LLUAHSC SCOPE Summer 2001 - Transplant surgeon

Service to humanity
Transplant surgeon continues his ministry by improving patient care

[SCOPE, Summer 2001]

Waldo Concepcion, MD, associate professor of surgery, School of Medicine, and director of the Transplantation Institute and Liver Center, LLUMC, discusses a procedure with a transplant patient.

Waldo Concepcion was just a young boy when he witnessed his first surgery. His grandmother was the surgeon; her patient was a chicken. As she opened up the chicken to extract the large rocks it had swallowed, Waldo knew he had to try it.

After performing his own surgeries on the chickens, he couldn't imagine another route for his future.

"Ever since my first memories, I knew I would be a doctor," says Waldo Concepcion, MD, associate professor of surgery, School of Medicine. "And I also knew I'd be a surgeon--it was just a matter of which area of surgery I would go into."

Now the director of the Transplantation Institute and Liver Center, Loma Linda University Medical Center, Dr. Concepcion lives out his mission daily.

"As Seventh-day Adventists, we are always looking for a way to perform our life ministry," Dr. Concepcion relates. "I decided my ministry needed to be medicine--a way that I could give back to the people around me."

While his parents were originally from Panama, Dr. Concepcion was born in Omaha, Nebraska, where his father was studying at the University of Nebraska. As missionaries, his parents returned to Panama. Six years later, the family moved to Costa Rica, where Dr. Concepcion spent much of his youth. This environment influenced his decisions for the future.

"Growing up in Panama, we didn't have a lot of sophistication in medicine, but there was that concept of helping people; that's what I wanted to do," he shares.

Concepcion/Sosa
Dr. Concepcion celebrates the 100th liver transplant performed at the Transplantation Institute and Liver Center, Loma Linda University Medical Center, by cutting a piece of low-calorie cake for transplant recipient Adelaido Sosa.

The career choice for Dr. Concepcion was obvious. He studied pre-medicine at the Central American Adventist University, Alajuela, Costa Rica, from 1970 to 1974. The next three years he spent at the School of Medicine, Universidad Autónoma de Guadalajara, Mexico.

In 1979, Dr. Concepcion followed the example of his parents and began mission work at the Southeast Hospital in Villaherimosa, Tabasco, Mexico. After a year of serving in public health at the General Hospital of Mexicali, Baja California, Dr. Concepcion returned to the United States for a six-month externship with Carlos Balarezo, MD, at Riverside General Hospital, Riverside.

He began his residency in heart transplantation at LLUMC in July, 1982, and joined the team of Leonard L. Bailey, MD, chair, surgery, School of Medicine, LLU. In 1984, Dr. Concepcion participated in the historical Baby Fae case, where Loma Linda doctors transplanted a baboon heart into the baby girl.

"That was a very exciting time because we thought we could make a difference for the newborns who are born and die of hypoplastic left-heart syndrome," he explains. "The most important factor we found was that cross-transplantation of hearts between animal and human was possible. And the quality of work of the baboon heart was excellent."

After being accepted into the cardiothoracic program at Loma Linda, Dr. Concepcion began a year of research at the University of Pittsburgh Medical Center under the training of Thomas E. Starzl, MD, PhD, world-renowned specialist who developed the field of modern liver transplantation. While working with Dr. Starzl, Dr. Concepcion changed his direction from heart surgery to liver transplantation.

"I found liver transplantation to be a booming, challenging field in which the transplant surgeon's capabilities and his dedication really make a difference in the outcome of the patient," Dr. Concepcion comments. "There's a narrow margin of success, and the patients are much more difficult to manage than in heart surgery."

Additionally, he found the visible change in his patients' lives to be the most rewarding aspect of medicine.

"In transplant surgery, we help people go from the most severe place in their lives--a life-threatening illness in which they have a limited time of survival--and give them a future," he relates.

Dr. Concepcion returned to the West Coast and joined the transplant team at California Pacific Medicine Center, San Francisco, which was performing more than 100 transplants a year.

"That was very exciting because liver transplantation had just started in the late '80s in Northern California," comments Dr. Concepcion, "and it was a big challenge to compete, to have good outcomes, and to treat very sick patients."

After moving to Stanford University, Palo Alto, where he helped revitalize the liver transplant program, Dr. Concepcion returned to Loma Linda University Medical Center in September, 1996. He acted as a liaison between the two schools in both the clinical and research areas--a relationship that lasted until 1998, when Dr. Concepcion decided to stay at Loma Linda and open the liver transplant center.

"My proudest legacy is creating a transplantation program--a multi-disciplinary environment--in complete harmony with the Medical Center," he states. "If we can maintain the system that we have now, we show the full aspects of health care working together for the patient."

While his patient list has changed dramatically from the backyard operations performed in Panama, Dr. Concepcion continues to perform the life ministry of which he dreamed.

"We need a justification for what our life is going to be," he says, "and I wanted mine to be a service to humanity, to make a difference, and to do whatever I can to help people."

Transplant service update

In April, 2001, United States Health Secretary Tommy Thompson announced his "gift of life donation initiative," which encourages an organ-donation friendly America by raising awareness about the need for donors.

With more than 76,000 Americans waiting for kidney, heart, liver, lung, or pancreas transplants, this initiative aims at increasing the number who receive organs. At present, approximately 22,000 organ transplants are performed each year, resulting in about 5,500 deaths per year as patients wait for a donated organ.
At Loma Linda University Medical Center, educating the community on organ donation has been recognized as one of the main challenges facing the transplant program.
"If we could educate people, we could completely correct the shortage of organs," says Waldo Concepcion, MD, director of the Transplantation Institute and Liver Center, LLUMC. "We have enough organs, but we can't capture them."
Despite such challenges, the program continues to improve its services, according to Dr. Concepcion. Since the first kidney transplant in 1967, LLUMC has performed 1,005 kidney transplants. To date, 146 liver transplants, 105 kidney/pancreas, 24 adult stem cell, and 458 heart transplants have also been performed.
"The dedication of this team makes Loma Linda the place to be for transplantation," Dr. Concepcion comments. "This program works as a big center, and people are really thinking with high goals and high expectations."
The center continues its research and clinical trials for innovative treatment of Hepatitis B and Hepatitis C--the main causing agents of liver disease--and liver cancer. Results from this research help the team improve management of patients through early diagnosis.
On June 1, 2001, the Transplantation Institute and Liver Center began its pediatric transplant program and pancreatic allied cell transplants for Type I diabetics. It also started the split liver transplant program, a procedure where one liver is divided between two recipients. Also started on June 1 was the living related donor liver transplant program, where a live person donates a segment of the liver to a relative.

[SCOPE, Summer 2001]