Q&A with Dr. Kim Olthoff
Published on in CHOP News
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Published on in CHOP News
Meet Kim Olthoff, MD, FACS, Surgical Director of the Liver Transplant Program.
Kim Olthoff, MD, FACS , is the Surgical Director of Children's Hospital of Philadelphia’s (CHOP) Liver Transplant Program and Chief of the Division of Transplant Surgery at the Hospital of the University of Pennsylvania. She formerly directed CHOP’s Transplant Center. She was recruited in 1995 to help build the liver transplant programs at Penn and CHOP. The combined Liver Transplant Program at Penn and CHOP is currently one of the busiest clinical programs in the country, transplanting more than 150 patients per year.
Dr. Olthoff recently spent some time discussing her work and the field of liver transplant.
A. I fell in love with transplant as a resident and never left. I worked with kids during my residency at Dumont - UCLA Transplant Center, and I wasn’t going to take a job where I couldn’t transplant children. Pediatrics is special. The position at both Penn and CHOP was incredibly appealing. I’ve now been at CHOP for 26 years.
Working with kids is rewarding — they do really well. It’s wonderful to see how they can be so sick and get better so quickly, and then see them grow up and have full lives. We often get annual cards or photos from these families – it really makes me smile.
A. Living donation is wonderful. It’s not just parents donating to kids. Sometimes it’s directed or non-directed donors — a stranger, an old friend, an aunt or uncle. It’s always very special to see. It’s just a lovely and amazing thing to do – to give part of your liver to someone else.
A. I was formerly the director of the whole Transplant Center many years ago when we created the Center, so the fact that we are a pediatric multi-organ program makes us stand out. We’re one of the largest and busiest solid-organ pediatric transplant programs in the country. We have some of the most experienced surgeons and medical directors in the country when it comes to liver, kidney, heart and lungs.
Regarding the Liver Transplant Program, we offer all potential options for transplant. We were the first to do living donors. We do whole transplants, split livers, transplants for very rare metabolic diseases, for fulminant liver failure. We have world-class colleagues in areas like hepatology and metabolic disease, and these partnerships are crucial to successful surgeries. We have pediatric anesthesiologists and intensivists who are focused on transplant kids.
We do very complex cases and super-tiny kids. Not many programs are comfortable transplanting 3-kg babies.
A. My research has spanned a broad array of things over the course of the years. I’ve done basic science in liver regeneration — investigating the pathways that lead to liver regeneration after donation. Now I’m mostly focused on translational and clinical research in the area of liver regeneration and dysfunction. I’m also interested in finding ways to expand living donation in this country. We could transplant so many more people with living donation.
Regarding research by our liver transplant team, we have world-class research programs in biliary atresia and Alagille syndrome. There’s also fascinating research being done about the genetics of liver transplant — when you put a liver in someone else, how do the genetics of that liver differ from the genetics of the recipient and how does that affect the recipient? Another area of research being pursued by the whole team is immunosuppression minimization — that’s really exciting.
A. The future of liver transplantation at CHOP is a bright one. We will, of course, continue to evaluate and transplant many children with complex issues. We will also continue to explore and advance more ways to get our kids transplanted. Our partnership with the Hospital of the University of Pennsylvania allows us to increase living donation as we explore and expand non-directed donation and liver and kidney “swaps,” where a donor that may not be appropriate for liver donation can donate a kidney to someone who needs a kidney, and then that recipient’s donor can donate part of their liver to the other recipient.
We also want to make sure that the children we transplant as infants and toddlers will be able to live long and happy lives, without complications. As we continue to do research in the long-term transplant outcomes and effects of immunosuppression, we hope that we will be able to apply these lessons to all the children we transplant.