When University of Alberta pediatric cardiologist Lori West was put in charge of the transplant program at Toronto’s Hospital for Sick Children in 1994, the situation was dire for newborns with bad hearts.
Up until the first infant heart transplant in 1986, children born with certain kinds of heart malformations had a 100 per cent mortality rate.
Even after that, the rarity of matching hearts with blood-type and size ensured that half the babies in need would die on the waiting list.
Increasing the donor pool was the solution, however getting around the blood-match compatibility issue was as big an impediment in organ transplantation in the early 1990s as it is today.
In thinking about options for increasing the donor pool, West says she kept coming back to the beauty of the infant immune system—its malleability.
“It’s not all set in stone like adults,” she said. “It is well known that babies don’t have antibodies and that has been known for decades.”
In animal models, researchers have shown that if an organ, like a heart, is introduced early enough, the still-developing immune system could be tricked into recognizing what is foreign as self, and not reject it.
If that’s the case, then it made sense—at least to West—that a mismatched donor heart, regardless of blood type, could be transplanted into a newborn with a bad one.
“Once you think it through, why wouldn’t that work?” she said.
Although this concept could never be tested in humans, West said the science was on her side, as was the fact that there was nothing left to lose.
“When you have a child who has a 100 per cent risk of dying, what is cautious about not trying a new way forward?”
The breaking point came when West watched a baby die on the waiting list as a perfectly good donor heart was turned down because it was the wrong blood type.
“It was a double tragedy,” said West. “I thought, ‘We could do this better.’”
On Valentine’s Day in 1996, Caleb Schoeder became the first baby to receive a donor heart of a different blood type.
And it took: Caleb is a healthy and happy adult turning 25 years old this month.
“The first big eureka moment was this is not only possible but it is actually really easy. And that’s why centres around the world are doing it.”
Today, many more babies born with a heart condition that requires a transplant get the heart they need.
“Organ and cell transplantation is a remarkable endeavour of human medicine, one that involves the very edges of life and death for both transplant recipients and donors,” she said. “The very fundamental nature of the altruism that gives life between donors and patients is unique in medicine.”
In 2005, West and her family moved to Edmonton at the behest of the surgeon who did the first ABO incompatible heart transplant, Ivan Rebeyka, who had come to the U of A some years earlier.
West is now director of the Alberta Transplant Institute and the Canadian Donation and Transplantation Research Program, while continuing her research tackling transplant rejection, the negative side-effects of immunosuppressive drugs and, more recently, the role blood type might play in the severity of COVID-19 cases.
She has also been appointed as an officer of the Order of Canada, announced just before the new year.
“It is my belief that success in complex endeavours such as science and medicine depends on the efforts of teams,” said West, who is also a member of the Women and Children's Health Research Institute. “I have been fortunate to work with talented and dedicated people over the years who have made important contributions to moving our field forward, and I am grateful for those efforts.”
Among the U of A standouts joining West in the Order of Canada are former University of Alberta chancellor and Faculty of Law alumnus Douglas Stollery, and the forefather of the Paralympic movement, Bob Steadward, who was promoted to companion of the Order of Canada, the highest level of the order.
Bob Steadward: crushing barriers to inclusive sport
Steadward came to the U of A in 1964, where he competed for the Golden Bears track and field team as a long jumper and sprinter. While a student in physical education, he became involved with creating and operating programs for athletes with disabilities—an interest that soon became a driving force in his career.
In 1971, Steadward began a five-year term as president of the Alberta Wheelchair Sports Association. By 1977, he was involved in creating the U of A-based Research and Training Centre for Athletes with a Disability, which in time became The Steadward Centre for Personal and Physical Achievement.
The multi-disability fitness, research and lifestyle centre was groundbreaking when it was first introduced and continues to be an innovative and internationally recognized model for independence and fitness training for people with disabilities.
After serving as the U of A’s director of athletics from 1985 to 1989, Steadward founded the Canadian Sports Fund for the Physically Disabled to ensure ongoing development in the field.
“Over time, this goal expanded to the international world of sport and the aspirations of Paralympians everywhere whose dreams were obscured by the cloud of unequal recognition,” said Steadward, who is now a professor emeritus in the Faculty of Kinesiology, Sport, and Recreation. “So, we got to work on our aims and ambitions, and I like to think we were the instruments of change; we revolutionized the status quo, and we crushed the barriers.”
His belief in the ideal of equality on and off the field of play eventually led to international meetings and the support of the head of the International Olympic Committee (IOC).
In 1989, Steadward was elected as the founding president of the International Paralympic Committee and in 2000, at the Sydney Olympics, Steadward and IOC president Juan Antonio Samaranch signed a formal memorandum of understanding that brought their two movements together.
“Amid adamantine efforts for the future, we can confidently claim that we changed the world of sport forever,” he said.
Douglas Stollery: defending human rights
Stollery was appointed a member of the Order of Canada in recognition of “his wide-ranging contributions to Canada’s legal landscape, for his defence of human rights and for his broad community involvement.”
A highlight of Stollery’s legal career includes pro bono work on the landmark Supreme Court of Canada case Vriend v Alberta, which led to the amendment of Alberta’s human rights legislation to include sexual orientation as a protected class.
Beyond his legal work, Stollery, who completed his four-year term as the 21st chancellor of the U of A in June 2020, has an unparalleled dedication to philanthropy. He serves as president of the Stollery Charitable Foundation, which helps communities, families and individuals flourish and overcome barriers.
He also serves as director of CARE Canada, a charitable organization that economically empowers women and girls, and as a director of The Stephen Lewis Foundation, which supports people affected by the HIV/AIDS pandemic in Africa.
U of A alumni named to the Order of Canada
Along with Bob Steadward and Douglas Stollery, the following alumni were recently named to the Order of Canada:
- Judy Birdsell (Nursing), for her contributions to improving health care and quality of life for patients in Alberta and across Canada
- John Brink (Arts), for promoting and preserving Blackfoot culture as an archeologist, curator and author
- Stanley Dragland (Arts), for his contributions to Canadian literature as a writer, publisher and editor, and for his distinguished career as an English professor
- John Geiger (Arts), for his fiction and non-fiction work, and for his commitment to celebrating the diversity of Canada’s geography, history and heritage
- Charles Guest (Engineering), for establishing the innovative profit-sharing and employee ownership plan at Spartan Controls, and for founding the Bearspaw Benevolent Foundation
- Sandra Kirby (Kinesiology, Sport, and Recreation), for her sustained advocacy for equity, inclusion and safety in sport
- John McNeill (Pharmacy), for his contributions to cardiovascular pharmacology and his pioneering research linking cardiac disease and diabetes
- Tom Radford (Arts), for showcasing the history and culture of Western and Northern Canada through his films and documentaries
- Roger Wong (Medicine & Dentistry), for his contributions to geriatric medicine, including advancing policies, education and culturally sensitive health care