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A Wall Profile

Exploring Ethical Challenges in Transplantation Keeps Prolific Researcher, Surgeon, Bioethicist Dr. Anji Wall Energized

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IMG 6797Anji Wall, MD, PhD, abdominal transplant surgeon at Baylor Simmons Transplant Institute in Dallas, says she is passionate about the technical challenge of transplant surgery, but dramatically improving the quality of life for a transplant recipient patent is most important to her. “What I love about transplant is that when a lot of my patients come out of the O.R., they feel better than they did when they went into the O.R.,” says Wall. “Your patients look like a different person when they come out with a functioning kidney. It’s really cool to see patients come in having been on dialysis forever, doing a three-hour operation and totally changing their lives. It’s fantastic.”

In addition to being a transplant surgeon, Wall is also a bioethicist. She served on the planning committee for the Organ Donation and Transplantation Alliance’s 2023 National Critical Issues Forum on NRP and spoke at The Alliance’s 2023 National Pediatric Donation & Transplantation Conference exploring NRP in Pediatric DCD. She first became involved with The Alliance in 2022 when Erin Vines, BS, clinical research associate at Southwest Transplant Alliance, asked her to present data from a research project on variations in donation after circulatory death hospital policies.

Wall was born in Nova Scotia, Canada, and moved to Daphne, AL when she was eight years old when her father joined the physical therapy faculty at the University of South Alabama. After high school, she wanted to study biomedical engineering and at the time there were only a couple of dozen undergraduate programs available, so she attended The Catholic University of America (CUA) in Washington, D.C. A bonus was that as an NCAA Division III school, she was able to play varsity volleyball and compete in varsity swimming.

“At CUA there was an exclusive research opportunity with the National Institutes of Health, and I was able to do my senior project on developing a wearable device that could determine walking speed,” says Wall. “This was before GPS was accurate.” During her time at CUA, she was introduced to global health outreach as a college student through trips to Guatemala and Jamaica.

Medicine a Chance to Provide Service

Coming out of high school, Wall knew she was interested in medicine and took pre-med classes to keep the option of going to medical school open. A graduation address convinced her that medicine was the field for her. “My brother was five years ahead of me, and when I was a junior in college, I was trying to decide if I was going to go on and do a master’s or a PhD in bioengineering or go to med school and the speaker at his  University of Pennsylvania medical school graduation was very powerful and shared a quote from Shirley Chisholm: “Service is the rent that you pay for your place in the world’ and that medicine is a perfect way to provide service to other members of society. It convinced me that medicine is a great field. It’s not just about being a doctor; it’s that you have the opportunity to provide a service that people need.”

She went on to medical school at St. Louis University where she also earned a PhD in medical ethics and was influenced by bioethicist and emergency room physician Carl Griffin Trotter. “I got really interested in the idea of research ethics and global and local standards of ethics,” says Wall. “I thought it would be it would be a good PhD to get in terms of learning a different way of thinking about medicine.”

She focused her dissertation on ethical issues that occur during medical missions and created a model for how to think about ethical problems in the context of medical volunteer work in developing countries. She turned the dissertation into a book, Ethics for International Medicine: A practical guide for aid workers in developing countries. She says that Professor Ana S. Iltis was her mentor during her graduate program and provided support during her PhD work. Iltis now directs the Center for Bioethics, Health and Society at Wake Forest University.

Love of Transplant Surgery

While in her general surgery residency at Vanderbilt, she had an ‘away’ rotation in Kenya with the Hope Through Healing Hands organization and had an appointment in Vanderbilt’s Center for Ethics. Wall rotated on the transplant surgery service during every year of her residency and found that she loved it.

“There were there are several things about transplant that fit with what I wanted to do,” says Wall. “Transplant surgeons are technically excellent. They’re the ones that other surgeons call when they’re struggling regardless of the operation. Developing that technical competency was very important to me. Transplant surgeons have the skill set that can get you out of trouble in many different situations, and if you can do the difficult cases, it means that you’re comfortable in the O.R. no matter what happens. I wanted to be a surgeon who doesn’t necessarily have to call for help because I know how to get myself out of trouble.”

“Additionally, in transplant surgery, you get to treat medically complex patients, so you have to provide a lot of critical and medical care. I really like medicine and I wanted to have a practice where I got to keep practicing the medicine and the critical care part of surgery.“

“Finally, I just love the operations. I recognized in residency that I was the most comfortable when I was doing the same procedure over and over again. I do kidney transplants, liver transplants, donor nephrectomies, kidney-pancreas transplants and deceased donor procurements. I do five operations and I can concentrate on being very good at those five. The bottom line is that I like doing the same thing over and over again. I like having expertise in a limited number of operations that I do frequently.”

Research Niche

She did her transplant surgery fellowship at Stanford where she also worked with Dr. David Mangus, director of the Center for Biomedical Ethics. A prolific researcher, with 80 published papers, Wall is the vice chair of research at the Baylor Simmons Transplant Institute. Her research interests include transplant policy ethics, ethical and clinical questions in uterus transplantation, and perceptions of waitlisted patients regarding different types of donors.

“It turns out that having a PhD in ethics is actually a fantastic research niche for transplant, because there are so many ethical challenges in transplantation across the spectrum–at the patient level, at the donor level, and at a bigger society policy level,” says Wall. “There are just so many ethical challenges that we face in transplantation that I’m never going to run out of research to do.”

In 2022, she presented on “The Ethics of NRP” at the  Annual Scientific Meeting of the Texas Transplantation Society. In March 2023, she served on the working group of the National Institutes of Health’s (NIH) National Heart, Lung, and Blood Institute (NHLBI) two-day workshop on “Heart and Lung Transplantation: Science and Ethics of DCDD and Xenotransplants.”

Busy Weekends

Wall’s husband is a sculptor and gallery director at the University of Dallas. They met while Wall was in medical school in St. Louis where they both played in a hurling league, which is Irish field hockey, according to Wall. She has joined the Dallas Master’s Swim Team, and when she’s not working every other weekend, she swims coached practices of 3,000 plus yards on Saturday and Sunday mornings. This past year, she joined a Swim Across America team from the Baylor Scott & White Sammons Cancer Center where her office is located and did an open-water mile swim to raise money for cancer research. On the weekends, she also attends the sporting events of her eight-year-old son who is involved in basketball, wrestling, baseball, and soccer.

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Wall recently vacationed in Rome with her husband and son.

Wall’s mother was from Ireland and her father was from England and because both of her parents were teachers, Wall spent a couple of months each summer in England and Ireland visiting relatives when she was growing up. This past summer, she took her son to Ireland to meet his 40+ cousins who live there.

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Wall and her son recently visited Ireland to visit over 40 cousins.
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