#155 - Chris Sonnenday, M.D.: The history, challenges, and gift of organ transplantation

Mar 29, 2021

Chris Sonnenday, Transplant Center Director at Michigan Medicine, dives deep into the captivating world of organ transplantation. He shares the journey of how kidney and liver transplants have evolved, highlighting critical surgical advancements. Sonnenday discusses the challenges posed by rising chronic diseases and the critical role of living donations. With poignant stories of both success and tragedy, he emphasizes the emotional impact of organ donation, revealing how it brings hope to those in need and shapes the lives of healthcare professionals.

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ANECDOTE

A Missed Compartment Syndrome

Chris Sonnenday caught a misdiagnosis during a chaotic trauma shift, likely saving a patient's leg.
He later presented the case, taking responsibility for the near-miss, demonstrating humility and systems-thinking.

INSIGHT

Kidney Transplants: A History of Challenges

Kidney transplants highlight the challenges of transplantation: technical, preservation, and immunological.
The first successful kidney transplant, in 1954, was between identical twins, bypassing immunological barriers.

INSIGHT

Understanding Rejection

ABO blood type incompatibility provided a basic understanding of rejection, like a simplified model.
This led to cross-matching, but didn't explain all rejection types, specifically acute rejection cases.

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Chris Sonnenday is the Transplant Center Director for Michigan Medicine. As Peter’s senior resident while at Johns Hopkins, Chris made a lasting impression on him with his remarkable leadership and ability to maintain his humanity through the stressors of that challenging environment. In this episode, Chris tells the incredible backstory of the history of transplant medicine, focusing on the kidney and the liver. He discusses the surgical and immunologic developments that launched the field forward, but also lays out the challenges ahead for the field, such as the rising prevalence of chronic kidney and liver failure. Chris also tells many stories of tragedy and triumph that comes with working in organ transplantation, but ultimately explains the rewarding nature of being a witness to the gift of organ donation.

We discuss:

What attracted Chris to medicine, and his leadership in residency (3:30);
How Chris maintained his empathy and humanity through the stresses of med school and residency (8:30);
Why Chris chose a complicated field like transplant medicine (23:15);
Explaining kidney transplantation to showcase the challenge of organ transplantation surgery (28:00);
Overcoming the immune-based challenges of transplant surgery (37:00);
How the discovery of cyclosporine transformed the field of organ transplantation (49:00);
Rising chronic kidney failure due to the prevalence of pre-diabetes and metabolic syndrome (53:45);
Why living kidney donations are superior, and the possibility of a market for kidney donation (59:30);
Designing a fair system of organ distribution (1:17:30);
The debate on what constitutes “death” when deciding when to take organs from a registered organ donor (1:21:45);
Reflections on the gift of organ donation (1:33:15);
The history of liver transplantation and why it’s so complex (1:39:15);
Addressing acute liver failure and the amazing baboon experiment (1:46:15);
The potential for the rising prevalence of NAFLD and NASH to overwhelm the liver transplant infrastructure in the US (1:54:45);
The importance of teamwork in successful organ transplantations, and the most tragic event Chris has ever witnessed (2:05:45); and
More.

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