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A difficult, but rewarding dream

Surgeon working to establish liver transplant program at Buffalo General

Published: May 15, 2008

By KEVIN FRYLING
Reporter Staff Writer

Several weeks ago, Mohamed Ibrahim operated on a 51-year-old diabetic man who had been taking four insulin shots a day for the past 35 years. Less than a week after receiving a new pancreas, the man left the hospital and is free of the disease that plagued him for much of his life.

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Mohamed Ibrahim says working with a pioneering surgeon in Japan during the late 1980’s "hooked" him on the challenging specialization of organ transplantation.
PHOTO: NANCY J. PARISI

Ibrahim, who joined the UB medical school faculty last fall as an associate professor of surgery and also serves as an attending transplant surgeon at Kaleida Health’s Buffalo General Hospital, says being a surgeon has been his dream ever since entering medical school in his home country of Egypt more than 25 years ago. And working under pioneering pediatric transplant surgeon Morio Kasai in Japan during the late-1980s “hooked” him on the challenging specialization of organ transplantation.

“I was fascinated by the field,” says Ibrahim, who previously was professor and chief attending surgeon—as well as director of liver and pancreas transplantation and chief of hepatobiliary surgery—at the Medical University of Ohio at Toledo. “I got attached to the extent that I decided to dedicate all my life to transplantation, in spite of its very difficult lifestyle.”

Being a transplant surgeon means being on call almost all the time. “When you get new organs, you have to work sometimes between 36 to 48 hours in a row,” he says. “You can’t wait.”

But even after so many years in the field—he has worked at hospitals in Japan, as well as in California, Kentucky, Virginia and Ohio since coming to the U.S. in 1997—Ibrahim says that organ transplantation never ceases to amaze him.

“I’ve being doing this for years and every time I am amazed and surprised by how these organs work,” he says. “We receive the organ in an ice container. The pale, cold organ turns into a vibrant, pulsatile one as soon as it is connected to the recipient’s vessels. It then assumes its assigned function—whether it is a kidney, a liver, a pancreas or small bowel. It starts to be alive again. It’s amazing, the ability of the human body.”

Ibrahim and two other UB faculty members are involved in several clinical trials with organ transplant recipients at Buffalo General Hospital involving new combinations of immunosuppressive, or “anti-rejection,” drugs.

“These medications are a double-edged sword,” Ibrahim says. “They make your immune system accept the [transplanted] organ, but at the same time, you become more susceptible to infection. They are not optimal right now; they are far better than before, but still they have a lot of side effects.”

The clinical trials are being funded by grants from private drug companies, including Roche Pharmaceuticals and Astellas Pharma Inc.

One of his major goals in coming to Buffalo has been to establish a liver transplant program at Buffalo General, says Ibrahim, who is working closely on the project with Merril T. Dayton, professor and chair of the Department of Surgery. A liver transplant program would provide a greater spectrum of care to patients by increasing transplant services and boosting intensive care capabilities at the hospital, as well as creating more teaching opportunities for medical students, residents and fellows, he says. Ten to 15 UB medical students have participated in rotations through the surgical transplantation division this year, he adds.

“It’s worth more to see one surgery than to read 10 books about the same procedure,” Ibrahim points out. In addition to lecturing on organ transplantation, he takes UB students on rounds and allows them to scrub into his surgeries. “They don’t operate themselves, of course,” he says, “but they assist and get great exposure.”

A liver transplant program also would help Ibrahim resume some of the work he was involved in before coming to UB. He explains that his research in Ohio was focused on hepatocyte transplantation, a cutting-edge treatment for patients suffering from serious liver disease, such as that caused by chronic Hepatitis C infection. In this process, stem cells are transformed into liver cells, or hepatocytes, and then injected into recipients to regenerate their failing organs.

“I think that stem cell research and stem cell transplants will be the future of organ transplantation,” says Ibrahim, pointing out that transplanting whole organs requires surgical incisions, not to mention the other risks that come with major surgery. “From a surgical point of view, this is much easier—it’s just one shot.”

The recipient of a medical degree from Alexandria University in Egypt and a doctorate in surgery from Tohoku University in Japan, Ibrahim says his familiarity with Japan came long before he spent time there as a medical exchange student, and later as a resident and clinical fellow. An avid martial artist since the age of 5, Ibrahim, who holds six black belts in various Japanese disciplines, first traveled to Japan for practice and competition in judo as a junior and senior high school student.

Today, Ibrahim, who has two sons with his wife, Hanan Ismail, a pediatric oncologist who most recently served as director of transplant immunology at the Medical University of Ohio, says his children also are competitive athletes. Daser, a seventh-grader at City Honors School, recently took first place in all events at a district-wide Buffalo Public Schools swimming competition; Luai, a high school student at Nichols School, is a state gymnastics champion.

While they currently are living in a rented house, Ibrahim says he and his family are actively searching for a permanent residence in Buffalo.

“Because of the nature of my work, I need to be very close to the hospital,” he says. “There are some very nice houses in the suburbs, but we prefer downtown.”