Lorenzo Machado, MD is an abdominal transplant surgeon at Allegheny General Hospital who specializes in liver transplant, hepatobiliary surgery, and laparoscopic liver surgery.
As we celebrate Hispanic Heritage Month, we had the privilege of hearing from Dr. Machado about his journey and the importance and impact of the perspectives and leadership of Hispanic transplant surgeons, professionals, and patients.
What inspired you to choose a career in transplant?
I became interested in transplant surgery during residency when I first witnessed the immediate and lasting effects of transplantation on recipients. The satisfaction of performing a technically difficult surgery on a very sick patient and within days to weeks seeing a complete transformation was life-changing. I was in awe when a liver transplant recipient who weeks earlier had minimal chance of survival walked out of the hospital, and in awe again when a different recipient, who received a kidney, made urine for the first time in years.
I also enjoyed the teamwork required between the medical team, patients, and their families to achieve a successful outcome. This teamwork was reminded me growing up in a Mexican family as part of Oakland, California larger Latino Community. The shared values of family and community and of supporting one another through difficult times was evident in patients and their families as they maneuvered through one of the most difficult periods of their lives.
Can you share a particular experience where your cultural background positively impacted a patient's outcome?
I completed my surgical training in an area with a large Latino population and there were countless times when I entered a Spanish-speaking patient's room and they were scared and unable to clearly communicate their needs. I saw their fear and anxiety fade as they communicated their problems in their native language to someone who shared the same cultural background.
The ability to provide care for some of the most vulnerable patient populations taught me humility and to meet patients where they are. Today, I practice in an area with a smaller Latino population, and although language is not barrier for most of my patients, the fear and anxiety of end stage organ disease or a new cancer diagnosis remain, and it is those lessons that I learned during my training that I continue to apply to all my patient interactions.
In what ways do you think the transplant field could benefit from more Hispanic perspectives and leadership?
Health disparities remain present in medicine and the field of transplantation is no exception. Minority groups disproportionally have longer wait times despite accounting for greater than 50% of patients on the wait list. Latino perspectives and increased representation in leadership is essential to addressing these gaps, not just for Latino patients, but all underrepresented communities. A diverse transplant leadership helps bring new ideas, challenges assumptions, strengthens outreach, and helps design patient/community centered care models.
Have you had any mentors who have significantly impacted your career? What impact did they have?
One of the things I value most about transplantation is the teamwork and the opportunity to learn from the many different perspectives. I have mentors who taught me surgical precision and technical judgment; others modeled leadership, empathy, and resilience. Collectively, they’ve shown me that excellence in transplant grows from collaboration and respect for different perspectives.
What does being a Hispanic transplant surgeon mean to you?
Throughout my career I have been asked how I was able to achieve becoming a transplant surgeon given where I started (I was born in Mexico and raised in Oakland, CA). I could never come up with a good response to the question, often thinking that we can all reach our dreams as long as we work hard enough. More recently, however, I’ve realized how fortunate I am to have realized my dream. Getting to this point in my career meant overcoming obstacles that existed not just for me, but for countless others with similar backgrounds who dream of becoming doctors. Socioeconomic barriers coupled with an underperforming education system and the allure of the streets is too great a challenge for most to overcome.
My becoming a transplant surgeon is a testament to the sacrifice and support of my family, friends, and community and it gives me a sense of responsibility to help the next generation of Latino doctors.
What is a key takeaway you'd like to highlight during Hispanic Heritage Month?
Hispanic and Latino people are a large, diverse group. It encompasses African, Indigenous, and European backgrounds with a common shared experience that is evident in our values of compassion, caring, resilience, family, and community. These values drive us to excel in our personal and professional lives.