the question always asked is if it’s safe
to transplant this patient with this
organ, and Dr. Pando can answer
that.” She explains that understanding
the compatibility between the organ
donor and the recipient is very
important for minimizing the chances
of organ rejection.
A leading researcher in immunology,
Dr. Pando wants to find ways to better
predict whether an organ will be a good
match for the recipient. “The tools we
currently have to assess compatibility
work well, but I think they can be
better,” he says. Currently, Dr. Pando
is able to examine antibodies from the
recipient and the antigens from the
donor organ to predict whether they
will be compatible. This “virtual cross
matching” can shave four hours off
the crucial time between the offer of a
donor organ and the start of surgery.
At Scott & White Medical Center
– Temple, Dr. Pando directs a lab with
a staff of four, and is excited about the
advantages of working with a smaller
team. “At other labs, you don’t get
time for innovation,” he says. “Here,
I think I have that opportunity.” He
also sees the chance for growth. “Here
we have a big opportunity to build this
transplant program and this transplant
laboratory,” Dr. Pando says. “We can
build the lab at the same pace the
program is increasing.”
in Dallas. The kidney transplantation
program has experienced a big increase
in the number of organs transplanted.
The program is on pace to transplant
130 kidneys this year, Dr. Kaplan says,
a much higher rate than the average of
30 to 40 kidneys per year. He credits
that increase to Dr. Lappin taking a
more aggressive, pioneering approach
that reflects a change in philosophy
toward kidney transplantation.
Dr. Lappin explains that many
organs from deceased donors have
some injury, and may not be “fit” to
transplant. But the kidney is a hardy
organ, and an imperfect one can
recover after a successful transplant,
says Dr. Lappin. Transplant surgeons at
Temple now take a closer look at donor
kidneys that may be imperfect. “Instead
of thinking about why you should not
use a kidney when you get an organ
offer,” she says, “you look at the organ
offer and see why you should use it. We
ask the question, ‘What potential does
this organ have, and who can I get off
dialysis with this kidney?’”
Getting patients off dialysis is a
priority for the transplant team. “The
right thing to do is push the envelope
for these patients rather than letting
them die slowly on dialysis. And they
will,” Dr. Lappin says. She stresses
that patients are told the circumstances
of the donor kidney and make the
decision with their doctors. “There
is full partnership with the patient,
full disclosure.”
Pancreas transplantation
Dr. Lappin’s team also performs
pancreas transplants, a less common
procedure. “Pancreas transplant is one
of the best kept secrets in the world,”
she says. “Pancreas transplant benefits
a very small population in a huge
“At other labs, you
don’t get time for
innovation. Here,
I think I have that
opportunity.”
— Marcelo Pando Rigal, PhD
Kidney transplantation
Wait time for a kidney transplant
at Scott & White Medical Center
– Temple is down to a year or less.
Dr. Kaplan says the average wait time
is five years in Austin, four to five years
in San Antonio, and three to four years
bswhealth.com | Fall 17 THE CATALYST
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