Haytham Elgharably1, Jin Ye Yeo2
1Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA; 2CCTS Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. CCTS Editorial Office, AME Publishing Company. Email: ccts@amegroups.com
This interview can be cited as: Elgharably H, Yeo JY. Meeting the Editorial Board Member of CCTS: Dr. Haytham Elgharably. Curr Chall Thorac Surg. 2025. Available from: https://ccts.amegroups.org/post/view/meeting-the-editorial-board-member-of-ccts-dr-haytham-elgharably.
Expert introduction
Dr. Haytham Elgharably (Figure 1) is a board-certified Cardiothoracic Surgeon with a special interest in lung transplant research, including ischemia-reperfusion injury and clinical outcomes. His specialties include lung transplantation, pulmonary endarterectomy, and different aspects of complex adult cardiac surgery.
Dr. Elgharably earned his medical degree from Zagazig University and completed an internship in cardiothoracic surgery at Zagazig University Hospital, both in Alsharqiya, Egypt. He continued his training as a resident in cardiac surgery at the Egyptian National Heart Institute, Cairo. Dr. Elgharably came to the United States in 2011 for a research fellowship in wound healing and biofilm infection at The Ohio State University, Columbus, Ohio. Following that fellowship, he completed his specialty training at Cleveland Clinic with a fellowship in cardiothoracic surgery followed by a residency in integrated thoracic surgery. He joined the Cleveland Clinic medical staff in 2019 on completion of his residency.
Currently, he is the surgical director of the Endocarditis Center at the Cleveland Clinic and co-director of quality at the Department of Thoracic & Cardiovascular Surgery. He holds a parallel appointment as Assistant Professor of Surgery at the Cleveland Clinic Lerner College of Medicine, Case Western Reserve University.
Figure 1 Dr. Haytham Elgharably
Interview
CCTS: What motivated you to specialize in lung transplantation, pulmonary endarterectomy, and complex cardiac surgery?
Dr. Elgharably: During my training at Cleveland Clinic, I developed a particular passion for lung transplantation and complex cardiac surgery by working with Dr. Gosta Pettersson, a world expert in complex cardiac surgery and lung transplantation, and Dr. Kenneth McCurry, a world leader in the field of lung transplantation and the surgical director at Cleveland Clinic. When I started my staff job in 2019, I specialized in pulmonary endarterectomy as a related field to lung transplantation.
CCTS: Can you discuss any recent breakthroughs in lung transplantation that have improved clinical outcomes?
Dr. Elgharably: There is no doubt that the development of Ex-vivo Lung Perfusion (EVLP) technology is one of the recent major breakthroughs in the field of lung transplantation. The EVLP platform allowed better utilization of extended criteria “marginal” donors that would have been otherwise declined in the pre-EVLP era (1). Also, EVLP contributes to decreasing the incidence of primary graft dysfunction after lung transplant by excluding allografts with poor function. Lastly, the EVLP platform can be utilized to study ischemia-reperfusion injury of the lung allograft (2,3).
CCTS: As Surgical Director of the Endocarditis Center, what trends have you observed in the management and surgical treatment of endocarditis?
Dr. Elgharably: We are observing a significant increase in the incidence of prosthetic valve endocarditis, especially in the face of the remarkable increase in cardiac implants, including prosthetic valves, trans-catheter devices, and pacemakers. These cases commonly present with invasive cardiac pathology that requires complex operations. Recently, we have examined the virulence factors produced by Staphylococcus aureus in patients with endocarditis to better understand the microbial factors that contribute to the invasive pathology (4). We are still dealing with the ongoing epidemic of intravenous drug abuse associated with infective endocarditis. We have developed a comprehensive multidisciplinary approach to manage these patients with post-operative rehabilitation plans (5).
CCTS: What are some key innovations you foresee shaping the future of lung transplantation?
