Dr. Jeffrey Punch — Challenging Diabetes Through Organ Transplant Surgery
Dr. Jeffrey Punch
Jeffrey Punch, M.D., is a “Michigan Man.” He completed his entire post-secondary education at one school and one school only: the University of Michigan. For Dr. Punch, U-M provided the best academic opportunities.
He came to U-M directly from high school and trained in the Integrated Premedical-Medical Program, Inteflex. The Inteflex program allowed Dr. Punch to complete his undergraduate and medical degrees in six years, earning his M.D. in 1986. He went on to complete a surgical internship and received fellowship training in Surgery Research. He completed his General Surgery residency in 1992. Dr. Punch received certifications in General Surgery and Surgical Critical Care. He completed a two-year fellowship in Surgical Transplantation in 1994, in which he trained to perform kidney, liver, and pancreas transplant procedures.
After completing his entire medical training program at U-M, it seemed only natural to begin his professional career with U-M as well. In 1992, he joined U-M as a Lecturer of Surgery. Two years later, he was appointed Assistant Professor of Surgery. He began a surgical practice that consists of kidney, liver, and pancreas transplants and performs these procedures on both adults and children. He has been in his current appointments of Division Chief of Transplantation Section of General Surgery and Associate Professor of Surgery since 2001. He was Director of the Liver Transplant Program from 1999 – 2003, and again from 2005-2008.
Dr. Punch’s early research focused on organ tolerance in transplantations. He used tolerance models in mice to examine treatments at the time of transplant that re-educate the immune system. Today, drug therapy is used to prevent organ rejection. The immune system is “tricked” into believing that the transplanted organ is its own. Dr. Punch continues his research on organ tolerance and is currently investigating immune suppression. He is working on a seven-year project with ongoing human trials.
Dr. Punch’s work with kidney and pancreas transplants has had significant impact on diabetes. Kidney transplants can double life expectancy for diabetics with kidney failure. He believes that understanding organ transplant tolerance has great potential for figuring out insulin dependent type 1 diabetes.
Dr. Punch has an extensive list of publications. Currently, he is focused on facilitating the work of others. He is very interested in the work of Michael Englesbe, M.D., U-M Assistant Professor of Surgery, on the business of medicine. In the United States, we spend a great deal on health care, yet it is difficult to show that the dollars spent have translated into higher quality health care.Dr. Englesbe’s research seeks to discover how health care can be delivered in a way that is more efficient, of better quality, and provides more care for less money. Dr. Punch’s role in this project is that of supervisory consultant providing ideas, feedback, and acquiring resources for Dr. Englesbe in his research efforts.
Dr. Punch is also engaged in the islet cell research work being done by Randall Sung, M.D., U-M Surgical Director -Pancreas Transplant and Assistant Professor, General Surgery. Islet cells are the clusters of cells contained in the pancreas that produce hormones. There are several different types of cells in an islet. Beta cells make the hormone insulin, which lowers the glucose level. In type 1 diabetes, the body's immune system mistakenly destroys the beta cells, causing the pancreas to lose the ability to make insulin. The research explores why the immune system goes haywire and destroys the insulin producing cells. This work has promise for novel therapies and models to help understand type 1 diabetes. Solving the immune problem will help to find a solution for diabetes.
“Advancements tend to build on previous advances and small steps,” says Dr. Punch. He admits that it may take a long time and that the progress is gradual, but it is the iterative advancements in research that has helped to change medicine today.
Patient care is a very rewarding aspect of Dr. Punch’s job. Taking patients who have chronic, debilitating disease and giving them a transplanted organ that enables them to resume active, healthy lives “is the feel good part” of his job, says Dr. Punch. Patients are made well and their families are grateful to have their loved ones back. Challenges exist along with the rewards, though. “We can do a liver transplant,” begins Dr. Punch, “but is the home environment one that will allow them to be and remain healthy to lead active lives?” The health care system is not designed to address all the issues patients will face on the road to regaining health. Issues that can impact the patient’s progress can include mental health, inadequate care giver assistance, substance abuse, finances, lack of transportation, and the list can go on. “The health care system can’t solve all of society’s ill,” says Dr. Punch. He finds this to be the most challenging aspect of patient care.
Dr. Punch is a member of several professional societies, among them, the United Network for Organ Sharing (UNOS). UNOS advances organ availability and transplantation and administers the nation’s only Organ Procurement and Transplantation Network (OPTN). Dr. Punch is actively engaged in UNOS’ organ transplant public policy initiatives. He has served on the Liver Intestinal Committee, the Pediatric Committee, and the Membership & Professional Standards Committee. He currently is in his first year of a 2-year term on the UNOS board of directors.
He is also a member of the Great Lakes Transplantation Association, the International Transplantation Society, and the Transplantation Society of Michigan.
Dr. Punch is married to Margaret Punch, M.D., U-M Associate Professor of Obstetrics and Gynecology. They have three children.
For more information on the University of Michigan Transplant Center, visit: http://www.med.umich.edu/trans/public/about/