William Irish, head of statistics for RTI Health Solutions, was recently
elected to full membership in the American
Society of Transplantation (AST). This honor makes Dr. Irish one
of the first statisticians admitted to the AST, which is made up primarily
of physicians and surgeons.
According to Dr. Irish, one of the advantages of being a statistician
is that he looks at the science of transplantation "more analytically
and quantitatively" than others may.
Dr. Irish received his doctorate in epidemiology from the Graduate School
of Public Health at the University of Pittsburgh while on the faculty
in the department of transplant surgery. The transplant program at Pittsburgh
is the leading transplant center in the world conducting research in
the areas of transplant immunology and graft acceptance.
AST is an organization of more than 1,800 transplant professionals.
As a member, Dr. Irish will help to develop the public policies of transplantation.
"The science of transplantation is a relatively new branch compared
to the other more established branches of science, but as proven by the
unfortunate events at Duke University, it is very much in the public
eye," Dr. Irish said.
"One of the problems in transplantation is the need outweighs the
donor supply. The dilemma is, how do you increase the donor pool?"
One method of increasing the donor pool is by using living donors in
addition to the more common procedure of removing organs from the recently
deceased. Using a living donor further complicates an already complicated
process because a doctor must make sure the donor's organs continue to
work for the donor as well as the recipient.
As new as transplantation is, the use of living donors is even newer,
and much research is left to be done. AST is currently working to begin
a living donor outcome registry.
According to Dr. Irish, while recipients of organ transplants are closely
monitored, "No system is in place to track the outcome of donors
-- clinically, socially and psychologically."
The living donor outcome registry would seek to answer questions doctors
have about the effects of transplants on donors and could ultimately
lead to a safer, more widespread living donor program.
One of Dr. Irish's latest projects involved creating a nomogram (a type
of visually represented model, which in this case, graphically illustrates
a complicated regression model) to help predict the likelihood that kidney
transplants will not immediately begin to work, thus requiring the patient
to undergo dialysis for several days after the operation. The model uses
both the recipient's and the donor's individual histories to predict
the operation's outcome. By using this information, the doctor can better
manage the patients and prepare the proper drugs to stabilize the situation
before it occurs. The model is currently being validated at several transplant
centers across the country.
In addition to being elected to AST, Dr. Irish won a blue ribbon at the 2003
World Congress of Nephrology along with Beth Sherrill, also of RTI Health Solutions.
The award was given for a poster they did comparing the effects of two immunosuppresive
drugs, tacrolimus and cyclosporine microemulsions, in transplant patients.
As to his motivation to work in the science of transplants, Dr. Irish
said, "Patients with End Stage Organ Disease are very sick and their
only option is transplantation. Unfortunately, a number of these individuals
will not survive the waiting period because there are not enough organs
available, and if they do, they may not survive the post-transplant period
because of immunologic factors beyond their control. It's a tragedy.
That's why we do our research."