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BWH Bulletin recently asked medical and surgical leaders to reflect on the past and future of transplantation. Here are their thoughts on the status of the field from a 50-year vantage point, and how they envision the legacy of accomplishment at BWH to continue.
Andy Whittemore, MD, chief medical officer Michael Zinner, MD, chief of Surgery Lawrence H. Cohn, MD, chief, Cardiac Surgery John Powelson, MD, associate chief, Renal Surgery David Sugarbaker, MD, chief, Thoracic Surgery
Andy Whittemore, MD, chief medical officer, captured the spirit inspiring so many transplant innovations in this way. “There is an intellectual vigor here that is truly unparalleled; we continue to attract vital staff with the most inquisitive minds,” he said. Michael Zinner, MD, chief of Surgery took it a step further—“Of all the hospitals in which I’ve built my career, BWH is the most willing to embrace creativity to find new ways to solve complex problems.”
That inherent spirit is capably demonstrated by Thoracic Surgery’s work to streamline the complex and delicate lung transplantation surgery. “In 1990, transplant surgery was an unscheduled interruption requiring everyone’s attention. But in the years since, we’ve worked to make it an almost routine part of a growing lung surgery program,“ said David Sugarbaker, MD, chief, Thoracic Surgery. The great efficiency and flexibility modernized by BWH transplant teams, including a myriad of multidisciplinary staff, has led to the hospital’s unique breakthroughs in multiple transplants, which are now a regular occurrence here.
For Cardiac Surgery, transplantation has led to innovations in related surgery to help patients that would have to face a daunting waiting list, because of chronic organ shortages. “Though we, like other centers have pursued artificial devices or drug therapy, we have also pioneered breakthrough surgical techniques like mitral valve repair to serve as alternatives to transplantation,” said Lawrence H. Cohn, MD, chief, Cardiac Surgery.
Renal Surgery’s response to the organ shortage has taken a different route – focusing on living donors. With state-of-the-art laparoscopic surgery now offered to donors, the minimally invasive procedure has expanded the options for many kidney patients in the last five years. “Living donation now accounts for two-thirds of the kidney transplants we perform at BWH,” explained John Powelson, MD, associate chief, Renal Surgery.
The Renal Division’s internationally recognized research program has achieved comparable major breakthroughs, evolving significantly since the first successful human organ transplant—a kidney—was performed at BWH by Joseph Murray, MD. Today, the new Transplant Research Center moves forward its accomplishments with immunosuppressive drugs, making significant contributions to helping transplant patients live longer, healthier lives.
Of course none of the transplant achievements would have been possible without the commitment of staffing and resources, BWH’s trademark interdisciplinary collaboration and the support of dynamic hospital visionaries. According to Cohn, “At the time of the first heart transplant in 1984, the surgery was quite controversial, but Drs. John Collins and John Mannick persisted in their support. This was despite an anti-transplant editorial that ran in New England Journal of Medicine just days before we performed the first one in New England,” he said. “To this day, many advances in cardiac transplantation have occurred here at BWH.”
As BWH commemorates the 50th anniversary of organ transplantation and looks ahead to more milestones in this surgical arena, Sugarbaker reflected, “No one in the world had ever done what Dr. Murray and his team did in 1954, and that spirit lives on here. The potential of BWH teams to perform medical and surgical firsts is perhaps far greater than what any of us here today can begin to imagine.”