complex, but the bigger lesson was about professional community: people from across the country, with sharply different opinions, showing up because the work matters and the impact is real.
“What resonated most with me was their commitment, these people who already give so much in their daily work, still choosing to volunteer their time and expertise to make this system better and save lives, she said.
A personal crisis, and an expanded view of “care”
A year into that work at UNOS, Ashley’s birth mother was diagnosed with metastatic pancreatic adenocarcinoma at age 44. Her mother declined aggressive treatment, choosing instead to prioritize the quality of her remaining time. Ashley left UNOS and returned home to care for her.
Despite Cardenas’s knowledge, connections, and advocacy skills, her mother suffered profoundly at the end of her life. “If this can happen to us,” she says, “what is happening to everyone else?” The experience left her furious—not with individual clinicians, but with a system that confused survival with care.
That suffering drew her into end-of-life policy. After her mother died in 2015, California authorized medical aid in dying, an option her mother wished she’d had access to. Ashley joined Compassion & Choices and spent five and a half years working to expand patient options at the end of life, passing eight laws in seven states.
What ultimately drew her back to transplant was community. Throughout her mother’s illness, leaders across the transplant world showed up—calling, advising, offering their connections to care and even their own homes, standing beside her as humans first and professionals second. That support cemented her belief that transplant, at its best, is a community bound by shared responsibility.
Returning to transplant, and choosing the hard work of building
Ashley re-entered transplant through quality and compliance roles at UC San Diego, earning Lean Six Sigma Black Belt certification and later her CPHQ, which she values for the ability it gives her to train and support others. “My job’s not actually to take care of the patients. My job is to take care of the team that’s taking care of the patients; to ensure that they are supported and able to do it well.”
When she heard talk of a new transplant program developing in Nevada, she paid attention. The idea of building access in Reno felt like both a professional challenge and a homecoming. She approached transplant leader Dr. David Mulligan, a longtime colleague and friend, who had supported her through her mother’s illness. Now the two work together at Renown, intentionally building a program and a team where quality is the foundation — and person-centered care is the standard. Her first year in Reno, she said, has been among the most challenging of her career.
The work ahead: trust and transparency
When Ashley talks about quality, she is not talking about compliance as an annual exercise. She is talking about predictive systems, proactive safety, and transparency that can withstand public attention. She is also talking about a culture shift, one that brings quality professionals fully to the table, alongside clinicians, administrators, OPO leaders, and national partners.
On the days when the work feels heavy, she returns to the practical truth that keeps her steady: community is built in the doing. “Transplant, either you’re going to love it or you’re going to hate it, there really is no in-between” she told her team. “And the people who love it? They represent the very best of who we are.”
For Ashley, the choice is already made. The question, now, is how quickly the field can bring quality from the margins to the center, and how many lives depend on getting that answer right.
Ashley lives in Reno with her husband and two children. Outside of work, she is adjusting to life in Northern Nevada, after years in Southern California, and slowly reclaiming pieces of herself now that her MBA is complete—reading, knitting, hiking and someday returning to Brazilian jiu-jitsu
