The newest patient for a former Philadelphia surgeon is the City of Rome.

Last week, Ignazio Marino won 64 percent of the votes in the Italian capital's mayoral race. He resectioned Rome's ties to incumbent Mayor Gianni Alemanno, promising to suture the Eternal City with a more transparent government.

Marino, 58, worked extensively in Philadelphia before his foray into politics. From 2002 to 2006, he did nearly 200 organ transplants at Thomas Jefferson University Hospital. In his last year, he headed the transplant division.

"I will certainly do my best to 'heal' the ill side of Rome," Marino e-mailed.

Colleagues recall Marino for his leadership and compassion. "He was always first at the operating room and first at the bedside," said John Fung of the Cleveland Clinic.

Surgeons nicknamed him "Rocky" - not because of any similarity to Sylvester Stallone. "It was just a hell of a lot easier than Ignazio. And it sort of fit him. He was charismatic and highly principled," said Thomas Starzl, a pioneering surgeon at the University of Pittsburgh.

Marino emigrated from Italy in the late 1980s to learn more about liver transplants. Fong and Starzl mentored him at Pitt, where Starzl had carried out the first liver transplant ever in humans.

But only Marino's closest friends could foresee the Genoa-born surgeon's entrée into a more Machiavellian realm.

"Marino always wanted to do something more for patients. He probably saw politics as a way to help people differently," said Cataldo Doria, the current director of transplantation at Jefferson.

Doria was a fellow when he first met Marino 16 years ago in Pittsburgh. In 1999, both doctors were the first to operate at ISMETT, an organ transplantation center in Sicily that still runs as a partnership between Pitt and the Italian government. During their time in Sicily, the rate of organ donation shot up from practically nothing to 10 percent.

Together, Marino and Doria performed the island's first liver transplant. They taught the procedure to local physicians before leaving their posts in 2002 amid funding disputes. Marino felt that the cost of ISMETT was not proportional to its benefits for Italians.

At Jefferson, Marino operated on patients and did research. His paper on the effects of age and gender on liver transplant outcomes remains among the most cited in its field. The paper linked organ donation from older females with transplant failure.

When Marino left to become an Italian senator in 2006, he fought to create living wills and improve mental-health institutions in Italy. Under the slogan "Rome is life," the left-leaning mayor will now focus on eco-friendly city redevelopment while preserving what is left of agrarian land.

"Italians respect the land more than anybody," said Jody Della Barba, a judicial secretary here who follows Italian politics. She says the mayor must deal with illegal immigration, nationalized health care, and falling tourism.

What is Marino's secret for getting it done? Doria thinks he knows.

"Before doing a transplant, Marino would cook at least a pound of spaghetti. That was his favorite food. He would eat the pound, and then go into the operating room. He might do the same when he's putting a bill forward these days."

Contact Leila Haghighat at 215-854-4869 or lhaghighat@phillynews.com.