Mental Health Week 2022: Interview with Dr. Istvan Mucsi
Did you know that since 1951, the Canadian Mental Health Association (CMHA) has hosted Mental Health Week in the first full week in May? This year, CMHA’s Mental Health Week is being observed May 2-8, 2022. This week is to encourage everyone to learn, talk, reflect and engage with others on all issues related to mental health. According to the CMHA, in any given year, 1 in 5 people in Canada will personally experience a mental health problem or illness. For more information on CMHA’s Mental Health Week, please visit their website.
In honour of Mental Health Week, Kristian Stephens, CDTRP’s Knowledge Translation Coordinator, recently caught up with Dr. Istvan Mucsi to learn more about his research project: “Emotion and Symptom-focused Engagement for Patients with Solid Organ Transplant (EASE-SOT): an Open-Label Pilot Randomized Study.”
About Dr. Istvan Mucsi
Dr. Mucsi is a clinician investigator and transplant nephrologist at the Multi-Organ Transplant Program and Division of Nephrology at the University Health Network (UHN) in Toronto. He also holds a cross appointment with the Semmelweis University Budapest.
His current research focuses on understanding and reducing barriers and disparities in access to kidney transplantation and living donor kidney transplantation and assessing the impact of psychosocial distress on clinical outcomes of kidney transplant recipients.
Can you please describe your project?
Simply this project is about building a tool to help solid organ transplant (SOT) patients deal with physical and emotional symptoms. SOT saves lives and improves quality of life. In 2017, nearly 3,000 SOTs were performed in Canada. However, up to 50% of transplant recipients still have pain, sleep problems, side effects of the transplant medications, and emotional distress from the illness, donor-related concerns, rejection anxiety, and fears about death. These concerns often go unnoticed and untreated, leading to poor quality of life, unnecessary suffering, emergency visits and hospital admissions. Emotional distress causes up to 30% of patients to fall off their treatment plan. SOT patients have often asked for help with these symptoms as a top research priority. Addressing these symptoms improves patient-doctor communications, helps patients stick to their treatment plan and improves quality of life.
A tool called Emotion And Symptom-focused Engagement (EASE) was developed to relieve similar distress in patients with leukemia through counselling and early detection and management of physical symptoms. Research has shown that EASE reduces distress and improves quality of life for patients newly diagnosed with leukemia. We are working with the developers of EASE at Princess Margaret Cancer Centre and with patients and transplant professionals at UHN to adapt EASE to the needs of SOT recipients and candidates. In this project, we will test the new program (EASE-SOT) in patients to see if it can be used with SOT recipients and how well they like it. These results will tell us how well and easily the tool can be used routinely in clinics. If the EASE-SOT tool is usable, we will plan a larger study to confirm its usefulness. We expect that the new tool will deliver better care by bringing the patient voice to the forefront of transplant care; greater satisfaction with care among patients and doctors; better general health after transplant; better quality of life for SOT patients and caregivers; and cost savings for healthcare systems.
Why is this research important to you?
I am very glad that I can work in the field of transplantation. Successful organ transplant is life-saving for many patients, life-altering, life-improving for others. Many patients still cannot enjoy the full benefits of the transplant because of ongoing physical and chronic symptoms and the impact of those symptoms have on their everyday life and on their quality of life. While not all symptoms can be fully eliminated, many of these symptoms can be better managed, and their impact on quality of life reduced. For many years we have been studying the tools that can precisely and efficiently measure and monitor symptoms. This project will enable us to take the next step and start using at least some of those tools in the clinical care of transplant recipients.
Why is your focus on mental health?
My wife, Dr. Marta Novak, is a psychiatrist and we have been conducting these studies together for many years. Furthermore, I can also see in my post-kidney transplant clinic the impacts of mental health concerns of people`s life – and this has been further emphasized by the impact of the COVID pandemic. Importantly, I think the current pre- and post-transplant care does not pay enough attention to the assessment and support of mental health concerns for patients and their families.
How do you think this research will advance the field?
The EASE intervention has been developed by Drs. Gary Rodin and Camilla Zimmermann at the Princess Margaret Cancer Center for patients with leukemia. During this project we will adapt the EASE intervention for solid organ transplant recipients – so we will have a clinical tool ready to be used. Our project will also answer the question if a large study to assess the effectiveness of this tool will be feasible.
What are some of the challenges that you have faced with this research? How have you overcome them?
We have a large collaborative team that works on this, that includes several patients with different organ transplants and several clinicians and researchers. It has not always been easy to find the time for the meetings to advance the work. Furthermore, with COVID we had to use the virtual platforms to meet. While these platforms allow increased efficiency, we miss the direct, in person interaction.
What are the next steps for this project?
