After receiving his recent Young Investigator Award from the Royal Australasian College of Surgeons' Section of Academic Surgery, Su Kah Goh talks about exciting new developments in organ transplantation, the challenges he faced as a junior scientist trying to establish his career, and his alternative dream career...
What do you do at the ONJCRI?
I am currently a final year PhD student and I am working on a collaborative project with my supervisors at the Translational Genomics and Epigenomics Group at the ONJCRI and the Department of Surgery of The University of Melbourne. I am hoping to submit my thesis in a few months’ time, after which I will return to clinical work with a view to complete my training to be a general surgeon!
Can you tell me about this project that you’ve been working on?
Unfortunately, 30-40% of people develop organ rejection in the first 12 months after transplantation. The current means of diagnosing this is rather invasive as we have to insert a large needle through the skin and into the liver under local anaesthetic in order to obtain a small sample of liver tissue. Under my supervisors, I am working on a project to develop a blood test that will monitor organ health after liver transplantation. We borrowed liquid biopsy techniques from oncology and applied them to our project. It’s actually quite cool! DNA between individuals is subtly different. If I, the donor, were to put my liver inside of you, the recipient, a small amount of my DNA would be shed into your bloodstream. The blood test that we have developed allows us to count the number of ‘donor’ DNA molecules that are in the recipients’ blood. Using this blood test, we have shown in our studies that an elevated amount of ‘donor’ DNA in the recipient can be diagnostic of organ rejection. Perhaps one day, this test may help clinicians reduce, or even better, replace liver biopsies. However, further studies are needed before we hit prime time!
Is there any way in which the results of your project could be used in cancer treatment?
It’s a stepping stone. We’ve repurposed a technique that was originally developed for cancer detection in another medical specialty. Although I work in a cancer-focused institute, my project is a good example of how sharing knowledge and expertise across disciplines can have benefits. The importance of tests like liquid biopsies will increase and it’s through these collaborations that we can start thinking about how we would apply liquid biopsies. More than 25% of liver transplantations performed at the Austin Health are for early stage liver cancers. Often in these patients, surveillance for cancer recurrence is difficult. Perhaps with more time and further collaborations, we can explore the use of liquid biopsies to improve the way that we look after this unique group of patients being treated for liver cancer.
When did you realise that you wanted to pursue a career that links surgery with scientific research?
In my brief career as a training surgeon, I have found it all incredibly rewarding, from treating patients for simple appendicitis to removing cancers from patients with a view to curing them. Often, I am fascinated by how we can use science to continually improve the way that we look after these patients. As time went by, I was presented with an opportunity to partake in a collaborative project at the ONJCRI and I thought that this would be a great chance for me to learn to use modern molecular technologies and genetics to change the way that we diagnose organ rejection after liver transplantation. So, with these interests in mind, I thought that I’d take this challenge on board as my PhD and see if I can make a difference!
What were some of the challenges that you faced as a junior scientist establishing your career?
It has been 10 years since I graduated from medical school. On the clinical side, as a young surgeon on his training wheels, there are challenges every day, like learning to operate and manage unwell patients, as well as meeting a reasonable work-life balance. But this was nothing compared to starting my career as a PhD student. I had no experience with dealing with pipettes, very little knowledge of DNA, let alone actually developing liquid biopsy tests! Those were some of the most challenging aspects of being a junior scientist for me; trying to learn all of these new ideas and foreign terminologies and then putting them all together. None of this would’ve been possible without the supervision that I have received from the people around me. It was really the support that I had from the professors and members of both the Translational Genomics & Epigenomics Laboratory at ONJCRI and the Department of Surgery at The University of Melbourne that got me to where I am today. Most importantly, there's my fiancée, who never fails to put a smile on my face!
What’s your favourite part of the job?
You can actually sit down and have lunch! Clinical work is actually quite busy and I think that the best thing about being a full time PhD student is the opportunity given to you to roam free and think, within limits of course…. You can kind of just sit down, reflect, and think about the problem, because you’ve got the time. Working in the lab involves, more often than not, troubleshooting and optimising your assays or tests so that they are reliable every single time. I like problem solving, so it’s actually quite a fun exercise and I think that it does become quite intellectually stimulating.
You’ve recently been awarded a Young Investigator Award by the Royal Australasian College of Surgeons’ Section of Academic Surgery. How did you feel after receiving an honour like that?
It’s very nice! It makes me feel like all those long weekends spent processing patient blood samples and endless days in the laboratory getting the assays to work paid off. To me, receiving this award has helped me reinforce the value of working hard, appreciate the support of the people around me, and understand the importance of working with others.
Are there any exciting new developments that you see in store for your field of study or for science in general?
I think that lots of things are going to happen as the technology improves, as our understanding of the genome improves, and as more research gets done. In the future, I think that we’ll see a lot of liquid biopsy tests that will help doctors and their patients make more informed and accurate treatment choices. I believe that these tests will not only transform the outcomes of transplantation medicine, but also those in oncology and across all other fields of modern medicine.
What advice would you give your younger self about embarking on a science career?
I would say that when you come across challenging times, just persevere, put your head down, and do the work. With time, if you put in a good share of work, you’ll see results in the end. Sometimes they’ll be really positive and that’s great, but if they're negative, that’s okay too – at least you know the answer now and can just move onto the next thing on your agenda.
If you weren’t a scientist right now, what would you be instead?
I’d be a pilot – come and have a coffee with me, and I’ll tell you more!
Read more about Su's research here