Skilled hands

Tung works to restore lost function and form after cancer, injuries

Robert Boston

Thomas H. Tung, MD (left), talks with patient Zachary Eggemeyer about his upcoming hand surgery. “With unsurpassed microsurgical technique, Tommy is able to skillfully move tissues from other parts of the body to create form and function, whether the loss is from cancer or trauma, in a child or an adult,” says Susan E. Mackinnon, MD, the Sydney M., Jr. and Robert H. Shoenberg Professor of Surgery and chief of the Division of Plastic and Reconstructive Surgery. “His knowledge, technical skill and dedication to complicated surgical reconstruction combine to give patients hope for recovery.”

If it hadn’t been for a scheduling conflict, Thomas H. Tung, MD, might be a marine biologist today.

Tung, associate professor of surgery in plastic and reconstructive surgery, was interested in marine biology as a zoology major at Duke University. Duke offered a semester-long marine biology lab, but Tung couldn’t fit the lab in with his premedicine courses and labs.

“Life would be very different right now if I’d gone that way, no question about it,” Tung says.

Marine biology still is a part of his life, however. Tung keeps a saltwater aquarium at home containing brightly colored clownfish, angelfish and tangs. The aquarium is one of the few hobbies he has time for as he balances his career as a busy and prestigious reconstructive surgeon, husband and father of three sons.

Family ties

Tung got a taste of medicine at an early age. His father, Thomas J.K. Toung, MD, is a neuroanesthesiologist at Johns Hopkins University School of Medicine. Tung says although there was no parental pressure to follow their father’s footsteps, he and his two siblings all are physicians. His sister, Jeany, MD, is an anesthesiologist at Mercy Medical Center in Baltimore, and his brother, Will, MD, is a surgeon in Cape Girardeau, Mo.

“We all spent time in my father’s research lab at Hopkins,” Tung says. “And since then, my cousins who worked in his lab have gone into medicine also. When they decided to go into medicine, he helped them as much as he could. He did the same thing for each of us, too.”

That encouragement extended into training as well. All three siblings did some training at Johns Hopkins: Tung completed a fellowship in plastic and reconstructive surgery, his sister completed an anesthesiology residency, and his brother earned a medical degree there.

But the family connection isn’t just at Johns Hopkins — it’s also at Washington University. Tung’s sister earned an undergraduate and medical degree at WUSTL, and his brother completed his general surgery residency at the School of Medicine.

That history helped convince Tung to come to the School of Medicine in 1998 for a one-year fellowship in hand, peripheral nerve and microsurgery in the Division of Plastic and Reconstructive Surgery in what was to be his final — and 14th — year of training.

Selecting surgery

While in medical school at the University of Maryland, Tung felt drawn to surgery. Always interested in art and a frequent sketcher who considered architecture as another career option, Tung was enthralled by the artistic aspect of plastic surgery.

“During training, microsurgery appealed to me because of the very fine skills that are needed and the meticulous aspect of it,” he says. “Microsurgery itself is a very powerful reconstructive tool. When I came here for training, I found nerve surgery very interesting and just as challenging, and I’ve been able to keep it a part of my practice.”

Tung performs a range of surgeries, including hand and peripheral nerve surgery as well as general reconstruction as a result of injury or cancer, including breast, abdominal and chest reconstruction.

He also performs some cosmetic surgery and breast reductions and augmentations. Many of these surgeries can take all day, but that doesn’t seem to bother Tung.

“When you really focus on a specific task, the time goes by quickly,” he says. “I have good help from residents and fellows who help keep things moving.”

But some of the surgeries, especially those resulting from injuries or cancer, can be trying in another way.

“These surgeries can be emotionally difficult, especially when treating kids,” he says. “Some of these patients have pretty horrible stories. We get satisfaction from helping them.”

Susan E. Mackinnon, MD, the Sydney M., Jr. and Robert H. Shoenberg Professor of Surgery and chief of the Division of Plastic and Reconstructive Surgery, says Tung not only supports his patients but also his fellow surgeons as well.

“His superb technical skills make him the ‘go-to’ surgeon for other surgical specialties with complex wound reconstructive challenges,” she says. “With unsurpassed microsurgical technique, he is able to skillfully move tissues from other parts of the body to create form and function, whether the loss is from cancer or trauma, in a child or an adult.

