Daniel Kreisel1, Jin Ye Yeo2
1Division of Cardiothoracic Surgery, Department of Surgery, Washington University in Saint Louis School of Medicine, St Louis, MO, USA; 2JTD Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. JTD Editorial Office, AME Publishing Company. Email: jtd@amepc.org
Expert Introduction
Dr. Kreisel (Figure 1) is a tenured professor of Surgery, Pathology and Immunology at Washington University in St. Louis. He is a general thoracic surgeon and serves as the surgical director of the Washington University lung transplant program as well as the scientific director of the Washington University / Barnes Jewish Transplant Center. He holds the G. Alexander Patterson MD / Mid-America Transplant Endowed Distinguished Chair in Lung Transplantation. Dr. Kreisel received his M.D. degree from the Mount Sinai School of Medicine and his Ph.D. in Immunology from the University of Pennsylvania. He completed his residency in General Surgery at the Hospital of the University of Pennsylvania and his residency in Thoracic Surgery at Washington University in St. Louis. He oversees a federally funded basic research laboratory where his work focuses on innate and adaptive immune responses after lung and heart transplantation as well as on mechanisms that regulate the trafficking of leukocytes in lung and heart transplants.
Dr. Kreisel is a member of multiple professional organizations including The American Society for Clinical Investigation, The Association of American Physicians, The American Surgical Association, and The American Association for Thoracic Surgery. He has published over 310 peer-reviewed articles, and he has served on editorial boards of several journals and as a standing member of NIH study sections.
Figure 1 Dr. Daniel Kreisel
Interview
JTD: What drove you into the field of thoracic surgery?
Dr. Kreisel: My primary research interest has always been in transplantation. As a medical student, my goal was to become a liver transplant surgeon. During my surgical training at The University of Pennsylvania I developed an interest in thoracic surgery, which was in large part driven by mentors in this field that I was exposed to. During my surgery residency I also obtained a PhD in Immunology, which was instrumental in helping me develop a career as an independent investigator in transplantation immunology.
JTD: What were some of the most crucial breakthroughs in lung transplant immunology in recent years?
Dr. Kreisel: Important advances in lung transplantation immunology have, in part, been facilitated by new pre-clinical mouse models that have been developed by our laboratory at Washington University. Many research groups use these models, which have allowed for new discoveries of pathways that drive ischemia reperfusion injury, acute rejection, chronic rejection, and promote tolerance. We have learned that mechanisms that regulate these processes differ between lungs and other transplantable organs.
JTD: What do you think are the most pertinent current gaps in lung transplantation immunology that are hindering the success of lung transplantation (e.g limiting the long-term survival/ quality of life of patients after transplant)
Dr. Kreisel: Immunosuppressive drugs that are used for our lung transplant patients are mostly based on clinical experiences with the recipients of other solid organs. However, research over the last few years has clearly shown that the immunological characteristics of lungs are different from those of other transplantable organs. Therefore, I believe that new therapeutic strategies need to be developed that are specifically tailored for lung transplant patients. Drs. Joren Madsen at Harvard University, Ramsey Hachem at The University of Utah and myself are overseeing a large clinical trial in North America where we are testing a new immunosuppressive approach for lung transplant patients. The foundation for this trial was based on experimental studies.
JTD: During your research, what are the biggest challenges you have faced? How did you overcome them?
Dr. Kreisel: The biggest challenge that a surgeon-scientist faces are to combine a clinical practice with a research effort and excel at both. Both can be full time endeavors. Francis Moore, a former Surgeon-in-Chief at the Peter Bent Brigham Hospital stated that a surgeon-scientist must be a “bridge tender”. He said that “those at one end of the bridge say that he is not a very good scientist, and those at the other end say he does not spend enough time in the operating room”. Yet, a career as a surgeon-scientist is very rewarding. Encountering problems in the clinical setting helps surgeons ask scientific questions that are significant and may translate into therapies that make a difference in our patients’ lives.
JTD: Can you tell us about any new and exciting projects you're working on? How will this influence your next steps in your research journey?
Dr. Kreisel: In collaboration with multiple groups at Washington University and other institutions, our laboratory works on multiple facets of transplantation immunology. We have learned that transplantable organs differ with regard to their immunological characteristics. We are defining pathways that result in ischemia reperfusion injury after lung and heart transplantation, where we are taking advantage of intravital imaging platforms to understand the cues that regulate the trafficking of various immune cells in these grafts. We are investigating immune mechanisms that mediate rejection and tolerance after lung transplantation and aim to identify new therapeutic targets.
JTD: The Lung Transplant Program at Washington University School of Medicine in St. Louis is recognized for its excellence and is ranked among the best in the U.S. You have previously shared your vision of achieving personalized medicine for each lung transplant patient under this program (1). How are you and your team working towards this goal?
Dr. Kreisel: In being appointed surgical director of the lung transplant program at Washington University, I was fortunate to succeed two giants and pioneers in this field, who directed the program before me and, in close collaboration with the Washington University transplant pulmonologists, established the international reputation of this program, Drs. Joel Cooper and Alec Patterson. Joel and Alec were the reason I decided to move to St. Louis to pursue my cardiothoracic surgery training at Washington University and I have greatly benefited from their mentorship over the years. A hallmark and distinguishing feature of the Washington University lung transplant program has been that, since its inception, a large and successful clinical program has been complemented by a productive research laboratory. Our laboratory (where over the years I have had the pleasure to work closely with many superb investigators who are close friends including Sasha Krupnick, Andy Gelman, Ruben Nava, Kory Lavine and Wenjun Li) has contributed significantly to advances in this field, including the development of several mouse models of lung transplantation which have shed new light on immune mechanisms that regulate the fate of transplanted lungs.
JTD: In addition to practicing thoracic surgery, you are also a member of multiple professional organizations and have published more than 310 peer-reviewed articles. How do you manage your time and energy in juggling your professional commitments?
Dr. Kreisel: There are limited hours per day. It is important to focus on things that are essential, professionally and personally, and avoid unnecessary distractions. We are all being regularly approached with a wide variety of “asks”. One has to learn to prioritize and be comfortable saying “no” at times. However, if one agrees to complete a task, it must be done well and in timely fashion.
JTD: As an Editorial Board Member, what is your expectation for JTD?
Dr. Kreisel: Over the last years, JTD has developed into a highly respected journal that attracts authors and readers from the entire world. It has been very successful in assembling an editorial board that represents multiple countries throughout the world. I think JTD could provide a great platform to foster international collaborations in thoracic surgery.
JTD: What would be your advice for early career researchers?
Dr. Kreisel: Mentoring trainees and junior faculty members is critically important and one of my favorite activities. A great advice that I received and that I tell my mentees who are interested in careers as physician-scientists is to align one’s research interests with one’s clinical interests and try to become an expert in a defined field. Also, it is critical for early career surgeon-scientists not to get discouraged if grant applications or manuscripts are not being favorably reviewed. As Dr. Samuel Wells, a former chairman of Surgery at Washington University in St. Louis and an elite surgeon-scientist stated in his 1995 Presidential Address to The American Surgical Association “Often the only personal characteristic separating the successful from the unsuccessful surgical scientist is perseverance”.
Reference
- William.A landmark achievement: lung transplant program completes 1,900 transplants. Washington University School of Medicine in St. Louis. 2021. Accessed May 13, 2024. Available online: https://surgery.wustl.edu/a-landmark-achievement-lung-transplant-program-completes-1900-transplants/