Investigating the Immunological Mechanisms Underlying Organ Transplant Rejection

My Name is Sang Mo Kang of the UCSF Department of Surgery. I'm a transplant surgeon. My work is trying to understand the immunology underlying transplant rejection.

Mechanistic studies are are best performed in road models as there is. It's very difficult to perform these types of studies in humans for obvious reasons. The models that we use are useful for trying to understand the mechanisms, which can then lead to potential development of therapies for human use.

But there would need to be a translation of this work often into primate models before going to human Trials. The Heterotopic heart transplant is performed by placing the donor heart into the abdominal cavity of the recipient. The donor aorta is hooked up to the abdominal aorta of the recipient.

The donor pulmonary artery is then anastos to the inferior vena cava of the recipient. The heterotopic heart transplant model is a useful model for transplant immunology because unlike skin transplants, which are very, very difficult to obtain, tolerance to heart transplants are a little bit easier to prolong transplant survival using a variety of techniques. So it serves as a useful assay of the overall immune response to Transplants.

The small Bowel transplants are performed by placing a choral patch that includes the superior mesenteric artery that supplies the small intestine into the aorta of the recipient. The portal vein, which drains the superior mesenteric vein of the donor small bowel, is then plugged into the inferior vena cava. This model is useful for studying the unique responses to small bowel transplantation.

In terms of the immune response. As the rejection rates of small bowel transplants are much higher than for other types of transplants, I Think that the views of people who are opposed to animal research are valid to a certain extent and certainly believe that the researchers throughout the US have tried to minimize the use of animals and to treat the animals very humanely. We have very strict regulations on how we can treat the animals and, but having said all that animal research is critical for developing new therapies, whether they're medical or surgical.

Certainly the advances that have been gained up until today would not have been possible without animal research. And there's really no way to continue medical progress without using animals at some level. So I think that if you cut out the use of animals, you're would be basically be saying that you don't want to have any further medical Progress.

The challenges of working both as a transplant surgeon and a scientists are certainly, there's quite a number of them. One obviously is, is the time commitment of both professions and certainly the amount of training that's required to be proficient in both transplant and research. So basically you have two full-time jobs.

The the nice thing about transplant is that I work with a number of partners who are excellent and we can cover for each other. So we have very discreet time periods when we're taking care of patients and when we're not taking care of patients, we can really fully focus on the research. Transplant surgery has traditionally been very research oriented because it's very young field and it's very tightly integrated with advances in the lab, which are then fairly rapidly translated to the clinical arena.

So it it, although it's very difficult, it's also a very exciting marriage of professions.