After more than three decades in transplant, Coleen Smart, MSN, RN, CCTC, has seen the field evolve while its mission has stayed the same: helping patients safely reach transplant. As Buckeye Transplant Solutions’ Waitlist Management Director, she works with transplant programs nationwide to keep patients active, supported, and ready when the right organ becomes available. We sat down with Coleen to talk about her career, the transplant community, and what continues to inspire her.

How did you get into transplant?

I never had a grand plan to enter transplant, I always wanted to be a nurse, and transplant was where the opportunity was. I started on the transplant floor over 30 years ago, and I quickly realized you either catch the transplant bug or you don’t. Transplant stays with you for life.

I spent more than 20 years at Hartford Hospital, training alongside some of the industry’s most renowned surgeons. Then, after successfully helping reopen a transplant center in Fort Myers, Florida, I joined Buckeye over six years ago. Today, I help lead our waitlist management program, where we are already seeing measurable improvements in keeping patients active, optimized, and ready for their life-saving surgery. 

What challenges do you see come up again and again?

Transplant evaluations are federally regulated, so every center adheres to the same fundamental pathway, but each center adapts to their physicians’ philosophies and specific patient populations. Having managed operations among centers nationwide, I have observed how geographic location and patient demographics influence center efficiency. For example, rural programs often face longer evaluation timelines due to differences in access to specialized services and resources. 

It’s a cohesive community, but a competitive one. Everyone is working towards the same goal: safely assisting patients from referral to transplant with a limited supply of organs. The widening gap between rising organ demand and stagnating or declining organ supply continues to be one of the greatest challenges.    

What have those shared challenges taught you about the transplant coordination community?

It is a privilege to work in a field where collaboration is so natural that you can reach out to almost any colleague. Our conferences really showcase how tight-knit this community is. People often talk about ‘reinventing’ multidisciplinary care today, but the reality is that transplant teams have been operating this way since the 1960s. 

How has working with Buckeye changed your perspective? 

Working with Buckeye has given me the incredible opportunity to stay in the field I love while enjoying the remote flexibility needed to care for my family. I am proud to continue supporting transplant programs across the country. Learning to connect with patients on their own schedules, rather than just traditional business hours, has shown me that flexibility is truly what builds lasting trust. 

Can you share a time when catching something early made a real difference for a patient?

There are so many…

A firefighter, father of three, was minutes from a liver transplant when he shared, “I don’t think tonight is my night.” No medical reason, just intuition. I advocated for the patient and brought the team back to his room and the decision was made to not proceed. It turned out to be a life-saving decision. Within a few weeks, he received a second chance and years later he continues to live a healthy life with his family.  

When I first started, a mentor told me if I continued to give too much of myself, I would burn out quickly. My response was, “My patients give me back ten-fold.” I still believe that today.  

What’s one piece of advice you’d give a new transplant coordinator?

Give yourself a break, it takes two solid years to feel truly comfortable. Six months is the minimum to know if transplant is for you. If you’re still curious, still asking, “What’s that about?” you’ll make it.

You also have to learn to pivot. This field never stops changing, patients, regulations, all of it. And this isn’t a job where you put your pencil down at shift’s end, which is exactly why self-care matters, but there’s nothing like hearing a patient say, “You did this with me.”

The “transplant bug” Coleen describes has never left. Today, she continues to help transplant programs and patients navigate the waitlist journey with the same dedication that first drew her to the field.

*Sponsored content. Buckeye Transplant Solutions is a 2026 Advocate Level Corporate Partner of The Alliance.