Next era of transplantation is on the horizon, transplant chief says

Satish Nadig, MD, PhD, the Edward G. Elcock Professor of Surgical Research and director of the Comprehensive Transplant Center (CTC), said he arrived at Feinberg in November 2021 with a mission statement: "to have patient-centric impact through quality innovation and education."

Nadig, who is also chief of Organ Transplantation in the Department of Surgery, looks to build on Northwestern's strong foundation of transplant initiatives and push the CTC into the next era of transplantation. Read a Q&A with Nadig below.

What drew you to Feinberg and the Comprehensive Transplant Center?

The CTC and Northwestern have always been on leading edge of innovation and function as a pipeline for the next generation of transplant surgeons and physicians. Northwestern Memorial Hospital has the number-one transplant program in the city — we performed 510 total solid organ transplants in 2021, a 28 percent increase from the previous year — and we need to build on that.

This is especially important as I believe we're on the cusp of the next era of transplant: the era of technology and innovation.

Where is the transplant field now, and what's around the corner?

Transplant has a very interesting history. After the very first transplant was performed in 1954, there was an era of immunosuppression: People had to trick the immune system to keep organs from rejecting. After that, we improved preservation to transport organs across state lines and sharpened surgical techniques to perform minimally invasive procedures and use less blood, to name a couple of examples.

Since the '90s, we've been very focused on policy and allocation — which is quite important, especially in regards to racial inequality in transplants — but the actual science of transplantation has not moved much since the '90s.

Here at Northwestern, we have the scientists and the interdisciplinary framework to bring things like cellular therapies, CRISPR/Cas9 technology and bioengineering from the bench to the bedside. For example, we are very interested in nano-therapies, and we are working with experts like Samuel Stupp and Evan Scott to jump-start our efforts here.

We can improve care before surgery, too, so we're doing things including pre-treating organs prior to transplantation to minimize the need for immunosuppression, and using biomarkers to replace invasive biopsies to improve quality of life for patients.

What makes transplantation different from other fields?

One of the things that transplant has that few other medical fields do is access to human organs. About 40 percent of donated organs go untranslated, for various reasons. This provides a tremendous opportunity for research: When a donor gives up an organ, their intention can be realized not by immediately saving a life, but by changing a paradigm in the field of transplant.

Further, transplant surgery itself is so broad-based and takes many skill sets. A transplant surgeon can operate above and below the diaphragm and in adults and children. We work with blood vessels, minimally invasively and in open surgery, and have to possess working knowledge of the medicine behind many different physiologies.

In addition, and perhaps most importantly to me, it's one of the only fields that relies on man’s humanity to man — we don’t have a job unless somebody gives up a part of themselves, in life or in passing, to help someone else.