In her hybrid role as transplant surgeon and medical director of a hospital-based Organ Procurement Organization (OPO) Nikole Neidlinger, MD, MBA, FACS, Associate Professor of Surgery and Associate Medical Director Organ & Tissue Donation at the University of Wisconsin-Madison Division of Transplantation has a distinctive perspective on the interplay between organ donation and transplantation—both for the donor families and for the recipients.
She co-chairs the planning committee with Richard Hasz, MFS, CPTC, President & Chief Executive Officer of Gift of Life Donor Program, for the Organ Donation and Transplantation Alliance’s (The Alliance’s) 2025 National Critical Issues Forum, “Partnerships to Grow Transplants in the Modern Era” on October 7-8 in Atlanta. She said she hopes to bring her singular perspective of being a transplant surgeon and medical director of an OPO to the committee. “I know how important it is that OPOs and transplant centers understand each other’s needs and workflows,” says Dr. Neidlinger. “Partnerships between OPOs and centers are so much more important than people realize, and both have to work together for the donation and transplantation system to work.”
Mentor Led Her to Hybrid Role
Dr. Neidlinger says her primary mentor has been Dr. Tony D’Alessandro, who served as Director of the UW Health Pediatric Liver Transplant Program and Medical Director for UW Organ and Tissue Donation while she was a transplant fellow. It was his influence that led to her hybrid career.
“One of Tony’s rules was that when the transplant fellows went on organ procurements, we met with the donor families,” she says. “On my first day, he called and said, ’You’re going to be flying to Marquette, Michigan, for a procurement. The donor is 15 years old and has died tragically in an ATV crash. When you get there, you’re going to meet the donor’s family and talk with them.”
“I remember saying, ‘That’s going to be hard for me. I’m a surgeon; we aren’t that good with grief; what am I supposed to say? ‘He said, ‘We’re putting a face to the process and it’s really important for the families. If you were doing a hernia operation on their son, you’d speak to them, so why wouldn’t you speak to them now?’ And he had a point.”
She says that about 80 percent of the time, the donor families expressed gratitude for the opportunity. “Those were overwhelming and incredible conversations.”
In the final year of her fellowship, Dr. D’Alessandro asked her to stay at UW for an extra year to learn the ropes of running the OPO. “He knew that I liked the organ donation aspect,” she says. “I agree to do procurement call 20 days a month and in return he gave me an office in the OPO and put me on the executive team. I did the job for the year and learned how an OPO works in a way that not many surgeons get exposed to. It turned out to be a really good year for me and led to my career pathway. It gives you a lot more credibility in the OPO world, if you’ve actually worked at an OPO.”
Medical Directors Think More Broadly
Currently in addition to performing kidney transplants and being a teaching faculty member, Dr. Neidlinger is the medical director at one of the seven OPOs (out of 55) that are owned and operated by a hospital. “I have oversight of our clinical practices at the OPO and do teaching and education for our staff,” says Dr. Neidlinger.
“It helps to be a physician for peer-to-peer teaching in our partner hospitals, as well as for educational outreach. I can go out and talk to referring doctors in a language that they understand about the importance of donation. Medical directors are also integral in the quality aspects of the OPO and approach organ donation with a mindset of improvement. I think about one-on-one relationships with a patient in front of me when I’m a surgeon, but being a medical director you think more broadly in terms of impacting change, guiding teams and mentoring people on the team to do their best.”
Opportunity to do Something Miraculous Every Day
She grew up in Atlanta and says she was interested in being a doctor from an early age although no one in her family was in medicine. In high school, she shadowed a surgeon for a week and that cemented her decision to attend Notre Dame University as a pre-med major (she’s now a huge Fighting Irish football fan).
She attended medical school at Tulane University and did her residency at the University of California, San Francisco, East Bay. “Much of our work was in community hospitals in communities that were less resourced,” says Dr. Neidlinger. “Training in hospitals that didn’t have as many fellows and learners, you got more hands on experience, which as a surgeon I loved.”
It was during a rotation in transplantation at California Pacific Medical Center that she fell in love with transplant. “I got to go on an organ procurement, flying a kidney across the country in a cooler. And then putting it in someone else and seeing that it worked right away, before you can even sew the ureter in, it starts making urine; it was like a miracle. I thought, transplant is an opportunity to do something miraculous every day.”
“This might sound kind of corny, but honestly, I still feel like that now. When I transplant a kidney now, we have so many learners in the room, and their faces show the amazement that my face did back then.”
After completing a Transplantation Fellowship at University of Wisconsin, Dr. Neidlinger served as a transplant surgeon at California Pacific Medical Center and medical director/Chief Medical Officer at Donor West from 2010-2020. She attended Executive Committee meetings of the leadership team at Donor West and decided she needed to earn an MBA to learn to speak the language of business.
She began an online program in 2013 when her twins were two years old and earned an MBA from the University of Massachusetts Amherst in 2019. “I like being able to speak the language of business in leadership meetings,” says Dr. Neidlinger. “If you have an MBA, you understand the nuances of negotiation and finance and accounting and quality which help you as a physician leader.”
In 2020, she was recruited by her mentor, Dr. D’Alessandro to return to the University of Wisconsin. “You can’t say no to the opportunity to be a successor to your mentor,” she says.
Dr. Neidlinger lives in a house on Lake Monona just south of Madison with her three children, 12 year old twins, and a 9-year old, and summer evenings may find everyone out on the lake in a kayak, on a stand-up paddle board or jet ski, or in their small boat. She also plays recreational ice hockey.
Representation Matters
Dr. Neidlinger identifies as Queer and says that representation matters, especially when she does a job like transplant surgery and there aren’t a lot of people who do it. “In my own personal life, when my twins were born in California in 2013, gay marriage was illegal. We had to do a second parent adoption. When things like that happen to you, you realize how vulnerable communities are to public opinion, and that it matters to be an advocate.”
“I do think it matters that people know that I am in the LGBTQ community, and so is my family, and that we’re advocates, and that we care.”
In 2023, Dr. Neidlinger was a presenter in The Alliance’s Conversation Series: The Power of Allyship Part II: Exploring the Impact of Donation & Transplantation in the LGTBQ+ Community.
Research Interests
As a faculty member in an academic medical center, Neidlinger publishes research that focuses primarily on outcomes between OPOs and transplant centers. In 2024, she was recognized as a general surgery research ‘all-star’ by Avant-Garde Health for her contributions to healthcare research that significantly enhance the quality of patient care. The research of more than 90,000 surgeons was examined and only the top five percent were honored based on the quantity and quality of their published research.
In 2023, she and one of her surgical partners, Dr. Carrie Thiessen, received a grant award from Donate Life Wisconsin to support a project evaluating the University of Wisconsin Organ and Tissue Donation program’s practice of having pre-procurement conversations. Read more here.
Organ Donation Matters to Donor Families
Back to those incredible conversations with donor families that began during her fellowship, Dr. Neidlinger says, “Overwhelmingly all the families were so gracious, and they would say the same things: ‘Thank you for allowing my person a legacy. We never anticipated this day. We haven’t felt like we had a choice in any of this, but saying yes to organ donation feels like the first time that we have some kind of say in something that is aligned with our values.’
“I always knew that organ donation mattered for the recipients, but I didn’t realize that it mattered so much to the donor families, too,” says Dr. Neidlinger. “I credit Dr. Tony d’Alessandro, because he was the one who had us talking to families, and for me it really made a difference. I think that more people should know that organ donation matters so much for families.”