We have revised the intervention manual based on our previous work and experience. We will start recruiting a small number of patients to start using this intervention and collect detailed intervention to see if further adaptation is needed. We are then going to apply for full funding from CIHR in the fall and we hope to get the pilot study going in 2023.
The CDRTP Mental Health and Wellness Hub
The CDRTP Mental Health and Wellness Hub is a targeted group specifically focused on ideas exchange, initiatives to build research capacity across Canada, collaborative grant development and project support. The goal is to develop and submit a team grant for national funding. This Hub focuses on mental health outcomes and its associated conditions related to transplant recipients – an under-researched patient and caregiver priority. Initial meetings sessions will feature short presentations from CDTRP researchers who are doing great work in mental health and transplant. Presentations are followed by discussions on how the CDTRP Mental Health Hub can advance work in this space. Ultimately, the meetings will be a forum for grant development, review and support for grant applicant teams – in preparation for funding applications.
ity of Alberta and has received training in patient-oriented research through the University of Calgary’s PACER (Patient and Community Engagement Research) Program. He is the Patient, Family, and Donor Partnerships & Education Manager with the Canadian Donation and Transplantation Research Program. In this role, Manuel builds relationships patient partners with investigators and strengthens capacity among CDTRP patient partners.
Anders Billström 
Gareth Wiltshire
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Sherrie Logan 
born and raised in Edmonton, AB. With a degree in Music Performance (saxophone performance) and Education, Lindsey has taught for over a decade in the Edmonton Public School system. When she is not teaching, she is very involved in the music community, performing in the Edmonton Winds, conducting her own community ensemble (The Beer League Band) and on numerous musical boards across the province. For the past 5 years, Lindsey has had to take a break from teaching after having her amazing son, George. Maternity leave did not goes as expected as George was diagnosed with Dilated Cardiomyopathy at 5 months old and required 2 heart transplants before the age of 4. During this time, Lindsey has also began to dedicate her time building and expanding her charity: Big Gifts for Little Lives, where they raise money to fund Pediatric Heart Transplant research at the Stollery.
Dr. Caigan Du is a scientist at the Vancouver Coastal Health Research Institute and an assistant professor in the Department of Urologic Sciences at the University of British Columbia. He received a Ph.D. degree in Biochemistry in UK and postdoctoral training in Immunology in USA. He is interested in the pathogenesis of kidney ischemia-reperfusion injury and transplant rejection, and molecular control of urinary malignancies. He has been studying the impact of kidney donor-derived factors on renal allograft rejection, and the molecular pathways of kidney injury and regeneration in experimental models. He is also interested in developing medical solution including drugs made from natural compounds for all kinds of health problems, including immune disorders, organ preservation, kidney failure and urinary cancer. He is the PI of many grant supports from the Kidney Foundation of Canada and the Canadian Institutes of Health Research.
Heather Badenoch is a non-directed living liver donor and communications strategist. As the president of Village PR, she provides strategic communications direction and training to not-for-profit clients in community and health. An active transplant volunteer, Heather helps transplant candidates find living donors by running their public appeals, small and large, pro-bono. She also mentors potential living donors on the path to living donation. Heather is a volunteer with the UHN Centre for Living Organ Donation and the Canadian Donation and Transplant Research Program. She and her spouse adopt rescue dogs and volunteer together with Community Veterinary Outreach, a group providing free veterinary care to the pets of people who are homeless.
Sean Dicks is a clinical psychologist who has 20 years’ experience supporting both families of organ donors and transplant recipients. While it is rare for him to have contact with a donor family and recipient linked to the same organ donation-transplantation event, his contact with families who have lived experience with organ donation on the one hand, and patients who have received transplants on the other hand has provided opportunities to explore how their journeys become linked when they attempt to make sense of and find meaning in their respective crises.
Terri Hansen-Gardiner is a Cree speaking Metis woman from Northern Saskatchewan as well as a 10 year Breast Cancer Survivor. Her tireless spirit and dedication to her community is undeniable. Terri is a cancer survivor who travels around the province to provide assistance, information, and support to Indigenous patients who are trying to access and navigate the cancer care system.
Dr. Golnaz Karoubi is Assistant Scientist at the Toronto General HospitalResearch Institute and principal investigator in the Latner Thoracic Research Labs. She currently holds an Assistant Professor appointment in the department of Laboratory Medicine and Pathobiology and a cross-appointment in the department of Mechanical and Industrial Engineering at the University of Toronto. Dr. Karoubi received her PhD in Applied Science and Engineering at the University of Toronto and joined the Lung Regenerative Medicine Program in the Department of Clinical Research in Berne University, Switzerland for a post-doctoral research fellowship. She stayed on as a Group Leader in 2008 to direct the basic and transitional science as related to Cancer Stem Cell and Lung Regenerative Medicine in the Department of Biomedical Research at the University of Berne until 2012. In early 2012, she joined the team of Dr. Tom Waddell at the Toronto General Hospital Research Institute as a Senior Scientific Associate and was appointed to Assistant Scientist at the Toronto General Hospital Research Institute (University Health Network) in November 2019 and to Assistant Professor in the Department of Laboratory Medicine and Pathobiology in July 2020.
