Pharmacy Student Aspires to Solid Organ Transplant Career, Gains Pharmacogenomics Experience During Rotations
Interest in personalized medicine is growing, and pharmacogenomics testing is one of the most actionable fields. The genotype results can inform a change in a patient’s care.
In July 2024, Wisconsin’s leadership in this space was bolstered by a $49 million grant to advance personalized medicine, awarded to the Wisconsin BioHealth Tech Hub by the U.S. Department of Commerce’s Economic Development Administration. Adding state funding and industry commitments to the equation, the Wisconsin consortium has received more than $80 million in funding that is projected to create up to 30,000 jobs. BioForward Wisconsin leads the consortium of 17 members, including the Medical College of Wisconsin.
Sage Orlowski, a 2025 MCW PharmD candidate, aspires to become a solid organ transplant pharmacist, a field which utilizes personalized medicine. She finds the science behind patient-donor matching to be fascinating and is interested in helping patients who have complex disease states.
The donor match process requires the patient to have their genetic makeup tested to ensure their body will accept the new organ. This pharmacogenomics testing – conducted via cheek swab, saliva sample or blood draw – can also be used to determine how the patient’s DNA will affect their response to certain medications.
“The medications used in organ transplant have narrow therapeutic windows, so overshooting or undershooting the dosage can be detrimental. You can cause the patient to reject their organs or to be so immunosuppressed that they get an infection and die,” explained Orlowski. “It's a great idea to use pharmacogenomics testing to know where the patient will fall after the first dose – especially when they are taking dozens of medications.”
The MCW School of Pharmacy’s Office of Experiential Education works with each pharmacy student individually to determine their career interests and match them with clinical rotation sites that align. The team matched Orlowski with RPRD Diagnostics, a company located just down the road from MCW, which specializes in pharmacogenomics testing and research. RPRD or “Right Patient, Right Drug,” aims to provide the highest quality and most comprehensive testing possible, prioritizing racial equity in its research. It works primarily with pediatric hospitals and cancer-focused groups but has provided testing for hospitals across the world.
The applications for pharmacogenomics testing in solid organ transplantation are still being developed. Currently, there are only two guidelines outlined by the Clinical Pharmacogenomics Implementation Consortium (CPIC) that deal with transplant-specific medications.
“The research is still emerging, so there are other gene-medication interactions with lower levels of evidence that will require more studies – and more people like Sage to do them,” said Amy Turner, MS, director of operations and innovation at RPRD Diagnostics.
Turner is Orlowski’s preceptor during her rotation and said it’s critical for pharmacy students to have a solid understanding of pharmacogenetics. She explained that pharmacists are often the champions who are running pharmacogenetics programs, interacting with the labs and everyone on the healthcare team to recommend the appropriate test, then communicating the results to patients.
“We’re proud to have a partnership with MCW, participating in their rotation program and having students engage in their own pharmacogenomics testing. When students swab their cheeks, receive their own report and interpret what the results mean for themselves, that’s very impactful and piques their interest in pharmacogenomics,” said Turner. “If pharmacy students are not learning this information in their programs or don’t have access to it, I think they will be underprepared."
Turner was awarded the MCW School of Pharmacy’s 2024 Interdisciplinary Colleague of the Year award along with Ashley Derezinski, BS, clinical lab supervisor at RPRD Diagnostics. They were selected for being outstanding preceptors, with nominating students writing that they "provided great feedback on research projects” and were “always available for support.”
Now that her rotation is complete, Orlowski says her takeaways from the experience are that the field of pharmacogenomics is ever-changing, more research is needed and pharmacists play an important role in advocating for its advancement.
“The theory of being able to know how a patient will react to a medication before you give it to them is brilliant. It takes the guess work out of the process,” added Orlowski.