Pancreas Transplant To Cure Diabetes Seminar
 

SPEAKERS

Dr. Anil Vaidya MBBS, DNB (General Surgery), MD (Transplant Surgery)
Professor of Transplant Surgery and Chief, Intestinal and Pancreatic Transplant Service
Apollo Hospitals, Chennai, India

Dr. Anil Vaidya is a multi-organ transplant surgeon with a varied clinical, translational and academic portfolio. After completion of his surgical/urological residency he went on to do an American Society of Transplant Surgeons (ASTS) accredited fellowship in multi-organ transplantation at the University of Miami.

He has been a Consultant Transplant Surgeon at the Oxford University Hospitals for 12 years where his main focus was on developing a robust pancreatic, intestinal and multi-visceral transplant program. With his leadership, the Oxford Transplant Centre is now by far the largest Pancreas Transplant Centre in Europe and fast becoming the Centre known for the most amount of Pancreas alone transplants worldwide. He is responsible for restarting the intestinal transplant program in the UK and bring it onto the map in the intestinal transplant community by organizing the International Conference for intestinal Transplant, biennial meeting at Oxford in 2013.

Dr Vaidya’s profile include a few firsts:

1. A world-first ground breaking multi-organ transplant, for Pseudo-Myxoma Peritonei, a disease that had no treatment until then. This has now become standard practice for patients with Pseudo-myxoma Peritonei who fail conventional therapy.

2. He is credited for having done the first composite tissue allograft (CTA) transplant in the UK in the form of vascularised abdominal wall transplantation to complement intestinal transplantation.

3. He currently holds the largest series of cases of abdominal wall transplants.

4. He is the first surgeon in the world to do a sentinel skin flap with a multi-visceral graft to help in monitoring the intestinal graft.

5. He was the first surgeon in the world to introduce the concept of ‘nephron sparing’ auto-transplantation for solitary kidneys with tumours.

6. He currently has the world’s largest successful series of renal auto-transplants for solitary kidneys with cancer.

7. He remains one of the few surgeons in the world who has done over 1000 pancreas transplants.

8. In October 2013, Dr Vaidya became the first surgeon in the world to successfully use Stem Cells to treat a patient with intractable bowel dysfunction after intestinal transplantation.

9. He is the first surgeon in the world to have successfully re-transplanted a composite tissue allograft after chronic rejection.

10. He conceptualized and helped in executing the first ever vascularised facial nerve transplant in the world for a patient that was already on immunosuppression for an intestinal transplant.

11. He currently has the most experience in the world in Pancreatic Transplantation with more than 1000 cases to his credit.

Apart from clinical kidney, pancreas and intestinal transplantation, his areas of translational research interest include developing novel strategies for improved graft surveillance and survival. At Oxford, they averaged 80-90 pancreas transplants a year with a big focus on deceased donor and extended criteria pancreas transplantation. The program does about 150-180 kidneys a year and has an active ABO and highly sensitised kidney transplant service including paired exchanges.

In addition to the pancreas and kidney-transplant service, he has been the pioneer for the intestinal transplant service. Here they averaged about 35 transplants in the last 5 years, with an 80% 3-year graft and patient survival. Six of their 25 patients have now reached the 5-year mark with their first grafts.

Publications:

Dr Vaidya has authored more than a 120 articles in peer-reviewed journals and continues to be very interested in active writing and publishing scientific data. His rating by Research Gate puts him among the top 3% of the surgeons in the world.

Teaching Experience:

He has a passion for education and has been a post-graduate teacher, as well as under-graduate teacher for over 10 years at Oxford. This has involved playing an active role in teaching the allocated medical students according to a pre-set syllabus. He has been a post-graduate teacher who has been involved with didactic teaching sessions for the residents in the hospital as well as in the region. Furthermore, he is a post graduate supervisor with access to resident’s log books and is involved in the certification process for these residents during their tenure in the hospital.

He has a keen interest in teaching operative skills and often embarks on that track in the operating room.

Research Interests

A. Intestinal Transplantation:

1. Interest in developing patient-led remote methods of immune monitoring for visceral transplants. This includes the use of vascularized sentinel skin flaps from the same donor.

2. Abdominal wall transplantation to complement intestinal transplantation.

3. Developing the use of Mesenchymal Stromal Cells (MSC) in intestinal transplantation.

4. Developed a scoring system to design a pathway for referrals for intestinal transplantation in Crohn's disease.

5. Major interest in the role of Intestinal transplantation for slow growing tumours in the abdominal cavity, especially neuro-endocrine tumours (NETs) and pseudomyxoma-peritonei (PMP).

B. Pancreas Transplantation:

1. Optimal use of pancreas grafts from extended criteria donors.

2. Patient led remote immune monitoring of pancreas graft.

3. Radiologic methods of determining functional islet cell mass in transplanted grafts.

4. Determining the volume of apoptotic signals from a transplanted pancreas for longitudinal monitoring of the graft.

5. Development of alternate sites for pancreatic islet cell infusion.

6. Pharmacological and immunological rescue therapy for failing pancreas grafts.

C. Auto-transplantation:

1. Key role in developing a renal auto-transplant service in the UK for solitary kidneys with tumours not resectable by conventional means.

2. Interest in auto-transplantation for slow growing tumours in the abdominal cavity

3. Expanding the role of auto-transplantation for major visceral trauma

D. Translational medicine

1) Normothermic preservation of ECD pancreas and kidney before transplantation

2) Patient-led immunological monitoring of visceral graft with sentinel skin flap from the same donor

3) Evaluating and defining skin characteristics in patients with a vascularised sentinel skin or a vascularised composite abdominal wall transplant.

4) Radiological imaging of beta cells after whole organ transplantation

5) Rescue therapy of a failing whole organ pancreas graft

6) Lymphatic activation markers after intestinal transplantation.

7) Developing a tissue engineered pancreas unit using vascularised donor strattice as alternate sites of islets infusion.

Former Patient Experience:

To learn more about the pioneering work that Dr Vaidya has taken on to improve the quality of life of his patients, please visit:

A blog written by his former patients.

http://beingapatient.blogspot.in/2013/01/interactive-bowel-transplant-patient.html?view=flipcard

A book written by his former celebrity patient in which he was asked to author a chapter

http://www.saintssuperstore.com/saints-souvenirs/books/1582_Steve-Prescott-Book-One-in-a-Million.html#

LIFETIME CAREER GOALS:

1. Establishing the ‘World Transplant Foundation’. To enable equal access to transplantation for patients who do not have transplant services in their country and also for those people who may not be able to afford it.

2. Establishing a world-wide central network of HLA matches to enable a world-wide paired exchange program for kidneys.

3. A world free of dialysis by 2050.

4. Cure for diabetes by 2030.

5. Multi-visceral transplantation for un-treatable, locally metastatic tumours of the abdominal cavity.

CHARITABLE WORK DONE WORLDWIDE:

1. Development of a Transplant Program in Minsk, Belarussia.

2. Development of a Transplant Program in Sousse, Tunisia.

Both these programs are now mature transplant units and have themselves become mentors for other start up programs in North Africa as well as Asia. Furthermore, there is not a single child on dialysis, waiting for a transplant in these countries.