#155 - Chris Sonnenday, M.D.: The history, challenges, and gift of organ transplantation

A surgeon at Johns Hopkins who pioneered the laparoscopic donor nephrectomy, a procedure that significantly increased living kidney donation.

A mathematician and wife of Dorry Segev, who collaborated on developing mathematical algorithms for kidney paired exchanges.

A colleague of Peter Attia and Chris Sonnenday, credited with developing mathematical algorithms for paired kidney exchanges, optimizing donor-recipient matches.

One of the godfathers of transplant and transplant immunology, whose lab Christian Barnard and Mel Williams trained in.

A legendary baseball player, whose story is often associated with the classic stereotype of an older individual suffering from liver disease due to chronic alcohol use.

The host of the Drive podcast and a former resident under Chris Sonnenday at Hopkins. He considers Sonnenday a remarkable leader whose example pushed him.

A legendary general surgeon at Vanderbilt who advised Chris Sonnenday on his surgical residency path, encouraging him to apply to Hopkins.

The program director of surgery at Johns Hopkins during Peter and Chris's residency, later Chair of Surgery at Massachusetts General Hospital, known for investing in residents' development as surgeons, individuals, and leaders.

The Chairman of Surgery at Johns Hopkins during Peter and Chris's residency, known for moderating M&M conferences and leading by example by presenting his own cases.

A plastic surgeon who performed the first successful human kidney transplant in 1954 between identical twins, for which he later won the Nobel Prize, focusing on tissue transfer and immunology.

A significant mentor to Chris Sonnenday during his residency and currently the head of transplantation at NYU. He is a transformative figure in the field of transplantation.

A transplant surgeon and former chief resident at Johns Hopkins, known for his remarkable leadership and ability to maintain humanity amidst the stresses of residency. He is the guest of this podcast episode.

Chris Sonnenday's former chair at the University of Michigan, who emphasized that you can gauge a department's soul by its M&M conference.

A surgeon at Johns Hopkins who, along with Lou Kavoussi, pioneered the laparoscopic donor nephrectomy, making living kidney donation more accessible and safer.

A pioneer in liver transplantation who, in the 1960s, explored combining prednisone with Imuran to improve survival, but faced high early mortality rates leading to a moratorium on procedures.

A student and contemporary of David Hume, who worked in Christian Barnard's lab and later founded the transplant program at Johns Hopkins. He experimented with cross-circulation of baboon and human livers for acute liver failure.

The surgeon who performed the first heart transplant, and who trained in David Hume's lab.

A hepatologist at the University of Michigan who has dedicated her career to understanding alcohol-related liver disease, emphasizing its behavioral disease aspect.

A state that has one Organ Procurement Organization (OPO) covering the entire state, contrasting with states like Texas.

A state with a huge population and high demand for organ transplants, where supply struggles to meet demand when only considering its local unit.

A major urban center facing high demand for organ transplants, similar to California, due to its large population.

A state that has multiple Organ Procurement Organizations (OPOs), making its network potentially confusing compared to states with a single OPO.

The state from which a flight team from Michigan was retrieving lungs when they tragically crashed.

The city where Chris Sonnenday's grandfather, an internist and researcher, practiced.

The area where Chris Sonnenday grew up and played competitive soccer as a child.

The city where Johns Hopkins Hospital is located, where Chris Sonnenday felt lucky and obligated to maximize his residency experience.

A country mentioned in the context of ethical concerns regarding organ sales, where wealthy individuals pay impoverished people for kidneys.

Mentioned as an example of a location where an available liver might need to be transported nationally to a recipient in Michigan or California.

The lake where a flight team from the University of Michigan crashed in June 2007 while retrieving lungs, resulting in the loss of six lives.

A surgical procedure for kidney removal from living donors, pioneered by Lou Kavoussi and Lloyd Ratner, which benefited recipients and streamlined donor recovery, leading to an explosion of living kidney donation.

A biomarker measured in urine twice a year to detect early kidney dysfunction.

A newspaper that published an article about the growth of kidney transplantation in Afghanistan, highlighting the ethical issues of wealth disparities leading to organ selling.

A prestigious medical institution where both Peter Attia and Chris Sonnenday completed their medical residency training.

Chris Sonnenday's current institution where he practices and where he observed improvements in how M&M conferences are run, focusing on patient outcomes rather than individual blame.

The college where Chris Sonnenday played Division I soccer and was a team captain.

Chris Sonnenday's medical school where he initially considered staying for residency before being encouraged to apply to Hopkins.

The institution where Keith Lillemoe later became the Chair of Surgery after being program director at Johns Hopkins.

The hospital where the first kidney transplant was performed in 1954 by Joseph Murray.

The institution where Bob Montgomery, a transformative figure in transplantation and Chris Sonnenday's mentor, is currently the head of transplantation.

Non-profit organizations responsible for identifying organ donors and facilitating the procurement and transplant process nationally.

The city in Wisconsin from which the flight team had taken off and attempted to return before crashing into Lake Michigan.

A corticosteroid used as an immunosuppressant, which Thomas Starzl utilized in early liver transplant attempts.

A common over-the-counter painkiller with a dangerously low lethal dose (LD50), making it a frequent cause of acute liver failure through overdose, either accidental or intentional.

An early immunosuppressive drug used in transplantation, making it a possibility but with high mortality rates compared to modern standards.

An immunosuppressant, similar to cyclosporine, that functions at the level of immunophyllons, interfering with T-cell activation and cytokine secretion.

A groundbreaking immunosuppressant drug derived from a fungus, introduced in the 1980s, that revolutionized organ transplantation by selectively interfering with T-cell activation, dramatically increasing graft survival.

A condition of fatty deposition in the liver leading to chronic inflammation, fibrosis, and eventual cirrhosis, projected to be the leading indication for liver transplantation by 2030 due to the obesity epidemic.

A liver disease that has seen an explosion in incidence, exacerbated by the pandemic, and is now a significant indication for liver transplantation, affecting increasingly younger individuals.

A group of proteins that determine individual tissue profiles, central to immune recognition and compatibility in transplantation.

The transplantation of a kidney, initially performed in identical twins due to immunologic barriers, and later made widely successful with the advent of immunosuppressants.

A medical procedure for kidney failure, which in the 1960s was difficult to access and offered a life expectancy measured in months to years; modern dialysis extends it to around 10 years.

The primary indication for kidney transplantation in the United States, often a consequence of chronic conditions like diabetes and hypertension.

A more sensitive biomarker for kidney function than creatinine, used to detect early kidney dysfunction.

A viral bloodborne illness that historically was a leading cause of liver failure and transplantation, but whose impact has drastically reduced due to the development of highly effective direct-acting antiviral agents.

A more severe form of NAFLD characterized by liver inflammation and damage, a growing indication for liver transplantation.

A measure of kidney function discussed in the context of longevity, with a decline in GFR indicating increasing risk for future kidney issues.

A specialized preservation solution used to store organs on ice during transport, mitigating ischemic injury and improving graft survival.