Marathoner Masters the Ultimate Team Sport
May 15, 2023
UH Clinical Update | May 2023
Marathoner Zoe Stewart Lewis, MD, PhD, MPH, new head of the Transplant Institute at University Hospitals, is taking the lead in what she considers the ultimate team sport, where minutes matter and crossing the finish line means a renewed chance at life through transplant surgery.
Drawn to medicine in the first place by the empathy of a compassionate care team when her mother was diagnosed with cancer during her college years, Dr. Stewart shifted her focus from basic science to medicine. She realized she could touch and transform lives as a physician. In her residency and fellowship at the leading transplant program in the country, she defined a path that would take her from Johns Hopkins Hospital to a leader in transplant surgery in the nation’s largest city.
“The ability to reset the clock for patients and their families with a life-saving transplant is truly amazing,” said Dr. Stewart, whose stamina, passion and drive have led her to run over 30 marathons and compete in dozens of triathlons. “Transplant is also unique in that for every surgery we do, we are impacting both the recipient's life and honoring the donor's life with their selfless gift. It’s the ultimate team sport.”
Dr. Stewart comes to UH from NYU Langone Hospital in New York, where she has served as the Surgical Director for Kidney and Pancreas Transplant and the Director of Quality for the Transplant Institute. She spent five years building that kidney program into the largest in the state of New York – and #1 in the country out of 256 programs for patient outcomes, according to the Scientific Registry of Transplant Recipients.
“Dr. Stewart is a leader in transplant surgery patient outcomes as well as a groundbreaking researcher,” said Joseph F. Sabik III, MD, Chair, Department of Surgery. “She is an outstanding addition to our transplant program and will help us continue to achieve excellence and pursue our goal of Zero Harm.”
Dr. Stewart joins UH as Director of the Transplant Institute and Chief of the Division of Transplant and Hepatobiliary Surgery at UH Cleveland Medical Center. She will be performing transplantation of kidneys, livers and pancreas in adults as well as pediatric kidney transplants and living donor nephrectomies. And she plans to grow UH’s program.
“I really love program building,” Dr. Stewart said. “I like the lift that goes into organizing and leading a team to provide a variety of transplants to the community. There is tremendous opportunity at UH to expand the delivery of outstanding care in kidney, liver and pancreas transplants.”
Dr. Stewart is a surgeon who holds organs in her hands and knows she is exactly where she is meant to be. She is a master at seeing how all the key pieces fit together in the complex lives of transplant patients, who undergo extensive medical and psychological evaluations and testing. She loves the truly multidisciplinary nature of transplant, with a spectrum of specialists from nephrology, hepatology, cardiology, infectious diseases and psychiatry.
Drawn to Medicine by Empathetic Caregivers
Before her mother developed cancer, Dr. Stewart thought she was headed toward being a scientist. She had not had enough exposure to health care fields earlier in her family’s relatively healthy life to consider medicine as a career path. Seeing the human aspect of the care delivery changed her perspective.
She earned her medical degree and a PhD in Biochemistry from Vanderbilt University before heading to Johns Hopkins Hospital, where she completed her residency in general surgery and a fellowship in abdominal transplant surgery.
“Aside from being the best in the country, they're known for very strong surgical oncology, in particular liver and pancreatic cancer,” Dr. Stewart said. “When I got into the residency there, that's where I had my first real exposure to transplant. And it was the light bulb moment. I scrubbed in on a liver transplant, and I knew that this this was where I was meant to be.”
As a daughter of a cancer patient, she already witnessed how compassion can impact the patient experience.
“What struck me was the empathy of my mother’s physicians and how effectively her different care team members explained things to us, and just took care of all of us,” said Dr. Stewart, who happily notes that her mother recovered and is ‘still crushing it at 75 – in phenomenal shape.’ “It occurred to me I would be good at this, being able to talk to patients in a way that they can relate to, and help them through the most terrifying time of their lives.”
Utilizing an Epic Tool
Dr. Stewart is delighted to see UH is adopting the Epic electronic medical record this year. She has used this EMR at NYU Langone and found it to be an extremely effective tool in transplant. Epic can provide clear checklists for caregivers and patients to keep track of all the testing needed during the transplant evaluation process, reducing return visits to the hospital. The transplant coordinator can more easily assess the steps in the process and group orders for each patient’s outstanding testing. Given that each test, depending on the outcome, may lead to additional tests, Epic allows the provider to create a customizable snapshot of a patient’s testing and results, and prompt the need for repeat testing annually for those still on a waitlist.
Through Epic’s MyChart patient portal, the coordinator can notify patients of needed tests, especially the critical weekly labs post-transplant. They can even hold some visits virtually, which was essential in congested Manhattan, where traveling downtown to the hospital may be a deterrent for some patients.
“Epic is very powerful, particularly within the transplant program,” Dr. Stewart said. “Having the ability to make efficient work flows for our coordinators on the pre- and post-transplant side is really key to delivering top-notch patient care. Epic is such an efficient and well-designed system. It was integral to facilitate the NYU program growth to what it is right now.”
An Enthusiastic Mentor
Dr. Stewart spent eight years as Surgical Director of Kidney, Pancreas & Living Donor Transplantation at University of Iowa Hospital before leaving to lead NYU Langone’s program in 2018. In her years performing these surgeries, she has seen an increase in indications for liver transplants at all ages, in part due to conditions like fatty liver disease and the obesity epidemic. Liver transplants could be necessary due to genetic diseases affecting the biliary system, viral issues or alcohol abuse. And livers do not have a dialysis equivalent that can keep a patient going until they receive a donor, she notes.
She has been a continuous active member of the Organ Procurement and Transplant Network since 2009, currently chairing its Membership and Professional Standards Committee, which reviews events that present a risk to patient safety, public health or the integrity of the transplant system in the U.S. An invited lecturer at scores of conferences and researcher who has received NIH support, she has published over 100 peer-reviewed publications and abstracts.
Dr. Stewart has developed training materials used nationally for general surgery residents and transplant fellows. She also has personally mentored several postdoctoral students and surgery residents, witnessing those “light-bulb moments” where her trainees have told her they want to be her someday, including one who repeated his internship year just to pursue transplant surgery.
“It’s exciting – you see it at really high-functioning transplant programs, where a high number of residents pursue transplant surgery,” said Dr. Stewart, noting NYU Langone performed 335 kidney transplants per year. “That’s what I intend to build at University Hospitals.”
A Runner Focused on the Finish Line
Dr. Stewart has found it gratifying mentoring surgeons who are promoted to full professors or landed prestigious positions. Those mentees over the past two decades have at times felt like her own.
Yet she and her husband, a former athletic trainer who became a full-time father when she took the NYU position five years ago, have two children. Their 11-year-old son is a competitive swimmer who is nationally ranked in the butterfly. Their daughter, 9, is a budding equestrian who is very excited about the move to Cleveland.
The couple met through a shared passion for mountain biking and travel to Colorado every year to hit the trails. She ran track in college and competed in the half-mile and mile in college and began logging marathons in states across the country. During a six-month stint at a hospital in Oxford, England during her surgical training, she participated in marathons in Warsaw, Berlin and Dublin.
“I was a super-competitive runner, though my knees don’t like it so much anymore,” she said, adding “But I still get to compete in the ultimate team sport, guiding the care of these complex transplant patients.”