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Physician Profile
Christopher R. Shackleton, M.D.
Director of the Center for Liver and Kidney Diseases and Transplantation Cedars-Sinai Medical Center
Christopher R. Shackleton, M.D., returned to Cedars-Sinai Medical Center with a mission to help expand the hospital's transplantation services and a drive to promote new strategies that may someday narrow the gap between supply and demand for donor organs.
Returning in the summer of 1999 to Cedars-Sinai -- where he served from 1995 to 1997 as program director for the Center for Liver Diseases and Transplantation -- Dr. Shackleton began to broaden the spectrum of transplant services and assist in the integration of several aspects of the abdominal organ transplant programs. He assumed responsibility for developing a kidney/pancreas transplant program, for example, and led in the creation of programs in partial liver transplantation for both adults and children.
"We want Cedars-Sinai be among the top tier of transplant centers nationally and internationally in terms of the complement of services we offer, and in terms of our responsiveness to the needs of our patients and to the realities of the managed healthcare environment. But above all, we put the needs of our patients first," said Dr. Shackleton.
While he is recognized for his involvement in the establishment of transplantation programs and policies in Canada, as well as his previous work in Southern California and his high rates of success in transplant surgery, colleagues say Dr. Shackleton's level of knowledge and experience sets him apart.
"He is a very unique individual because he is one of the few transplant surgeons who is able to perform all of the abdominal organ transplants, including the pancreas, liver and kidney. He has had experience in all three of those solid organs and has an outstanding track record," said Milan Kinkhabwala, M.D., assistant professor of surgery and director of the pancreas transplant program at New York Presbyterian Hospital/Cornell Medical College.
"In addition, he has a background in nephrology and had trained in medical aspects of transplantation," said Dr. Kinkhabwala. "There are very few people who have that breadth of experience. Most people are limited to one kind of niche in this field but he really has a tremendous range of skills."
Dr. Shackleton received his medical degree from the University of British Columbia, completed his residency and fellowship at the University of Toronto, the University of British Columbia and Harvard Medical School. He earned certification in internal medicine and nephrology before embarking on his surgical career. Following his general surgical residency, he completed training in transplantation surgery and biology as well as vascular surgery. He has now authored more than 160 scientific papers and abstracts.
"He brings tremendous technical expertise and experience in a number of areas," said Achilles A. Demetriou, M.D., Ph.D., chairman of the medical center's surgery department. "He has proven credentials, impeccable skills, and he is adding a new dimension to a very strong program."
A native Canadian, Dr. Shackleton served on the faculty of the Department of Surgery at the University of British Columbia from 1988 to 1993. He established a provincial organ retrieval team, directed British Columbia's organ procurement network, and co-founded the liver transplant program in Vancouver. The programs maintained the highest rates of organ retrieval and graft success in Canada, and Dr. Shackleton received national recognition for his contributions to the Canadian transplant community.
He also has been involved in shaping American transplant policies, having served in the mid-1990s on the Liver and Intestinal Transplant Committee of the United Network for Organ Sharing (UNOS), the not-for-profit organization that contracts with the federal government to manage the nation's organ donor resource.
Dr. Shackleton came to Southern California in 1993 to help breathe new life into the whole-organ pancreas transplant program at UCLA. He played a major role in UCLA's pediatric liver transplant program, introducing microsurgical techniques of arterial reconstruction that resulted in better function and improved success rates.
Hugo R. Rosen, M.D., director of research for the gastroenterology/hepatology fellowship training program at Portland Veterans Affairs Medical Center in Oregon, was a hepatology fellow at UCLA in 1995 when Dr. Shackleton was a transplant surgeon. Dr. Rosen recalls receiving assistance on several liver transplant projects and said Dr. Shackleton was "an excellent mentor."
"Chris is truly a gifted physician and surgeon, having trained in a number of specialties. He is extremely competent in a number of areas," said Dr. Rosen.
Because the gulf between the number of names being added to organ recipient waiting lists and the number of donor organs is ever-widening, Dr. Shackleton stresses the importance of employing transplantation techniques that make the best use of cadaver organs and those provided by living donors.
"If we look at the growth in the number of candidates for liver transplantation in this country on an annual basis -- the number of new registrants -- that number continues to grow exponentially at 30 percent per year. Contrast that to cadaver donor numbers that are increasing at only one or two percent per year," said Dr. Shackleton. "There's no way that the need for liver transplantation is going to be met from the cadaver donor source alone without a dramatic and sustained rise in organ donation rates. And it seems unlikely that this will happen any time soon."
As part of the solution, the living-donor adult liver transplant program being implemented at Cedars-Sinai allows surgeons to take part of a liver from a living donor and transplant it into a recipient who has a matching tissue type. Even as this adult program is launched, the living-donor pediatric liver program is expected to increase dramatically, providing new hope for families with young children and infants afflicted with liver disease.
Dr. Shackleton said the success of today's transplant programs depends on the ever-increasing use of various "partial liver grafting techniques." For example, one cadaver liver is "split" to save two lives, or a segment of a living donor's liver is transplanted to someone whose liver is failing.
"What we want to do is employ those techniques that will expand the donor pool and offer more options for recipient candidates so they can be transplanted in a timely fashion," said Dr. Shackleton, adding that Cedars-Sinai is pursuing the development of another new procedure that is likely to increase the number of living donor kidney transplants.
Called laparoscopic living-donor nephrectomy, this technique allows a family member to donate a kidney to a relative without the long incisions and long-term recovery time required after major surgery.
Dr. Kinkhabwala, who like Dr. Rosen completed his fellowship training in transplantation at UCLA, said he thinks his former mentor is a "good fit" for the program at Cedars-Sinai. "He's a very skilled surgeon and also a great manager who takes care of the people who work for him. He has a good relationship with his medical colleagues and all of those things lend themselves to leadership in building a successful program."
An outdoors enthusiast who enjoys hiking and camping, Dr. Shackleton and his wife, Paula, have a daughter and two sons: Emaleah, Benjamin, and Daniel.
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