WASHINGTON— Georgetown University Medical Center (GUMC) announces the formation of the Center for Translational Transplant Medicine to explore novel findings that could lead to a completely new approach in transplantation.
The centerbrings to bear the expertise of a wide variety of laboratory scientists at GUMC — immunologists, cell biologists, biostatisticians and a host of others, to collaborate with physicians at the MedStar Georgetown Transplant Institute (MGTI).
The center’s co-directors are Thomas Fishbein, MD, executive director of the MGTI, and Michael Zasloff, MD, PhD, director of surgical immunology and scientific director at MGTI.
The two physician-researchers plan to tackle what they call the “Holy Grail” of transplant medicine — finding a way to suppress the ability of a patient’s immune system to reject a transplanted organ, but not suppress the body’s critical need to fight bacteria and other pathogens.
Fishbein and Zasloff have been on the cutting edge of what scientists have only recently come to appreciate — that there are two different immune systems, each with its own army of cells and biological mechanisms that co-exist within the human body.
“Anti-rejection drugs suppress the adaptive immune system, which fights foreign tissue, as well as the innate immune system, which fends off pathogens,” Fishbein explains.
The drugs that patients must take to suppress the immune system from rejecting their “new” organs are ironically the same drugs that lead to the new organs’ demise, Zasloff says.
Given this new information, Fishbein and Zasloff say it might be possible to design drugs that turn off (or “exquisitely modulate”) the adaptive immune system, leaving the all-powerful and protective innate immune system intact.
It will take a marriage of clinicians and scientists, such as the union occurring in the new center, to solve this immunity modulation problem, says Fishbein. “We have to integrate clinical programs and very sophisticated immunologic studies that can’t be done alone,” he says. “When clinicians encounter problems in transplantation, we have to be able to go back to the immunologists and cell biologists to solve those fundamental problems, and bring solutions back to the human transplant program.”
The MGTI, created in 2010, merged all organ transplant programs in the MedStar Health network. “In that short time, we have become a national leader in both volume and clinical outcomes,” says Fishbein.
With nine surgeons and more than 20 physicians, the institute transplants more than 300 solid organs a year at MedStar Georgetown University Hospital, and most of these transplants are abdominal organs — the bowel, pancreas, liver and kidneys.
Fishbein says the approach to transplantation medicine has become personalized.
“One of the goals of the center is to use the powerful molecular tools we have to identify individuals who are at greatest risk of rejection due to their genetic inheritance,” Fishbein says. “There was a time when every patient was treated the same. They came in for a transplant, we looked at a few immune parameters and that was it. Now we know there are genes we can focus on that may mean the difference between a successful transplant and one that will fail. And we need to apply these findings to all different organs being transplanted here.”
“We are entering a new era of transplant immunology, and this center has great potential to make a very big difference in the lives of our patients,” Zasloff concludes.
About Georgetown University Medical Center
Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health). GUMC’s mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing & Health Studies, both nationally ranked; Georgetown Lombardi Comprehensive Cancer Center, designated as a comprehensive cancer center by the National Cancer Institute; and the Biomedical Graduate Research Organization (BGRO), which accounts for the majority of externally funded research at GUMC including a Clinical Translation and Science Award from the National Institutes of Health.