Dr. 史蒂文·海斯 is a pulmonologist and the medical director of the UCSF肺移植项目. The program is one of the most successful in the nation in terms of overall patient survival rates. Below, Hays talks about the program's success, his hopes for the field and the best part of his job.
这个项目成功的秘诀是什么?
我们团队的实力. We work very well together and every person is experienced and dedicated. The surgeons and pulmonologists are frequently in the limelight but it's the strength of everyone behind the scenes — the 护士协调员, 药剂师, 物理治疗师, dietitians and social workers — that makes UCSF's program top-notch.
We also recognize that paying attention to the whole patient makes the biggest difference. For instance, in patients with connective tissue disease, like 硬皮病, the lungs as well as the skin, joints and digestive tract are affected. We've developed protocols to help these patients manage the disease in the other organs, so it doesn't have a detrimental effect on the success of the transplant.
Our multi-faceted approach doesn't end at discharge. When people get lung transplants at UCSF, they become our patients for life. 移植后, patients come back regularly for appointments with nutritionists, 护士协调员, 十大赌博平台排行榜和药剂师, 当然, 进行严格的年度检查. We've spent the past 10 years refining our follow-up protocol and it has had a huge impact on our patients' long-term success.
The UCSF肺移植项目 is known for accepting patients with complex cases who've been rejected by other centers. 为什么要冒这个险呢?
我们不会回避复杂的案件. Pushing the boundaries is how we develop our expertise. We figure out what works for patients who come to us with complex issues and we report our outcomes to the broader community in hopes that others may benefit. Over time, that's how transplant medicine improves and transforms.
What about UCSF's internal culture makes this possible?
加州大学旧金山分校创造了一种非常协作的文化. We have fantastic providers who have mutual respect and trust for one another. Because we work well together, we can put our egos aside to agree on what's best for patients. At the end of the day, everyone is invested in the patients and the program.
We also have incredible collaborators from specialties such as pathology, 传染病, 心脏病学, 血液学, 重症监护和胃肠手术, 举几个例子, who have really helped us develop our protocols and provide state-of-the-art care for our patients.
移植治疗的前景如何?
Increasingly we are taking a holistic approach to transplant care. We've seen how diet and exercise — both before and after surgery — can help our patients thrive. Without a doubt, lung transplant surgery is hard on the body. So we are creating specialized nutritional and exercise programs for our patients in hopes of helping them live longer, fuller生活.
What are the biggest challenges in lung transplantation today?
The biggest challenge continues to be chronic rejection of the lungs. Up to 50 percent of recipients see signs of rejection at the three-year mark and we don't really understand why.
Lungs are rejected more often than other organs, like kidneys or hearts. We think environmental factors are at play since the lungs are the only solid organ transplant that is continuously exposed to the outside world. That exposure makes the lungs susceptible to infections and other pathogens.
If we could understand what causes the body to reject lung transplants, that would be the Holy Grail. 与此同时, our understanding of what makes for long-term success is getting better all the time and the past decade has seen improvements in survival rates.
In the realm of lung transplant, what achievement do you hope to see in your lifetime?
While I'm a firm believer in the benefit and utility of transplant, the ability to cure some of the underlying diseases that require lung transplant is something I think is feasible in my lifetime.
其次, 对于那些需要移植的病人, I hope we'll have a better understanding of the complex relationship between the immune system and the new organ.
你最喜欢你的工作的哪一点?
The best part of my job is seeing my patients navigate a very scary time in their lives and come out the other side. 当他们到达移植点时, most of our patients are grappling with issues of death and dying. Being able to walk people back from that precipice is an amazing feeling.
I get to make a huge impact on someone's life and then keep long-term relationships with them and their families. 没有比这更好的了.
