Dies Natalis Pharmaciae Sacrum

Prof. dr. D.J. (Daan) Touw

My name is Daan Touw, and I am a hospital pharmacist, clinical pharmacologist, and toxicologist at UMCG. I lead the laboratory within the Department of Clinical Pharmacy and Pharmacology (KFF), where we measure drug concentrations in serum, plasma, and other biological matrices to optimize therapy (personalized medicine). We also conduct toxicological research. As UMCG is the leading transplant center in the Netherlands, it is no surprise that our lab analyzes numerous concentration measurements of immunosuppressants drugs essential to prevent rejection of transplanted tissue. Besides routine analyses, we participate in research focused on improving the survival of transplanted tissue and thus enhancing our patients’ quality of life. Throughout my career, I have primarily focused on pharmacokinetic research. I earned my PhD in 1996 with a study on the pharmacokinetics of intravenous andinhaled tobramycin in patients with Cystic Fibrosis. Since then, I have supervised many colleagues during their PhD journeys. The majority of my career was spent at the Apotheek Haagse Ziekenhuizen (The Hague), where I led the laboratory. Since 2013, I have been a Professor of Bioanalysis, Therapeutic Drug Monitoring, and Clinical Toxicology at UMCG and am also affiliated with the Faculty of Science and Engineering at the University of Groningen. You may know me from courses such as Pharmaceutical Analysis, Advanced Pharmacokinetics, and Clinical Toxicology. At UMCG, I have initiated and supervised numerous pharmacokinetic studies. Since starting my work in Groningen, I have also become closely involved in transplant care, and our laboratory has contributed to over 50 studies. During the scientific symposium, we aim to give you a glimpse into the world of transplants.

Dr. W.S. (Willem) Lexmond & Dr. C.I. (Carlijn) Buis

In the Netherlands, an average of 25 children undergo liver transplants each year. The UMCG has been the national center of expertise for pediatric liver transplants for 40 years, and these surgeries are conducted exclusively in Groningen. Patients eligible for liver transplantation suffer from severe (either congenital or acquired) liver diseases, metabolic disorders, or liver cancer. Until about 10 years ago, children, like adult patients, relied on organs from deceased donors. Today, however, this practice has evolved. Currently, the majority of liver transplants in children are performed using a portion of the liver from a healthy living donor. Pediatrician Willem Lexmond and liver surgeon
Carlijn Buis will reflect on the rise and success of this program and discuss the processes of screening, the transplantation itself, and post-operative care. 

Willem Lexmond studied Medicine in Groningen and encountered pediatric liver transplant care for the first time during his final internships. Following his doctoral research in mucosal immunology at Boston Children’s Hospital, he trained as a pediatrician at the Sophia Children’s Hospital of Erasmus MC in Rotterdam and the Beatrix Children’s Hospital in Groningen. Since completing his fellowship in pediatric gastroenterology and hepatology, he has worked as a pediatric GI and liver specialist at UMCG since 2023, playing a key role in the care of children before and after liver transplantation. Carlijn Buis is a surgeon at UMCG in the Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation. She studied in Groningen and, inspired by professors Gips and Krom from the Mayo Clinic in Rochester, developed a passion for liver transplantation. After internships in Deventer, she pursued an AGIKO (clinician-researcher) track in Groningen, Adelaide, and Deventer, combining a PhD project with her surgical training. Her dissertation was titled “Molecular and Biochemical Mechanisms of Bile Duct Injury after Liver Transplantation.” She then completed a two-year fellowship in HPB and Liver Transplantation at UMCG, culminating in certification by the European Board of Surgery (FEBS). Her main focus areas include living-donor liver transplantation and transplants for colorectal liver metastases. She also holds several administrative roles related to her position.

Dr. M.B. (Midas) Mulder

Liver transplantation (LT) has become a lifesaving treatment option for patients with end-stage liver disease and acute liver failure. Over the past decades significant developments have been made in the field of LT, which steadily led to improved outcomes and  long-term survival. However, long-term care after LT remains complex. LT recipients undergo significant changes in their medication regimen during the follow-up with an increased risk for medication-related problems.

LT recipients need to adhere to difficult therapeutic regimens, which often consist of multiple immunosuppressive drugs to prevent for rejection of the graft.  In addition to the complex therapeutic regimens, LT recipients are prone to multiple other pharmacotherapeutic problems such as side effects and immunosuppression-related complications (e.g. nephrotoxicity and malignancies). Furthermore, LT recipients will usually receive more medication over the years due to the development of new-onset diabetes mellitus, hypertension, and hyperlipidemia. 

In this lecture we will discuss the different immunosuppressive drugs for transplantation available nowadays. What side effects do these drugs cause? How do we handle these side effects? And how could you guide transplant recipients in the outpatient setting as a pharmacist?

Midas Mulder graduated in 2014 from the University Utrecht and in 2015 got the opportunity to start his residency in hospital pharmacy at the Franciscus hospital, Rotterdam. After finishing his residency he worked as a hospital pharmacists and PhD-student at the Erasmus University medical Center. Since November 2023, Midas is working as a hospital pharmacist and deputy trainer at the Haaglanden Medical Center, The Hague and in June 2024 he defended his thesis titled “Optimizing drug therapy in liver transplantation – for better patient outcomes”. Midas is specialized in the care for patients with a liver disease, liver transplantation and other gastrointestinal diseases. In 2019, he initiated a weekly outpatient monitoring program for the liver transplant recipients of the Erasmus MC. 

