Adrien Lam remembers driving with her parents when it was announced over the radio waves that University of Alberta virologist Michael Houghton had won the 2020 Nobel Prize in Physiology or Medicine.
"I said, 'Did you hear that? There's a Nobel Prize winner from the U of A, and he's in my department,'" says Lam, who back then was in the early days of a bachelor of science undergraduate degree studying immunology and infection.
"I didn't even realize we could have Nobel Prize winners at the U of A. My next thought was, 'I could do something like this one day.'"
Beginning her undergraduate degree amid the pandemic, Lam says she found her stride through hands-on laboratory work. For four consecutive summers, she pursued research opportunities that included an antimicrobial stewardship under Dr. Joseph Ting, a study looking at pan-coronavirus nasal vaccines with Dr. Babita Agrawal and a project exploring diabetes vaccine adjuvants alongside Dr. Sue Tsai.
And while each placement grew her ambition, Lam found her life's calling after being accepted to take on an integrated master's-PhD under Dr. Darren Freed in cardiac surgery looking to improve transplants.
Upwards of 25 Canadians actively waiting for a heart transplant die each year before a matching organ becomes available. Yet, 60 to 80 per cent of deceased donor hearts are not transplanted because a human heart packed in ice can only survive outside the body for about six hours, and requires precise blood-type matching.
Loosening up the restrictions on this life-saving race against the clock is at the heart of an ingenious project Lam is running, combining a pair of technologies in an effort to expand heart availability, particularly for pediatric patients.
Partnering with Vancouver-based biotech company Avivo, Lam's project uses specialized enzymes designed to strip away A-type blood antigens, thus converting donor hearts into universal type O organs compatible with any recipient.
"If you have an O blood group, there are no sugars on the outside of the cellular surface. If it's A type, those antigens are present. The enzyme cleaves off that A antigen, transforming the cell surface to look like an O type," says Lam.
To deliver the enzyme, Lam employs the made-in-Edmonton Ex-Vivo Organ Support System, a technology pioneered by Freed and surgery colleague Dr. Jayan Nagendran, which extends organ preservation windows to upwards of 12 hours by cycling a warm, oxygen-rich, nutrient-dense solution called perfusate through the heart to allow the organ to beat outside the human body.
She explains that the implications for organ transplantation are vast, particularly for young patients between the ages of two and 17. While infants under 12 months can often undergo ABO-incompatible transplants because their immune systems are still developing - a concept famously substantiated by U of A cardiologist Dr. Lori West - older children face strict blood-type matching constraints and excruciating wait times.
"Our goal really was to help children past the age of a couple years old to be able to receive these hearts," Lam says.
Initial testing on 100 human vein segments demonstrated 100 per cent antigen removal. In early September, the team ran the protocol on their first complete human heart. Although results confirmed successful antigen stripping in several key cardiac regions, other areas proved incomplete, prompting protocol adjustments currently underway.
She adds that creating a universal organ presents complex scientific frontiers that extend beyond initial antigen removal, including whether antigens re-emerge after transplantation, which will be a next step.
Her innovative research recently earned her the 2025 Chancellor's Leadership Medal and top honours at the Falling Walls Lab competition, which will send her to Berlin to present her findings on an international stage Nov. 6.
Lam says the research and the accolades wouldn't be possible without the opportunity provided by some of the world's best medical researchers.
"There's nowhere else I want to be. I think it's motivating to know there's such great work done here, and there's a really great learning environment. I honestly wouldn't trade it for the world."
