A successful transplant is only the beginning

A pediatric cardiologist works to uncover the secrets of children's immature immune systems

Dave von Bieker - 07 February 2017


Simon Urschel knows the power of the human immune system all too well. He works to understand how it defends our bodies around the clock from anything that doesn't belong, including a life-saving organ with an incompatible blood type.

The antibodies patients develop to fight a transplanted organ can become the greatest obstacle to the operation's success. Urschel has spent years of his career to research and practice developing techniques to suppress these antibodies in young patients, while maintaining their immune system's strength to fight illness. It is a delicate balance.

"Usually, you become a cardiologist because you don't like things like T- and B-cells and immunology," says Urschel. "It's very rare that people are interested in both immunology and cardiology." At the University of Alberta and the Stollery Children's Hospital, Urschel can balance research with clinical practice.

That balance drew him to Edmonton from his prior home and practice in Munich. "I think you will always gravitate to where you see the best opportunity to fulfill your passion, to do your clinical work," Urschel reflects. "I'm not a pure scientist and I couldn't be a pure scientist. I need to balance research and working with children and their families." Another draw to Edmonton for Urschel was the chance to work with world leaders on blood group incompatible transplantation, like department member Lori West.

For Urschel, a successful transplant is only the beginning of a journey with each patient. He fondly remembers soccer games with kids at transplant camp where he says the families have bonded strongly. Urschel recalls the surprise on a parent's face when their child outpaced the doctor on the soccer field. Transplant camps are among many innovative programs that make Urschel's division an authority in the field and are a key factor for wellbeing beyond medical care. The Stollery handles heart transplants for kids across Western Canada, which amount to anywhere from eight to 17 operations in a given year.

"I find it pretty impressive that our protocols are shared," says Urschel. "They're used at Stanford, in New York, in Chicago, in Miami. Those are all top organizations that request our protocols and regularly ask our advice."

Urschel is currently preparing slides for a presentation he'll give to 4,000 attendees of the International Society for Heart and Lung Transplantation. He collaborates on research with national and international groups like the Canadian National Transplant Research Program's Positive Study to discover how immune systems react to transplants of different organs at various ages.

With his recent promotion to associate professor, there are no signs of Urschel resting on his laurels. "I've just published a paper about the development of B-cell memory, which is important for transplants but also has important implications for how kids deal, for example, with certain infections."

He is already adding years to the lives of transplant patients at the Stollery, but there is always more to learn. The immature immune systems of the very young are incredibly resilient, holding secrets that Urschel believes may help improve the lives of patients of all ages.

Perhaps Urschel's greatest advancements lie ahead.

This article comes from the 2015 Department of Pediatrics Annual Report.