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Dr. Lori West: Pioneer in Pediatric Heart Transplantation and Transplant Immunology
Dr. Lori West is a clinician-scientist, pediatric transplant cardiologist and transplant immunologist whose career has spanned the bedside, the bench and the leadership of national and international research programs.
Meet Dr. Lori West
Dr. Lori West is a clinician-scientist, pediatric transplant cardiologist and transplant immunologist whose career spanned the bedside, the bench and the leadership of national and international research programs. Her work has helped expand what is possible for infants and children facing life-threatening heart disease, including pushing past barriers that once made transplantation in the youngest patients seem out of reach. Much of Dr. West’s contribution lies in expanding what is clinically and immunologically possible for younger populations, including patients with complex anatomy and a developing immune system that responds differently than that of an adult.
Across her roles, she has remained anchored to a single question: how do we offer children with minimal options a real chance at life? That question continues to shape her work as a physician, scientist, mentor and national leader. Building from that perspective, her contributions to transplant science and medicine, particularly related to ABO glycoimmunology in transplantation, have not been limited to the young but have also had a major impact across the age spectrum. Her story shows how curiosity, mentorship and a deep sense of purpose can shape a career that moves an entire field forward.
Career Overview
Dr. West completed her pediatric residency at Harbor/UCLA Medical Center in Los Angeles, where an inspiring teacher shaped her decision to train in pediatric cardiology at the Hospital for Sick Children in Toronto. At the time, heart transplant programs for children were rare and were extremely rare for infants. Pediatric heart transplantation differs from adult care, given the often-complex anatomy of infants and small children with congenital heart disease, so standard procedures cannot typically be applied to these cases. When a child faces a 100% risk of dying without a transplant, the risk-benefit assessment differs substantially.
Faced with a choice between further training in heart transplant medicine as a clinical fellow at Cambridge University or taking a research position at the University of Oxford, Dr. West chose the laboratory. Though already fully clinically trained, she stepped away from clinical work for four years to learn transplant immunology from the ground up, ultimately completing a Ph.D. focused on models of tolerance in the developing immune system. She credits her husband, Dr. Jeffrey Smallhorn, a prominent pediatric cardiologist himself, with supporting that decision to pursue the deepest possible training. As he put it, “If you want to move the field forward, you need to have the very best training you can.”
She later completed clinical training in pediatric transplant cardiology in the US, then returned to Toronto as the Medical Director of the Heart Transplant Program; she went on to build clinical and research programs that have shaped pediatric heart transplantation in Canada and beyond. Recruited to the University of Alberta in Edmonton, she is currently Professor of Pediatrics, Surgery, Immunology, and Laboratory Medicine/Pathology.
• Helped build and grow pediatric heart transplant programs, including foundational work as Medical Director of the Heart Transplant Program at the Hospital for Sick Children in Toronto and the Stollery Children’s Hospital in Edmonton.
• Led the clinical team that pioneered ABO-incompatible heart transplantation in infants as a way to address high waitlist mortality; expanded this protocol to international use, leading to global impact on the pediatric heart transplant field (featured in ‘60 Minutes’ in 2004).
• Founding scientific director of the Canadian Donation and Transplantation Research Program (CDTRP), spanning 39 sites across the country to advance all streams of collaborative trans-disciplinary research in donation and transplantation.
• Director of the Alberta Transplant Institute, alongside continued roles as clinician, researcher, professor and mentor.
• Tier 1 Canada Research Chair (CRC) in Cardiac Transplantation.
• Recipient of Lifetime Achievement Awards from the Canadian Society of Transplantation and the International Society of Heart and Lung Transplantation, recipient of the Outstanding Science Leadership Award from the Alberta Science and Technology Leadership Foundation, the Physician of Distinction Award from the American Society of Transplantation, and the Woman Leader in Transplantation Award from the Women in Transplantation initiative of The Transplantation Society, among other honors.
• Elected as a Fellow of the Royal Society of Canada and the Canadian Academy of Health Sciences.
• Appointed as an Officer of the Order of Canada, a recognition she describes as one of those stunningly unexpected and meaningful moments (bringing recognition to the specific needs of children throughout Canada and beyond).
• Awarded the King Charles III Coronation Medal in 2025.
Contributions to Transplant Science and Priorities for the Future
She has worked to bridge the bench and the bedside. Her dual training as a clinician and a scientist has shaped a body of work that intentionally connects laboratory discovery directly to clinical care. Dr. West has expressed concern that clinician-scientists are at risk of disappearing as one role is often valued over the other. She emphasizes the need to reunite research and clinical care under a shared commitment to science and curiosity, as well as to solving clinical problems.
Additionally, as founding Scientific Director of the CDTRP, together with co-Director Dr. Marie-Josée Hébert in Montreal, Dr. West helped transform a fragmented set of efforts into a national collaborative environment. The community, she notes, was ready to move from fragmented research efforts into a collaborative sandbox, bringing expertise together and helping researchers find collaborators across disciplines and sites. She believes innovation moves forward when people from different backgrounds are placed in the same room around a common thread. Nurturing collaboration, in her view, is what makes innovative ideas more likely to surface.
She also encourages thoughtful use of AI and emphasizes the importance of consulting primary literature. When sources are misquoted or inaccuracies are repeated, she notes, it can erode confidence in science. Her advice is to return to the original evidence and always remain curious.
Looking ahead, she continues to prioritize mentoring the next generation. Mentorship runs through every part of Dr. West’s work. Her own path, from clinic to bench and back again, gives trainees a roadmap for building careers that bridge both worlds. She invests in trainees by
• Inviting them into real research questions, not just side projects
• Modeling careful, reflective thinking, and deep questioning, together with persistence and resilience
• Encouraging them to seek the very best training, wherever it takes them
• Showing that clinical proficiency and research experience can strengthen each other
Her message to early-career clinicians and scientists centers on curiosity and persistence: “I was very motivated and determined when I was young. I would say, stick with it, because curiosity is a great driver and motivator.”
Where Science Meets Purpose
Today, she finds deep gratification in seeing patients who were once at death’s door as infants now thriving 20 to 30 years later. Some have gone on to university and have built full adult lives. She is candid that the path isn't always easy, as some patients face difficult roads and not every story is one of straightforward recovery.
She echoes a sentiment attributed to Isaac Asimov: the most interesting moment in science is not the triumphant “Eureka!”, but the quieter “Hmmm, that’s interesting...” That sentiment, she says, is what rewards paying attention to nuance and thinking carefully.
Pediatric heart transplantation stands at a moment of both real progress and unfinished work. Donor availability, immunologic tolerance, and the continuity of the clinician-scientist role remain open questions. Through continued collaboration, mentorship and an insistence on going to the source, leaders like Dr. West continue to expand what is possible for young patients and their families. Sitting down with a family receiving devastating news and being able to say, “Yes, this is a challenging problem, but we have something we can offer you,” is the greatest gift. For Dr. West, this moment is where the science and the calling meet.
The perspectives shared reflect Dr. West’s clinical experience and are intended for educational purposes only. They do not constitute medical advice or specific treatment recommendations.