Leading Transplant Surgeons Available for Expert Commentary
Apr 29, 2011
The nation's leading transplant surgeons are available for expert commentary on the latest research findings presented at the 2011 American Transplant Congress (ATC) in Philadelphia, April 30 to May 4.
Among those presenting at this year's ATC meeting are physician-scientists from NewYork-Presbyterian Hospital/Columbia University Medical Center. The following are some of their notable research studies:
Dr. Benjamin Samstein
Surgical director of the living-donor liver transplant program at NewYork-Presbyterian Morgan Stanley Children's Hospital/Columbia University Medical Center, and assistant professor of surgery at Columbia University College of Physicians and Surgeons.
"Introduction of Fully Laparoscopic LLS for LDLT: New Standard of Care" Poster Session: Living Liver Donors Poster Session Sunday, May 1, 5:30 p.m. Hall B
NewYork-Presbyterian Morgan Stanley Children's Hospital/Columbia University Medical Center is one of the only medical centers in the United States to offer minimally invasive liver donation for pediatric transplantation. Surgeons use a laparoscopic technique to remove a section of liver from a living donor for implantation in a pediatric patient — typically a parent donating to his or her child. The innovative approach promises dramatically improved recovery for the donor. Standard open organ retrieval requires a foot-long incision from the breast bone to the belly button. Dr. Benjamin Samstein and his co-investigators offer a comparison of the fully laparoscopic technique with standard open retrieval. They found excellent outcomes for the laparoscopic approach, with potential for reduced complications and quicker recovery. They write that efforts to expand use of the technique appear warranted.
Dr. Tomoaki Kato
Surgical director of liver and intestine transplant programs at NewYork-Presbyterian Morgan Stanley Children's Hospital/Columbia University Medical Center, and chief of abdominal organ transplantation and professor of surgery at Columbia University College of Physicians and Surgeons.
"Long-Term Outcomes of Auxiliary Partial Orthotopic Liver Transplantation for Fulminant Hepatic Failure" Concurrent Session 31: Living Liver Donors Monday, May 2, 2:51 p.m. Room 114
NewYork-Presbyterian Morgan Stanley Children's Hospital/Columbia University Medical Center is among the first medical centers to perform a partial-liver transplant. The innovative surgery helps the patient's original liver heal, possibly eliminating the need for the lifelong immunosuppressant drug therapy required after a traditional liver transplant. In the surgery, a section of the patient's diseased liver is removed and replaced with a portion of a donor liver. The donor organ supports the patient's liver function while the patient's original diseased liver regenerates and heals. When the original liver has sufficiently regenerated, the patient is taken off immunosuppressant drugs. As a result, the patient's immune system naturally rids his body of the partial donor organ, which by then should no longer be needed. The best candidates for partial-liver transplants are children with acute liver failure, a condition where the liver abruptly stops functioning for unknown reasons. Dr. Kato and his co-investigators report on outcomes of partial-liver cases in 10 children (age 8 months to 8 years). The found that the partial-liver technique successfully resulted in liver regeneration allowing patients to come off immunosuppression.
Dr. James V. Guarrera
Surgical director of adult liver transplantation at NewYork-Presbyterian Hospital/Columbia University Medical Center, and assistant professor of surgery at Columbia University College of Physicians and Surgeons.
"Quantification of Inflammatory Biomarkers in Perfusion Effluent Collected During the First Liver Machine Perfusion Clinical Trial" Poster Session: Clinical Science: Non–Organ Specific: Organ Preservation Tuesday, May 3, 5:30 p.m. Hall B
Preserving organs on ice prior to transplantation, an approach known as cold storage or CS, has been the standard practice in liver transplant for 20 years. Now there is new evidence that a technique called hypothermic machine perfusion (HMP) may offer an improvement. Potential benefits include improved early graft function due to diminished ischemia/reperfusion injury. Dr. Guarrera and his co-investigators report on 15 consecutive cases in their Phase 2 trial of HMP for extended criteria donor (ECD) livers. They showed that HMP is an effective technique to reduce preservation injury in grafts declined due to poor donor quality.
"Excellent Outcomes of Machine Preservation of 'Orphan' Extended Criteria Liver Allografts: Interim Results of a Phase 2 Trial" Concurrent Session 80: Extended Donor Issues Wednesday, May 4, 10:15 a.m. Room 113 B
In a related study, Dr. Guarrera and his co-investigators report on their investigation of biomarkers released into hepatic venous effluent (HVE) during HMP. Their research — one of the first of its kind — reported that ILl-1ß and TNF-α are key mediators of inflammation in ischemia reperfusion injury (IRI), and IL-1Ra is secreted in response to IL-1ß, and MCP-1 in response to TNF-α. The study reports that their decreased production over the course of HMP suggests that attenuation of inflammatory cytokines in the graft during HMP may reduce reperfusion related graft injury. Further clinical experience is needed to determine if any of these markers may be predictive of clinical graft dysfunction.
Organ Transplantation at NewYork-Presbyterian Hospital
The organ transplantation program at NewYork-Presbyterian Hospital — which includes NewYork-Presbyterian Hospital/Weill Cornell, NewYork-Presbyterian Hospital/Columbia and The Rogosin Institute — is the most active program of its kind in the nation, offering comprehensive and personalized care for the heart, liver, pancreas, kidney and lung. With outcomes ranked among the nation's best, the Hospital is dedicated to improving quality of life for its patients. NewYork-Presbyterian's dedicated teams of surgeons and physicians are responsible for many significant advances made over the past several decades in transplant surgery and the maintenance of healthy organs. The Hospital has been on the forefront of developing and improving anti-rejection medications (immunosuppressants), minimally invasive surgery for living donors, genetic methods to detect transplant rejection, strategies to increase opportunities for donor matching, islet cell transplantation, and the FDA-approved Left Ventricle Assist Device (LVAD) that functions as a bridge to transplantation for those waiting for a new heart.
Columbia University Medical Center
Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The Medical Center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians & Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia's College of Physicians and Surgeons was the first institution in the country to grant the M.D. degree and is now among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and state and one of the largest in the United States. For more information, please visit www.cumc.columbia.edu.
NewYork-Presbyterian Hospital, based in New York City, is the nation's largest not-for-profit, non-sectarian hospital, with 2,353 beds. The Hospital has more than 2 million inpatient and outpatient visits in a year, including more than 220,000 visits to its emergency departments — more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian/Morgan Stanley Children's Hospital, NewYork-Presbyterian/The Allen Hospital and NewYork-Presbyterian Hospital/Westchester Division. One of the most comprehensive health care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. The Hospital has academic affiliations with two of the nation's leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.