Hi, I'm Jonathan Bromberg. I'm a professor of surgery and microbiology
here at the University of Maryland.
I am a kidney and pancreas transplant surgeon and I've been a
kidney and pancreas transplant surgeon for over 20 years.
My background is medical school and an MD PhD at Harvard Medical School.
Residency at the University of Washington in Seattle and a multi-organ
transplant fellowship at the University of Pennsylvania.
I've been as I said practicing for over 20 years doing kidney and pancreas
transplantation also doing dialysis access for
kidney transplant patients and general surgery procedures on organ failure patients
whether it's kidney failure, pancreatic failure, or other types of failure.
I have a huge interest in these patients and providing really comprehensive care
to patients with renal failure and with type 1 diabetes and pancreatic failure, too.
I introduce to them the types of options available for treating these diseases
through transplantation or through other medical modalities
and to follow these patients for very long periods of time
from the time that we've worked them up and place them on the list
following them while they're on the list and making sure things are going okay for them
and then from the time of transplant.
Transplanting them, taking care of them while they're in the hospital
and taking care of them in the outpatient facility.
We're concerned about first and foremost having excellent outcomes
that people receive kidney transplants or pancreas transplants that work
and work well and work for a long period of time.
We're concerned about all of their medications particularly their immunosuppressive medications
and that each person receives the right amount and the right dose of medication
for them and their organ and their immune system
so that they received neither too much immunosuppression
nor too little immunosuppression and that they
get excellent graft function, excellent outcomes with
very very few side effects and very few problems.
We deal with a lot of other issues with these patients,
as I mentioned, things like other general surgical procedures in these patients
such as hernias or gall bladder disease or colon disease or things like that.
I deal with dialysis access, whether it's peritoneal dialysis or hemodialysis.
And other types of procedures that these patients need.
I also have a very strong interest in research.
I've been an active investigator and researcher for over 20 years.
Doing the basic science research, translational research and clinical research.
In transplant patients we're always looking for new ways and better ways to diagnose rejections
and to treat rejections and to prevent rejections and that's something that I've been
concerned with in both my clinical work and my research work over the last 20 years.
We are trying to develop new medications and novel medications for
preventing or treating rejection.
We're trying to develop techniques to induce what we call tolerance
so that maybe at some time in the future patients will
never need immunosuppression they'll just receive a few doses of a procedure
or medication at the time of transplant and then get off all medications.
Unfortunately, that still remains a goal for the future, we're not near that.
On the other hand, we do very very well with immunosuppression in this day and age.
We give far fewer drugs than we used to give in the past.
We give lower doses, we're able to manage them much better.
We have much lower rejection rates than we did 10 or 20 years ago.
We have much lower medication complication side-effect rates than we had 10 or 20 years ago
and I think overall our patients are doing much much better.
The other areas that we're very interested in and research is looking at infections.
We know that new types of viruses and bacteria are being discovered all the time
and they're being discovered to cause problems in transplant patients and in other kind of
patients and we're very interested in developing new techniques for discovering
these organisms and for treating these organisms so we can either prevent
the infections or that we can discover the infections very early on and treat them.
That's another area of active research for us.
We're also very interested in genomics and looking to see how people's genetic makeups
influences their ability of acquiring organ failure,
looking at how their genetics changes their reaction to an allograft,
whether they accept it or reject the organ
and how their genetics also influences their reactions to medications,
whether the medication works well for them or works poorly for them.
The University of Maryland is one of the major genomics centers in the United States.
It has world-class genomic scientists and one
of our plans is to really increase the interaction of the genomic center with
the transplant center in order to study our patients and in order to devise new
techniques for treating them and improving outcomes.
And then the last thing we're interested in is also stem cells.
As many people know, there's lots and lots of interest
throughout this country and throughout the world in understanding stem cells
and perhaps using stem cells for treating various diseases.
We have a clinical, rather we have basic science projects that are in the process of,
that are ongoing to look at the role of certain types of
stem cells in the immune response and how that might influence the immune
response and our patient's abilities to have their organs work and to have
immunosuppression work and to become tolerant.
We're also interested in stem cells in certain organs
and if we can change the stem cell content or perhaps add to the stem cell content
of say a kidney or a pancreas, we might be able to improve the function of those organs
and make those organs last much longer after transplantation.