Dr. Elgharably: I believe that the innovations will be in the application of novel therapeutics during EVLP to convert unacceptable donor lungs into transplantable lungs, along with improving our understanding of the underlying molecular mechanisms of primary graft dysfunction (PGD) and chronic lung allograft dysfunction (CLAD), both are the primary limitations of lung transplant outcomes. A better understanding of these pathologies will lead to the development of effective therapeutics to improve early and late clinical outcomes of lung transplantation. Other areas of innovation are allograft preservation and mechanical circulatory support during the lung transplant procedure. Ongoing clinical trials and research efforts will contribute to the standardization of allograft preservation during transport from the donor hospital and storage at the transplant center prior to the transplant procedure, as well as the routine use of VA ECMO during the lung transplant procedure.
CCTS: What have been the most challenging yet rewarding moments in your journey from resident to surgical director at Cleveland Clinic?
Dr. Elgharably: The transition from residency to becoming an independent junior surgeon can be stressful in the first few months. But proper support and guidance from the senior surgeons and my mentors made that transition smooth and successful.
CCTS: Given your extensive experience, what do you believe is the most pressing research question in cardiothoracic surgery today?
Dr. Elgharably: The cardiothoracic surgery research field is very broad to pinpoint a certain area that contains the most pressing research question. In my mind, the most pressing question is when we do not accept publishing reports with long-term results of a given procedure but with very limited follow-up data. This is critical to better understand the long-term outcomes of any procedure we perform. The current quality metrics for cardiothoracic surgery are focused on the early outcomes (30-day or hospitalization course) but with less focus on the mid- and late-term outcomes. The goal of any surgery is to ensure improving quality of life and survival benefit. However, it has been acceptable to publish large cohort reports of a given procedure with very limited follow-up data in the mid-and long-term (some reports may have a “number at risk: that is 20% or less of the original cohort after factoring in the interval from the procedure and competing risk of death). We, cardiothoracic surgeons, have been the top in our class through our journeys and put our best effort every day to execute cardiac surgery procedures in the most meticulous and efficient way. I am not sure why we should accept the limited information we have about the long-term impact of some of the cardiothoracic procedures. Understanding the long-term results is the only way to help us identify areas of improvement to ensure better outcomes for our patients.
When it comes to infective endocarditis, as one of my research focuses, I believe that the most pressing question is what are the mechanisms used by microbes to cause the pathology we encounter during surgery? A better understanding of the in vivo microbial behavior in patients with endocarditis will guide the management of these patients in terms of the timing of intervention and also set up future research to develop effective therapies against microbial resistance to standard antibiotics.
CCTS: As an Editorial Board Member of CCTS, what are your expectations and aspirations for the journal?
Dr. Elgharably: CCTS is an excellent platform for thoracic surgery and lung transplant-related research. I am the editor for an upcoming issue about the updates in the field of lung transplantation. Inviting experts in the field to contribute to the journal with ongoing original research, review articles, or editorials would accelerate the growth of the journal.
References
- Kyrillos Ragheb D, Elgharably H, Ayyat KS. A narrative review on ex vivo lung perfusion: up-to-date role in lung transplantation. Curr Chall Thorac Surg 2025;7:2.
- Elgharably H, Okamoto T, Ayyat KS, et al. Human Lungs Airway Epithelium Upregulate MicroRNA-17 and MicroRNA-548b in Response to Cold Ischemia and Ex Vivo Reperfusion. Transplantation 2020;104(9):1842-1852.
- Elgharably H, Kish DD, Keslar K, et al. Cold storage of lung allograft modulates microrna-223 expression & nf-kb-mediated reperfusion response. The Journal of Heart and Lung Transplantation. 2021;40(4, Supplement):S68-S69.
- Elgharably H, Claesen J, Sangwan N, et al. In vivo virulence of Staphylococcus aureus in native versus prosthetic left-sided valve endocarditis. JTCVS Open 2024. Available online: 10.1016/j.xjon.2024.12.004
- Javorski MJ, Rosinski BF, Shah S, et al. Infective Endocarditis in Patients Addicted to Injected Opioid Drugs. J Am Coll Cardiol 2024;83(8):811-823.