Much has changed in the world of kidney transplantation in the 30 years since Dr. David Landsberg was hired to start the renal transplant program at St. Paul's Hospital, to complement and enhance the existing program at Vancouver General Hospital.
In those early days, organ rejection occurred in up to 30 per cent of kidney transplant patients, often leading to a return to dialysis. Today, the effectiveness of modern anti-rejection drugs and protocols has brought the failure rate for kidney transplants down to about two per cent.
"Thirty years ago, every transplant was an adventure, and not always a good one," says David, who first came to Vancouver in 1984 after training and starting his career as a transplant nephrologist in Ontario.
Although the intensity of looking after transplant patients still requires a 24/7 commitment, David says most long-term patients now do well with relatively infrequent visits to a transplant nephrologist. Care of the transplant patient today also involves well-trained teams and systems. Although he spends most of his time providing transplant care, David enjoys working with all nephrology patients, and attends the St. Paul's Kidney Care Clinic every two weeks. He also runs a consultative out-patient practice.
"I still really like general nephrology," says David, who feels that including CKD patients in his practice helps maintain his "credibility" as a nephrologist.
Clearly we are our own harshest critics. As leader of St. Paul's kidney transplant program since its inception, David has played a key role in its success. He is also program director of the renal program at St. Paul's. As the medical director of kidney transplantation at BC Transplant, he has been instrumental in helping build the partnership between BC Transplant and the BC Renal Agency. One outcome of that work has been the success of the Living Donor Program in BC, which is the strongest program of its kind in Canada. He has also devoted considerable time to teaching, and has mentored a number of local transplantation nephrologists, including Drs. John Gill, Jagbir Gill and Olwyn Johnston.
In recognition of his role in these accomplishments and others, he recently received the Canadian Society of Transplantation Clinical Achievement Award.
David says he originally came to Vancouver with the firm idea he would only stay for five years before returning to the "centre of the universe," his hometown of Toronto. But as often happens, life on the west coast soon exerted its charm and he discovered a passion for skiing, which over time has led to another pastime.
"My major recreational activity these days is injuring myself," explains David, who has missed a whole season of skiing this year, recuperating from a shoulder injury.
David and his wife, a medical oncologist, have two daughters and live in Vancouver.