“His knowledge, technical skill and dedication to complicated surgical reconstruction combine to give patients hope for recovery,” she says.

Searching for clues

Microsurgeons worldwide recently have performed hand and even face transplants. However, those who receive a transplant must stay on immune-suppression drugs for the rest of their lives so their bodies don’t reject the transplanted tissues.

The Tung family: (From left) wife, Tobey; son Nathan; son Isaac; Thomas; and son Garrett.

For the past several years, Tung has been studying limb transplantation, focusing on transplanting hindlimbs to mice from unrelated donors without using immune-suppression drugs. He is one of only a few researchers in the United States investigating limb transplantation with this protocol, which uses proteins called costimulation-blocking antibodies.

Limb transplantation is especially difficult because it involves skin, muscles, tendons, nerves and bones, all of which elicit a different degree of response from the patient. In his study, the mice that received the transplanted hindlimb received an antibody that blocked the immune response only to the donor tissue. The mice also received donor bone marrow, which helped them better tolerate the transplanted tissues.

The mice that received this treatment survived an average of 222 days with the transplanted hindlimb, while mice who did not receive the treatment rejected their limbs after about 10 days.

“Once we figure this out, it’s going to open up a whole new field of reconstructive surgery,” Tung says.

Tung’s peers say they expect him to continue to make significant contributions to the field.

“Dr. Tung has developed a national reputation as a hard and conscientious worker, a team player and someone who is sincerely interested in the progress of the field of reconstructive microneurovascular and academic surgery,” says Paul S. Cederna, MD, associate professor in the Section of Plastic and Reconstructive Surgery and associate chair of the Department of Surgery at the University of Michigan.

“He is interested in making changes where things could be better and helping to guide the direction of our specialty,” Cederna says. “I believe Dr. Tung will be influential in the shaping of all aspects of our specialty in an uncertain future of dynamic health-care management and resident-education reform.”

Making a home

After growing up in Baltimore, Tung and his wife, Tobey, a native of Canada, planned to stay in St. Louis for the yearlong fellowship and head back east.

But, almost 11 years later, they still are here, now with their three children: Garrett, 12; Nathan, 10; and Isaac, 4.

“Our house is a busy place,” Tung says. “There is never a dull moment.”

Between the children’s Russian and piano lessons, plus sports, the family enjoys time together skiing at Hidden Valley in Wildwood, Mo., and traveling to family-oriented destinations, such as Disney World and San Diego.

Tung cites several reasons he stayed at Washington University School of Medicine after his fellowship.

“Part of what we stress to the residents and students is this idea that we’ve been trained for many years to do plastic surgery, and part of that idea is contributing back to plastic surgery,” he says. “One way to do that is to teach and train future generations of plastic surgeons.

“There is a greater potential to make a difference in plastic surgery when you are in academic medicine, like advancing new techniques and technologies, or through new surgeries like reconstructive transplantation,” he says.

In addition, Washington University’s outstanding reputation and forward-thinking environment played a big role.

“Washington University is such a large center for research, teaching and cutting-edge surgeries and patient management, and you really can’t beat that,” he says.

Tung says St. Louis also was part of the draw.

“St. Louis is a very easy, affordable and family-oriented city,” he says. “We didn’t expect any of that when we came here. It came as a surprise even to us when we decided to stay at the end of training. The pace isn’t as hectic as on the East Coast, which is probably good for us because we keep things pretty hectic ourselves.”

Fast facts about Thomas H. Tung

Title: Associate professor of surgery (plastic and reconstructive surgery)
Education and training: BS, zoology, Duke University; MD, University of Maryland School of Medicine; internship, Case Western Reserve University; residency, University of Rochester School of Medicine; fellowship in plastic and reconstructive surgery, Johns Hopkins University and University of Maryland schools of medicine; fellowship, peripheral nerve and microsurgery, Washington University School of Medicine
Hobbies: Skiing, playing piano, drawing and illustrating, and keeping a marine aquarium
Favorite restaurants: Sidney Street Cafe, Niche and Monarch