Transplant Surgery and Epidemiology
MD from Johns Hopkins University School of Medicine; PhD from Johns Hopkins Bloomberg School of Public Health
Associate Vice Chair, Department of Surgery, Johns Hopkins University
I founded and direct the Epidemiology Research Group in Organ Transplantation, which consists of 12 core faculty, 14 affiliate faculty, 17 residents and students, and 40 analysts and research assistants at Hopkins, as well as collaborators from all over the world. Our NIH-funded research includes two national trials of HIV-to-HIV liver and kidney transplantation, a longitudinal cohort study of living kidney donor risk and outcomes, a longitudinal study of frailty and its impact on liver and kidney transplant outcomes, a randomized trial of prehabilitation in preparation for transplantation, a longitudinal study of HLA and ABO incompatible kidney transplant outcomes, development of mathematical methods to improve equity in organ allocation, and a randomized trial of education-based and social media-based advocacy initiatives to help expand living donation. With my background in computer science, and my graduate degree in biostatistics, I also focus on advanced mathematical approaches to leverage the big data available in our field to improve policy and patient care.
What made you decide to work in transplantation?:
When I rotated on the transplant service as a surgery resident, I thought to myself “These people must be totally insane to fly in the middle of the night to get organs and then spend the whole night and next day transplanting them into patients with end-stage organ disease whose immune systems we purposefully annihilate. Where do I sign up?”
What do you find to be the most valuable aspect of your work?:
Transplant surgery is a beautiful balance between helping people one at a time in the operating room, helping people thousands at a time through changes in policy and patient care, and mentoring the next generation to do the same. An example of this has been the HIV Organ Policy Equity Act, a congressional bill that I conceived of, drafted, and advocated for several years ago. In 2010, we watched HIV+ patients dying on our waiting list while throwing away HIV+ organs because of a restriction in the National Organ Transplant Act; we wrote a paper in AJT estimating the size of the potential HIV+ donor pool and the impact it would have on our field; we worked with the NY Times to get this on the front page, to give it legitimacy with congressional staffers; we worked for 3 years on the Hill (with a particular shout-out to my mentee Dr. Brian Boyarsky for countless hours of work, and to members of AST, ASTS, UNOS, AOPO, and many other organizations for their support) to get a bill introduced and passed; we performed the first HIV-to-HIV transplants in the country; and then we worked with the NIH to fund a national trial to help HIV+ patients across the country (with another particular shout-out to my mentee and now co-PI Dr. Christine Durand for her outstanding leadership and insights). I can’t think of a more rewarding experience, full-circle from a problem that affected our patients to a policy solution that we were able to directly apply to our patients, with dozens of opportunities for mentorship along the way.