Top Docs Q&A: Mohamed Akoad

He recently participated in chain of 10 live donor kidney transplants.

This post is part of our Top Docs Q&A series where we ask a physician who was selected as one of our Top Docs questions about their field, life as a doctor, and practicing in the Greater Boston area. 

Name: Mohamed Akoad

Hospital Affiliation: Lahey Hospital and Medical Center

Title: Senior staff surgeon in Lahey Hospital’s department of transplantation; Assistant professor of surgery at Tufts University School of Medicine

Field: Surgery

Specialty: Organ transplantation

This March, Lahey Hospital and Medical Center was one of the 10 hospitals across the U.S. that participated in a chain of live donor kidney transplants, which resulted in 10 lives saved. Mohamed Akoad performed the surgeries.

Why did you choose the speciality of transplantation surgery?

When I was a resident in New York I saw the impact that an organ transplantation really has on the patient, so I decided to pursue it.

What do you love most about the field?

I love the way that organ transplants can really transform a person’s life. I see patients who were sick and on the verge of dying, but just a few months after they receive an organ transplant they are energetic, active, and able to return to their normal activities. It’s pretty amazing.

How has the field of transplantation changed?

Transplantation is a relatively new field in medicine. The first successful kidney transplant was in the ’50s and the first successful liver transplant in the late ’60s. It wasn’t until the ’80s that liver and kidney transplants became consistently successful. Now they are continuing to improve because of advancements in techniques, understanding of the diseases that cause organ failure, and better patient management.

What are some of the most recent advancements in transplantation?

There have been many trials on minimizing the use of immunosuppressants (a medication that prevents the recipient from rejecting the organ after a transplant). Long term immunosuppression has dangerous side effects like increasing the risk of infection and cancer. I was involved in some of these trials in Pittsburgh, around 2004 to 2007, and we saw success in lowering the amount of immunosuppressant medications in patients.

What do you hope for the future of transplantation surgery?

I hope we will be are able to do transplants without immunosuppressants. Also, another exciting advancement on the horizon is organ engineering, which uses something called regenerative technology to synthesize and manufacture tissue and organs. I think within the next five or 10 years we could possibly see this coming out, and if this were to become a reality it would help solve the problem of organ shortages.

In March, Lahey Hospital participated in a chain of 10 live kidney transplants, how did the exchange work?

Through the National Kidney Registry (NKR) we participate in an exchange program called the live donor kidney transplant program. Essentially, if a patient has someone willing to be their donor but they are not compatible, then that kidney would go to someone else while the patient would receive a kidney from a different compatible donor. The exchange that recently happened was a notably large one with 10 medical centers across the nation. The procedures started on a Tuesday and by Wednesday night we had 10 lives saved as a result of this collaborative effort.

How does it feel to be involved in such a immensely successful effort? 

I performed the transplant on the kidney recipient here at Lahey. We were already very happy that our patient had a successful operation, but then later that day we heard that all of the transplants were successful. It really made me appreciate the effort of everybody involved, and that because of the hard work of the people at the NKR we were able to logistically do this. It felt absolutely incredible.

What went into making this exchange actually work?

There were so many factors that had to work out for this to come together like compatibility, logistics, timing, etc. To put it into perspective, the kidneys actually were transported on commercial flights, so we had to fly 10 kidneys all over the country and get them transplanted in a matter of hours.

Are you hoping to see more large chains like this in the future?

Yes, every time we have a recipient who has a donor that’s not compatible we submit an application to participate in the exchange program. However, there’s obviously a lot of work that the NKR must go through before an exchange of this size can happen. There are many patients waiting for organs but there are not enough organs out there, especially compatible ones, which is why it’s such a big deal that we were able to utilize the registry so effectively this time around.

What do you like most about practicing in Boston?

Boston has world class institutions for research, medical care, and medical schools. When you get used to living in New York City, you think you can’t live anywhere else, but I came to Boston after my residency and I loved the city and medical community. In fact, I went to Pittsburgh after my fellowship in Boston, but ended up coming back here partly because I really enjoy being a part of the Boston transplant community.