Expertscape interviews Dr. Dorry Segev about organ transplantation and where the latest research is headed. Dr. Segev is Professor of Surgery at the Johns Hopkins University School of Medicine, where he is also the department's Associate Vice Chair for Research. His Twitter handle is @Dorry_Segev.
What are the most important questions to be asking physicians about organ transplantation?
Dr. SegevThere is a major gap between people who have kidney failure and those referred for transplantation. It is estimated that fewer than 25% of people who need a transplant have made it onto the transplant waitlist. I would recommend that anyone with kidney failure ask their doctors to refer them to a transplant center for evaluation. Kidney transplantation doubles your remaining life expectancy: that's a big deal.
What are you working on now, and what do you hope to discover?
Dr. SegevOne of the biggest challenges in organ transplantation is medication adherence. It's not easy to take transplant medications every day, but if you miss some doses, you put yourself at very high risk of losing your organ and dying. This is actually a big challenge in all of medicine. We are developing and testing novel artificial intelligence technology to help people take their medication regularly.
What makes your work in organ transplantation so rewarding/challenging/difficult?
Dr. SegevOrgan transplantation is an incredible field which combines the technical challenges of complex vascular surgery with immunology, infectious diseases, ethics, and policy. We fly in helicopters in the middle of the night to recover organs to save lives. We struggle with reprogramming the immune system to not reject these organs, while still protecting the patient from infections. And, in the context of a profound organ shortage, we have the profound responsibility of deciding who lives and who dies.
What is a major change you've made in organ transplantation in the last few years that you are particularly proud of?
Dr. SegevToday, people living with HIV can be organ donors. Making this possible in the US involved doing the science to predict the impact of HIV-positive donors, writing a congressional bill to make it legal, and doing the first HIV-to-HIV transplants to prove it could be done. Through this work, we not only impacted those in need of transplants, but every single person living with HIV who, until this point, were told that they were too sick to be organ donors.
What is something most people don't know about organ transplantation that you would like them to know?
Dr. SegevIn the past, when looking for living donors, people needed to find someone who was a "match" (in terms of blood type and HLA). Today, with kidney exchanges, chains, and desensitization, this worry is a thing of the past. If you have a healthy, willing living donor, we can make the transplant happen.
Thank you, Dr. Segev.
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