Dr. P. (Paola) Mian 

Paola Mian (1990) studied Pharmacy at the Utrecht University, Utrecht, the Netherlands. During her master pharmacy she developed an interest in pediatric and perinatal pharmacology. She performed her master thesis at the University College London, Londen, UK where she worked for 6 months on a research project studying the efficacy and safety of the pneumococcal vaccine in children. In addition, she performed a clinical pharmacy rotation at St Jude’s Children Hospital, Memphis, TN, USA with special focus on therapeutic drug monitoring (TDM) and pharmacokinetic of oncolytic drugs in pediatric cancer patients. After obtaining her master degree, she started as a PhD student at the Department of Pediatric Surgery and Intensive Care, Erasmus MC Sophia Children’s Hospital, Rotterdam, the Netherlands. During her PhD she worked in the field of perinatal and pediatric pharmacology in combination with pharmacometrics (both population pharmacokinetic and physiologically based pharmacokinetic modelling) to develop evidence based dosing regimens for those special populations. During her third year of her PhD, she performed part of her PhD at the Pediatric Pharmacology and Pharmacometrics research Center, UKBB, Basel, Switzerland. Additionally she was trained as a clinical pharmacologist, for which she obtained her certificate in 2017. In 2019, she started as a resident clinical pharmacy at Medisch Centrum Twente, Enschede, Prinses Maxima Centrum for Pediatric Oncology, Utrecht, and the University Medical Center Groningen (UMCG), Groningen, the Netherlands. During this four year period she specialised even further in perinatal and pediatric pharmacology, drugs and lactation, TDM and toxicology. In addition, she started her own research group focusing on pharmacometrics and perinatal-pediatric pharmacology. In addition, she built her own wet lab for ex vivo and in vitro experiments (ex vivo placenta perfusion model, placenta on a chip system, placenta cut slices) to inform the in silico models with, all to move to better and safer drugs in the above mentioned special populations. Currently she (co)-supervises 7 PhD students and has already supervised over 80 bachelor- and master students. From 2023 onwards, she is a full staff member of the UMCG and Principal Investigator. In 2024, she was appointed assistant professor at the UMCG. In the same year she obtained her European Board Certificate as a Toxicologist. During this presentation she will give an overview on drugs used in transplantation in both pediatrics and pregnant women.

Dr. T.J. (Tanja) Zijp 

Tanja Zijp (1994) was born and raised in Wageningen and moved to Groningen in 2012 after completing her pre-university diploma. She studied Pharmacy at the University of Groningen, combining her Bachelor’s degree with an Honours College program. For her Master’s, she completed a research project in the Department of Clinical Pharmacy and Pharmacology (KFF) under the supervision of Prof. Dr. H.J.L. Lambers Heerspink, focusing on diabetic nephropathy. Immediately after finishing her studies, she obtained a position in the KFF department of UMCG as a PhD candidate. Alongside her PhD, she worked as a
project pharmacist in compounding (2019) and as a trial pharmacist in Clinical Research Support (2023–present). In her research, she collaborated with her supervisors Prof. Dr. D.J. Touw, Prof. Dr. S.J.L. Bakker, Prof. Dr. J.F.M. van Boven, and Dr. T.J. Gan. In 2024, she successfully defended her dissertation publicly, titled “Optimising Tacrolimus Treatment in Solid Organ Transplant Recipients.” Her lecture covers various aspects of her PhD thesis, highlighting improvements in tacrolimus treatment for transplant patients. This includes recent advances in tacrolimus bioanalysis, studies on factors influencing clinical variability in tacrolimus levels (such as sex differences and interactions), and new approaches for therapeutic drug monitoring and adherence research.

Prof. dr. S.J.L. (Stephan) Bakker 

TransplantLines is a data and biobank. With the information in this biobank, scientists can conduct research on both short- and long-term outcomes following organ transplantation, as well as on all factors, participant characteristics, and treatments associated with it. Using biological material such as blood, urine, and tissue samples, along with medical data, scientists can investigate short- and long-term outcomes after organ transplantation and explore all related factors, participant characteristics, and treatments. Transplant patients are often affected by numerous health issues, many of which are similar to those in the general population but appear at a much younger age. By collecting data from thousands of transplant patients, we aim to learn more about the specific health challenges they face. 

Prof. Dr. Stephan Bakker is a professor of Internal Medicine and the founder of TransplantLines. During the symposium, he will delve deeper into the importance of the data and biobank in research for transplant patients.

Dhr. S. (Sjors) van Kats

In current medical practice donated human tissues can be applied to replace tissue structures in patients that are affected because of disease or trauma. The predominant human tissue structures that are being replaced for donated tissue are eye (cornea), bone and tendons, skin, heart valves and vascular conduits. ETB-BISLIFE (Haarlem) is a multi-tissue center that receives, processes, stores and distributes donated human tissues from deceased and living donors. As a not for profit foundation, ETB-BISLIFE collaborates closely with the Netherlands Transplant Foundation (NTS) and the Netherlands Tissue Retrieval Organisation (WUON) for the procurement of donated tissues from deceased donors. ETB-BISLIFE also collaborates with orthopedic departments of hospitals for the procurement of femoral heads from living donors. After donor approval, donated tissues are aseptically processed in a state of the art processing facility in Haarlem. The donor tissue is dissected and the tissue grafts considered suitable for application in humans are selected and preserved.
Following quality control (sterility testing, qualitative and quantitative tests), the tissues can be released for storage and distribution. Donated human tissue grafts can be applied in patients to restore sight (corneal tissue), to treat congenital cardiovascular defects (heart valves and vascular conduits), to serve as temporary bandage in burns or other dermal trauma (skin) or to fill bone defects (local or structural) or replace soft tissues (tendon, menisci) in orthopedic surgery. In this way ETB-BISLIFE contributes to the improvement of quality of lives, and occasionally the saving of lives of patients.