Meet Dr. Adriana Zeevi

 

“I think we are very fortunate to work in this field,” Dr. Zeevi says. After more than four decades advancing transplant immunology, it’s clear the field has been just as fortunate to have her. She has helped transform how transplant physicians match organs with patients who need them.

 

Her journey shows how basic science discoveries can directly improve patient care. Through her work with T cells, antibodies and new testing methods, Dr. Zeevi has helped more patients receive successful transplants while reducing the risk of organ rejection.

An Impressive Career

Dr. Zeevi began her career in 1979 at the Milwaukee Blood Center, working as a postdoctoral fellow with Dr. Rene Duquesnoy. Though she had no prior knowledge of human leukocyte antigens (HLA), she quickly became fascinated by the field’s rapid discoveries. During this time, she witnessed a breakthrough: the identification of a second HLA Class II locus. Dr. Duquesnoy discovered by pattern recognition a group of HLA antigens that was initially named MB (“Milwaukee Blood”). Later designated as HLA-DQ, this locus encodes Class II HLA molecules that remain crucial in transplant matching today.

 

Dr. Zeevi successfully cloned T cells from mixed lymphocyte cultures that could specifically recognize these new DQ molecules, and even allele-specific Class I molecules. Her work helped confirm the existence of these important markers before molecular identification methods were available.

 

In 1984, Dr. Zeevi moved to Pittsburgh with Dr. Duquesnoy, joining Dr. Thomas Starzl’s renowned transplant team. She started as an assistant professor and transitioned from pure research to clinical applications. She became Director of the Tissue Typing Laboratory in 2000, a position she held for over 25 years.

Key Achievements and Contributions to Transplant Science

Dr. Zeevi has been instrumental in the field: she propagated graft-infiltrating T lymphocytes from biopsies to determine their specificity against donor HLA molecules. She tested the in vitro efficacy of then-emerging immunosuppressants such as tacrolimus on biopsy-derived cells. This is what Dr. Starzl memorably called “mini transplants in vitro.” She also helped bring antibody science to the center of clinical decision-making. More on her specific contributions below:

    · Understanding organ rejection: Dr. Zeevi pioneered methods to study the immune cells that infiltrate transplanted organs during rejection, developing techniques to grow these cells from heart, liver, and other organ biopsies. Her work pinpointed which donor HLA antigens these cells recognize, demonstrated how agents like tacrolimus can halt their destructive activity, and helped explain why some organs are rejected more frequently than others.

    · Advancing antibody detection: While kidney transplant teams had long recognized the role of antibodies, Dr. Zeevi championed the same level of focus in non-renal transplants—particularly lung and small bowel—where donor-specific HLA antibodies (DSA) were often overlooked. She showed that DSA are pivotal drivers of chronic rejection across these solid-organ settings.

    · Risk assessment before transplant: To better predict who faces heightened rejection risk, Dr. Zeevi prioritized memory cell profiling to identify alloreactive T and B cells, molecular matching that extends beyond traditional HLA typing, and standardized monitoring protocols that can be applied consistently across transplant centers.

The HLA Community: The Importance of Collaboration and Education

Dr. Zeevi shares that it’s imperative to foster knowledge sharing through frequent touchpoints that unite technologists, directors and experts, welcoming open exchanges of methods and discoveries that can move the needle, while mentoring the next generation of scientists. She notes:

    · As an industry, we want to advance clinical integration by ensuring HLA professionals sit at the decision-making table.

    · The use of virtual crossmatching can speed organ allocation, and real-time monitoring can guide treatment adjustments.

    · Coming together as an industry is in the best interest of patients everywhere. Now, highly sensitized patients who once had no options, can receive transplants.

    · We’ve learned through collaboration that better matching reduces rejection rates, and improved monitoring catches problems earlier, essential for enhancing patient outcomes.

Research Priorities, Unmet Needs and the Road Ahead

Emphasizing that “one size doesn’t fit all,” Dr. Zeevi advocates for a clear standard of care that still allows personalization, combining multiple biomarkers (for example, pairing DSA characteristics with cell-free DNA testing to detect early post-transplant injury), integrating pharmacogenomics to understand individual drug metabolism and dynamically adjusting therapies based on real-time test results.

 

With sufficient, industrywide resources, she would target these critical areas, as they will shape the next decade:

    · Multi-factor prediction models: Integrate genetic, immunologic and clinical data to build large, well-annotated databases for pattern recognition and design trials tailored to specific patient characteristics.

    · Non-HLA discovery: Identify new rejection markers beyond HLA, develop reliable testing methods and establish thresholds for clinical significance. Deeper investigation of non-HLA antibodies can illuminate rejection pathways that traditional HLA-centric approaches can miss.

    · Tolerance induction: Identify patients for whom immunosuppression medications can be safely reduced, develop T regulatory cell therapies and create protocols for controlled immunosuppressant withdrawal.

    · Responsible artificial intelligence: Applied to integrate complex, multimodal data and strengthen outcome prediction.

 

Looking ahead, she underscores the need for continued innovation as new tools and developments open unprecedented opportunities, paired with the importance of education so that shared knowledge sustains progress. Through collaboration, education and innovation, the HLA and transplant community can build on foundations laid by pioneers like Dr. Zeevi, bringing hope to patients worldwide who await life-saving organ transplants.

 

“The future can be filled with bright spots, if we work together,” she says.

Thank you, Dr. Zeevi

Dr. Zeevi’s message to the next generation is clear: “You need passion, you need perseverance, and you need to continue to educate the next generation of researchers and clinicians.” That ethos underpins the deepest reward—a successful transplant—because “every time a patient reaches transplant or recovers from graft dysfunction, we’ve played an important part,” she says.

 

The field stands at an exciting crossroads, where emerging technologies promise to enable even better patient care.

 

As she reflects, “I wish I was younger to be part of what’s coming;” yet her ongoing work continues to shape the field’s future, helping ensure more patients receive the transplants they need.

 

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