Passionate about pulmonary rehabilitation and exercise strategies, researcher Dr. Dmitry Rozenberg, combines both interests in an emerging field in transplantation.
Aiming to enhance physical functional ability and the quality of life for lung transplant candidates through his research, Dr. Rozenberg focuses on the significant impairments in skeletal muscle mass, strength, and function — all individual components of sarcopenia (muscle dysfunction) that are potentially associated with frailty in a person.
“In lung transplant, and all solid organ transplant, muscle dysfunction is a significant problem in the pre- and post-transplant periods,” says Dr. Rozenberg, who is enrolled in the Clinician Scientist Training Program at the University of Toronto and is pursuing his master’s degree through the Institute of Medical Science. “In the pre-transplant period patients have malnutrition, protein break down, and physical inactivity, which are associated with muscle dysfunction. In the post-transplant period, there are a lot of body composition changes, such as increased fat distribution, as well as side effects of medications like Prednisone, that can give recipients significant muscle dysfunction.”
Having studied kinesiology and health science as an undergraduate at York University in Toronto, Dr. Rozenberg has experience with exercise and muscle testing. “It is not completely surprising that a respirologist [like myself] is doing muscle testing,” says Dr. Rozenberg. “It is one of the things that helps me in my research.”
After attending medical school at the University of Ottawa and training in internal medicine and pulmonology at the University of Toronto, Dr. Rozenberg decided to stay in Toronto because it is one of the largest transplant programs with an established pulmonary rehabilitation program and dedicated team. With the help of the American Society of Transplantation’s (AST) Clinical Fellowship Award in July 2014, Dr. Rozenberg is working alongside influential supervisors Dr. Lianne Singer and Dr. Sunita Mathur, and is about six months into his research. They have 33 out of 50 participants tested, following each candidate every three months to monitor muscle dysfunction.
“This research helps optimize these patients from a rehabilitation standpoint,” says Dr. Rozenberg. “This can certainly be applied to other patient populations, like cardiac, renal and liver patients, in the future. It can be helpful for a number of researchers.”
Dr. Rozenberg is hoping to launch a rehabilitation clinic for patients in the pre- and post-transplant periods, tracking each patient every three months to clinically improve the problems associated with muscle dysfunction and improve each patient’s quality of life. Eventually Dr. Rozenberg would like to collaborate with a few other transplant programs, such as those specializing in liver transplantation, and take similar measures with each — improving organ transplant rehabilitation in the long run.
“It has been a very positive experience and I am really enjoying myself,” says Dr. Rozenberg about his research. “Rehabilitation is something I am really passionate about and it is an emerging field in transplant. There is a lot that can be done with it.”