As a surgeon, I'm particularly interested in intestinal transplantation and how the transplanted intestine functions. Small-bowel transplantation is the new frontier in transplantation. There are four major centers in the United States doing these today. Though the results are improving at a steady rate each year, there still are many complications and a lot of dysfunction after surgery. Because the intestine does not exist in a sterile environment, and organ rejection poses a serious risk for the patient, most research has been done by immunologists. This research has focused on how to prevent the organ from rejecting and how to treat rejection. Very little has been done on how the organ actually works after the transplant.
To focus on function and not on immune system responses, we transplant within the same animal. The term for this is autotransplantation, taking the denervated organ out and putting it back in the animal. Occasionally, we'll use rats that are immunologically identical so that we can study the effects of the transplantation without having to use medication to suppress the immune system.
How Might this Research Contribute to Our Understanding of Disease and Potential Treatment or Prevention of Disease?
There is direct clinical application. Some operations involve cutting the nerves to the stomach or the intestine, and disorders such as diabetes may lead to denervation of the intestines. If we can understand the way the denervated intestine works, we might be able to come up with new pharmacologic treatments or surgical procedures that would maximize the function of the intestine. Our major goal, however, is to understand the denervated intestine so that we may better understand how the transplanted intestine works.
How Do You See Your Work Contributing to Mayo's Mission?
The field of transplantation is a major focus of this institution. We've developed heart, liver, kidney, lung, pancreas and heart-lung programs here. Mayo Clinic is one of the leading healthcare centers in gastrointestinal diseases, and we have a large patient population who could be helped by intestinal transplant.
How Does Mayo Clinic Contribute to the Success of Your Research?
When I came to Mayo, I was given time to develop a research program that would attract peer-reviewed extramural funding by the National Institutes of Health. I also was given technical support, secretarial support, space, start-up funds to buy the equipment I needed, and a research budget.
Today, I collaborate with world-class gastroenterologists and basic scientists, all of whom are well known in the field and have tremendous ideas. And you couldn't ask for better mentors than Keith A. Kelly, M.D., Eugene P. DiMagno, M.D., Joseph Szurszewski, Ph.D., and Nicholas F. LaRusso, M.D. In addition, my technician, Judy Duenes, and my secretary, Debbie Frank, have worked with me for sixteen years. We're a team.
