Photo: Toronto General and Western Hospital Foundation
Dr. Shaf Keshavjee, 55
Director of the Toronto Lung Transplant Program at Toronto General Hospital-University Health Network
He engineers super organs.
By Katie Hewitt
On the night of Nov. 26, 1986, Dr. Shaf Keshavjee – then a thoracic-surgery resident at Toronto General Hospital – was called in to assist with the world’s first double lung transplant. The challenges of this operation would preoccupy him for the next three decades.
No organ is designed to live outside the human body, but lungs are especially fragile. Their thin membranes are prone to damage from blood and nutrient loss after being removed. As a result, 80 per cent of donor lungs end up being unusable.
Worried about the resulting wait-list fatalities, Keshavjee and his team developed the Toronto Ex Vivo Lung Perfusion technique (Toronto EVLP), a system that keeps a lung breathing for 12 to 20 hours – outside the body.
As the lungs start taking in oxygen through a ventilator, antibiotics can be administered, blood clots treated and injuries repaired. In some cases, using gene therapy or stem cells with the same technique can create what Keshavjee has called a “super organ” – one that’s “better than the organ that was donated.”
Other ex vivo (outside the body) systems have been used elsewhere, but the Toronto team is credited with mastering a technique that sustains lungs at body temperature until the transplant, rather than the alternate method of cold-static preservation, which involves cooling the organ to 4 C. The cold slows down cell death, but it has a downside: it also slows down the regeneration process necessary for repair.
Since ’86, Keshavjee has scrubbed in for nearly 800 lung transplants at Toronto General Hospital, now a world leader in the field. And since the first trial in 2008, Toronto EVLP has saved 290 lives at its creator’s workplace, as well as dozens more at hospitals in Paris and Vienna. Hundreds of lungs that would have been unusable are now keeping people alive.
Photo: Sian Richards
Jessica Ching, 32
Co-founder of Eve Medical in Toronto
She designs services that let women self-screen for STIs.
By Megan Jones
While Jessica Ching was having coffee with friends in 2008, the subject of Pap tests came up. “Everyone’s face fell,” she says. She realized that many women she knew were avoiding the test, as well as screening for HPV – an infection that can lead to cervical cancer – and other sexually transmitted infections, because the process was uncomfortable.
At the time, Ching was studying industrial design at OCAD University in Toronto. For her thesis project, she developed a prototype for a hand-held screening device that would allow users to take samples themselves – a boon for the skittish, but also for patients in underserved communities.
A fully functional version, called HerSwab, was released in 2015. It’s part of a screening system called Eve Kit, which will be available shortly for $90. After collecting samples using HerSwab, users send the kit off to a lab and are able to check their results online within a week.
If the device helps even a few more women get screened, Ching will consider the initiative a success. “No one should be dying of cervical cancer,” she says. “It’s so preventable.”
Photo: Heidi Jirotka
Dr. David Martell, 45
Family physician at Lunenberg Family Health in Lunenberg, N.S.
He provides addiction treatment in the comfort of a family practice.
By Megan Jones
In 2011, a teenage patient and his mother visited Dr. David Martell’s practice in Lunenberg, N.S. The young man was struggling with opioid addiction and needed medication to prevent withdrawal symptoms. No one in the community of 2,300 was qualified to dispense it.
That unfortunate experience prompted the doctor to seek out the necessary training. Today, he sees 40 patients dealing with opioid use disorder in the same building that houses his family clinic. The location is important: treating people with addictions in his practice diminishes the stigma that can arise when they are segregated. As a family physician, Martell is also familiar with his patients’ histories, allowing him to provide comprehensive care.
Across Canada, most doctors don’t know how to treat opioid use disorder. Martell stresses that this can’t go on. “We haven’t seen the worst of the opioid crisis,” he says. “If we don’t address the problem early, many young people will be exposed to drugs that will kill them.”