The Review 2007

20 21 International Honour for Student Researcher A bright young student and his open-minded teachers have cracked new ground in liver transplantation and undergradu- ate research, and gained international recognition for their efforts. Kendrick Co Shih is a promising medical student who has completed only three of his five years of study. He took the bold decision in 2006 to take a year out and devote it to research, a move that earned him the “Rising Star Award” from the International Liver Transplantation Society in June 2007. He shares his award with his mentor, Dr Nancy Kwan Man, Assistant Professor of Surgery, who won the Rising Star Award as a mentee in 2006. They were the only Asians honoured from a field of more than 100 entries. Professor Lo Chung-mau, Chair Professor of Surgery, also helped to supervise the research. Kendrick’s work focused on the recurrence of liver cancer in patients who had received liver transplants from living donors. These grafts are 40-60 per cent smaller than the ideal liver volume and are more likely to develop injury after transplantation. Kendrick discovered a molecular link between the small grafts and higher tumour recurrence, a finding that has implications for the development of targeted therapies in patients who receive such transplants. “As a medical student without prior exposure to labo- ratory research, the support I received from my supervisors and team-mates was crucial to my success,” Kendrick said. “The award has given me massive encouragement as a hopeful future academic clinician.” Dr Man said the results showed how effective under- graduate research could be. “It is important and worthwhile to provide support for undergraduate students, especially financial support, so they can carry out feasible and valuable research projects,” she said. World’s First Vertebrae Transplant Cures Back Pain and More A quest to cure back pain and keep the spine mobile has re- sulted in the world’s first intervertebral disc transplantations being carried out under the auspices of the Department of Orthopaedics and Traumatology. Back pain is the third most common reason for surgi- cal procedures in Hong Kong. The conventional treatment is to fuse the affected segment of the spine, but while this abolishes pain, it also reduces mobility. To Professor Keith Luk, “that’s an admission of defeat because the spine is meant to be flexible. Fusing can get rid of the back pain but it’s not the best treatment.” Working with doctors at The Navy General Hospital in Beijing, Professor Luk and his colleagues have developed a means of transplanting discs to replace those that have degenerated and are pressing on nerves. The first five patients received the transplants in 2000 and 2001 for ruptured discs in the neck area. After a five- year follow-up period, they had complete relief of symptoms from nerve compression and no persistent or clinically signifi- cant neck pain. Their spines remained mobile and stable and they reported no problems with immunoreactions or surgical complications. The results were reported in The Lancet in March 2007. The next step is to move towards a large-scale clini- cal trial. Researchers are also investigating how to preserve grafts better and how to apply basic research in repopulating the transplanted discs with the recipient’s own living cells. Another line of investigation is to gain a better un- derstanding of disc degeneration. Researchers from the Department of Orthopaedics and Traumatology and the De- partment of Biochemistry have found a significant genetic component in cases from Hong Kong and south China. The results have implications for the development of new drugs and treatments for the disease. The spine is meant to be flexible. Fusing can get rid of the back pain but it’s not the best treatment. Professor Keith Luk Kendrick Co Shih