I graduated from the Otago University Medical School in Dunedin New Zealand in 1976. My pediatric residency was at the Children's Hospital of the King's Daughters in Norfolk Virginia, and I completed my fellowship in pediatric gastroenterology and hepatology at UCLA in 1988. I joined the faculty at UCLA in 1989 and became a Professor of Pediatrics and Surgery in 2000. In 1995 I founded the Studies of Pediatric Liver Transplantation – now the Society of Pediatric Liver Transplantation. In 2005 I served as the President of the International Liver Transplantation Society, and in 2007 completed my term as President of the United Network of Organ Sharing and the Organ Procurement Transplant Network. Currently, I serve as the immediate Past President of the American Society of Reconstructive Transplantation. In 2006 I was awarded the Clinical Science Established Investigator Award by the American Society of Transplantation.
I have been involved in the Pediatric Liver Transplantation Program at UCLA since soon after its inception 36 years ago – and have been the Director of our Program since 1994. I have therefore been in a position over many years of clinical experience to understand the complications of immunosuppressive therapy, both too little and too much. My research has centered on clinical trials of new immunosuppressant agents, and a wide range of outcome studies. As a result of my research and clinical experience, and the appreciation of the long term detrimental consequences of immunosuppression, it is clear that one of the most important unanswered questions is how to individualize immunosuppression. This is particularly pertinent for children, in the field of a pediatric liver transplant, many of our patients are transplanted as infants. I now see many of these patients now entering adulthood. The exciting new tools available now to clinicians exploring biomarkers, and particularly the science of genomics and proteomics may allow a whole new frontier in the management of immunosuppression.