Dr. Haykal graduated from the University of Ottawa Faculty of Medicine in2007 as class valedictorian and silver medalist, and subsequently completed her residency training in Plastic and Reconstructive Surgery at the University of Toronto in 2016. During her residency, she completed a four-year Doctorate of Philosophy (PhD) in tissue engineering, regenerative medicine and immunology with a focus on tracheal reconstruction. She obtained numerous grants and awards including a CIHR Vanier Scholarship. Dr. Haykal then pursued fellowship training in microsurgical reconstruction at the Albany Medical Centre in New York. Dr. Haykal joined the University Health Network and the Toronto General Hospital in 2018. Her clinical focus is on complex oncological reconstruction and microsurgical reconstruction of the breast, head and neck and extremity. She started a lymphedema program in 2019 where she offers microsurgical techniques for the treatment of lymphedema.
Dr. Ahmed is a Professor in the Cumming School of Medicine at the University of Calgary. The recipient of the 2022 Hypertension Canada Senior Investigator Award, she is a nephrologist and clinician-scientist with a focus on sex and gender differences in human cardiovascular/kidney physiology and clinical outcomes. Dr. Ahmed is the Vice Chair (Research) for the Department of Medicine, Lead of the Libin Institute Women’s Cardiovascular Health Research Initiative at the University of Calgary and Lead of the Alberta Strategy for Patient Oriented Research Capacity Development Platform. Dr. Ahmed is an Advisory Board member for the Canadian Institutes of Health Research Institute of Gender and Health, a member of the Canadian Medical Association Journal Governing Council and the President-Elect for the Organization for the Study of Sex Differences.
r. Christopher Nguan is an Associate Professor at the University of British Columbia in the Department of Urological Sciences, Surgical Head of Kidney Transplantation at Vancouver General Hospital and the Director of the Surgical Technologies Experimental Laboratory & Advanced Robotics (STELLAR) facility at Vancouver General Hospital.
r Caroline Lamarche is a clinician scientist and transplant nephrologist at Maisonneuve-Rosemont Hospital. She is an assistant clinical professor at the Université de Montréal. After her nephrology training at the Université de Montréal (2015), she completed a Master degree on the use of adoptive immunotherapy to treat/prevent BK nephropathy in kidney transplant recipients. She then pursued a post-doctoral fellowship with Dr. Megan Levings at the University of British Columbia on the use of chimeric antigen receptor (CAR) regulatory T cells (Tregs) to induce transplant tolerance. Her lab is working on the development of adoptive immunotherapy in nephrology and understanding Treg dysfunction.
Dr. Tandon is an Associate Professor of Medicine, Co-Director of the Cirrhosis Care Clinic, Transplant Hepatologist and lead of the Cirrhosis Care Alberta quality improvement program. She obtained her training at the University of Alberta, the Hospital Clinic in Barcelona and Yale University. Her clinical practice and research are focused on cirrhosis with research interests including cirrhosis related complications, malnutrition, frailty, exercise therapy, palliative care, integrative health approaches such as meditation and knowledge translation. It is her career goal to provide wholistic, interdisciplinary, evidence based, patient-centered care through education, empowerment, engagement and team-work.
Emily is a PhD student at the University of Alberta, where she completed her Master of Science (MSc) degree in medicine. With a passion for patient-oriented research and a commitment to improving health outcomes, Emily’s doctoral project focuses on EMPOWER, a 12-week online mind-body wellness program designed for adults living with chronic health conditions.
Dr Basil S. Nasir, M.B.B.Ch
Dr. Victor Ferreira is an Assistant Scientist in the Ajmera Transplant Centre at the University Health Network (UHN) and the Toronto General Hospital Research Institute (TGHRI). He is also an Assistant Professor at the University of Toronto in the Department of Laboratory Medicine and Pathobiology (LMP). He completed his PhD in Medical Sciences – Infection and Immunity Specialization at McMaster University in 2014 and post-doctoral training at UHN. His research program is focused on three pillars: I) using systems vaccinology to reveal insights into vaccine responses in immunocompromised individuals like transplant recipients; II) characterizing the impact of chronic viral infection on host immune responses; and III) developing novel methods for eliminating latent viruses in human organs. His work has been cited >2,500 times and is published in journals including the New England Journal of Medicine, Nature Immunology, the Lancet Infectious Diseases, Clinical Infectious Diseases, the American Journal of Transplantation and Journal of Infectious Diseases.