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Philip K. Caves Award Recipient Shares Career Highlights
Since Winning Award

Gregor Warnecke, MD
Hannover Medical School, Hannover, Germany

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gregor warneckeIn 2006, I received the Philip K. Caves Award from the ISHLT in Madrid, Spain, for my presentation on T cell regulation in tolerant lung transplantation recipients in a miniature swine model. I was working on this research from the lab at Hannover Medical School (HMS) for the better part of 8 years. Tolerance induction in lung transplantation and, recently, T cell regulation in transplantation, are my major research interests. In the latter field, I received thorough training from Kathryn J. Wood during my 2 years research fellowship in Oxford, UK, from 2004 to 2006.

At the time I received the Caves award, I was 32 years old, was just back from Oxford, and still was a resident in cardiac surgery in only my 3rd year of clinical training. My major clinical interests since medical school have been lung (and heart) transplantation. I actively took part in the program at HMS from then on, by first being responsible for our intermediate care and transplant ward.

Things have really changed a lot since the Caves award, which came at the right time. In 2009, I was board certified as a cardiac surgeon and in 2010 I was promoted to the director of the thoracic transplant program at HMS after Andre R. Simon left Hannover to take over the transplant program at Harefield Trust in London, UK. I am very grateful to my boss, Axel Haverich, for his confidence in me.

In March 2010, I instituted a new innovative transplant program structure at HMS with two junior cardiac surgeons and long-standing colleagues of mine, Igor Tudorache and Christian Kuehn, to lead and share the program with me. We have since both increased numbers and upgraded the quality of our transplant program in Hannover. In 2010, we performed 114 lung transplants, and 131 in 2011 (including 6 and 5 combined heart-lung transplants, respectively). We discarded the use of standard cardiopulmonary bypass in lung transplantation and substituted with veno-arterial ECMO that is instituted in those 35% of the patients requiring extracorporeal circulation. We also try to avoid mechanical ventilation for bridging to lung transplantation and, instead, substitute with 'awake ECMO'. These and quite a few other improvements have reduced 90-day mortality from more than 14% in 2009 and years prior, to 9.6% in 2010 and, so far, 7.0% in 2011.

Later in 2010, my application for 'Habilitation' (the approximate equivalent of a junior professorship within the German academic system) passed, adding the title 'Privatdozent' to my name.

For the last 3 years, I have set up a dedicated transplant immunology laboratory within our department, which routinely monitors regulatory T cells in clinical lung transplant recipients. Further, I have a pilot study (very close to recruiting the first patient) which will transfer parts of our long-standing tolerance induction protocol in miniature swine lung transplantation into our clinical program.

In 2011, HMS became part of the German Centre for Lung Research. In this major research body, I am one of 20 principal investigators from Hannover, and am responsible for 3 grants of relevance for the lung transplant program.

In early 2011, I started using the transportable 'organ care system' for warm perfusion of donor lungs in a clinical pilot trial at HMS. Since December 2011, we initiated the respective worldwide prospective, randomized 'INSPIRE' trial and already recruited the first 12 patients in Hannover.

The years since receiving the Caves Award have been very exciting with my involvement thoracic transplantation. I will always be grateful to the Society for recognizing that I made a scientific contribution which would one day improve clinical care, something I believe epitomizes the Caves Award. Today, I eagerly look ahead to new horizons, especially the ISHLT meeting in Prague!

Disclosure Statement: The author has no conflicts of interest to disclose.