Multispecialty team completes rare lung-liver transplant

John M. Vierling, MD, FACP

Physicians in the Transplant Services Division at Texas Children’s Hospital recently performed a rare 16-hour double lung-liver transplant to treat the effects of cystic fibrosis in a 17-year- old patient. John Goss, MD, Medical Director of Transplant Services, transplanted the patient’s liver. David Morales, MD, Pediatric Lung Transplant Surgeon, and Jeff Heinle, MD, Surgical Director of the Lung Transplant Program, performed the lung transplantation and Marc Schecter, MD, Medical Director of Lung Transplant and Beth Carter, MD, Interim Medical Director of Liver Transplant monitored the patient’s lung and liver function.

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ISSUE 4 n 2012

Inside2 Liver Center Update

3 Honors and Awards

4 Presentations

5 Publications

John M. Vierling, MD, FACP

The Michael E. DeBakey Department of Surgery

bdominalTRANSPLANT

BCM TransplantHepatology Fellowship

The BCM Transplant Hepatology Fellowship Program is accredited by the Accreditation Council for Graduate Medical Education (ACGME) to provide advanced training in the science and practice of hepatology and liver transplantation to candidates who have completed a gastroenterology fellowship. Successful completion of the Transplant Hepatology Fellowship allows graduates

to seek an American Board of Internal Medicine (ABIM) certification in Transplant Hepatology, as a certificate of added qualification to their ABIM board certification in the subspecialty of gastroenterology. The Transplant Fellowship Program is directed by John M. Vierling, MD, FACP, Professor of Medicine and Surgery and Chief of Hepatology at BCM. A unique attribute of the Program is the fact that all five of the full-time Baylor hepatology faculty members have triple ABIM certification in internal medicine, gastroenterology and transplant hepatology. The full-time BCM surgical faculty is exclusively focused on orthotopic liver transplantation, hepatobiliary surgery and simultaneous liver and kidney, heart or lung transplantation.

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Liver CenterThe liver center provides specialty care for the treatment of liver cancer, hepatitis, abdominal paracentesis, fulminant liver failure, end-stage liver disease and the evaluation and treatment of all forms of liver abnormalities. Specialty physicians in cardiology, nephrology and pulmonology are available for consultation. A wide range of services including liver transplantation and resection are available. Pharmacy, dietary, nursing, and various spiritual affiliations are available to help patients and families cope with their disease. The Center participates in and conducts several clinical trials, offering the latest therapies, in the areas of chronic viral hepatitis B and C, treatment of thrombocytopenia in liver disease and treatment of liver tumors. The Center also offers the unique services of the Hepatitis Program, which focuses on patient and

family education and optimal management of side effects of antiviral therapy. The ultimate goals of the research are to advance the treatment of liver diseases and the field of liver transplantation. The clinic is located in the Baylor Clinic at 6620 Main, Suite 1450. You may contact the clinic by calling 877.685.0361.

Drs. O’Mahony and Goss at work in the clinic.

Tyler, who was diagnosed at birth with cystic fibrosis, was referred by a Fort Worth area pulmonologist to Texas Children’s Hospital, one of the few hospitals in the nation with a comprehensive pediatric organ transplant program. Since 2009, nine patients at Texas Children’s have been transplanted with double organs. “He has had a long journey with this disease that damaged both his lungs and liver,” said Schecter. “Because his new lungs are not damaged by cystic fibrosis, he now has four to five times more lung capacity. We expect his recovery to progress well, and we are optimistic he will enjoy a normally active lifestyle.” To see a video of Tyler’s journey, please visit youtube.com/watch?v=HTRtQpXBG1U.

Reprinted with permission courtesy of Texas Children’s Hospital

Transplant hepatologists and surgeons work together in a multi-departmental, multidisciplinary manner that adds to the education of all trainees. In addition, the Program’s core curriculum in hepatology and liver transplantation provides training to fellows in BCM’s ABIM- and ACGME-accredited Gastroenterology Fellowship. The training of the next generation of academicians and clinicians in the discipline of hepatology and liver transplantation is crucial to the health and welfare of patients afflicted with diseases of the liver and bile ducts. The BCM Transplant Hepatology Program is committed to this mission. For more information visit our web site at www.bcm.edu/surgery/abdominal/hepatology.

Dr. Goss speaks with a referring physician.

Rare transplant Continued from page 1 Fellowship Continued from page 1

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Honors and Awards

Drs. Lappin and Katz at Celebrate Life 2012

JACQUELINE A. LAPPIN, MD, FACS, associate professor of surgery, was honored for her work in transplantation by the Living Bank at the Celebrate Life 2012 Gala, October 2012.

Dr. Lappin is director of pancreas transplantation at St. Luke’s Cooley Transplant Center. The Celebrate Life 2012 event was held October 19 at The Junior League of Houston. The night’s proceeds benefited programs of the Living Bank. The Living Bank was founded in 1968 to raise awareness of the need for organ donors and to serve as an advocate for living donors.

F. BLAINE HOLLINGER, MD, professor of medicine, was presented with the Advisory Committee Service Award by the US Food and Drug Administration, Center for Biologics Evaluation and Research, in recognition of distinguished service as Chairman of the Blood Products Advisory Committee from 2008-2012.

RISË STRIBLING, MD, associate professor of surgery, was featured on Great Day Houston, Channel 11, October 10, 2012. The segment discussed fatty liver disease, prevention and general care of the liver.

SEE VIDEO: http://www.khou.com/video?id=173529611&sec=642524

Dr. Stribling also was nominated to the St. Luke’s Episcopal Hospital Medical Executive Committee “At-large” position.

Dr. Hollinger receiving the award from CBER Director Karen Midthun, MD

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PresentationsJOHN A. GOSS, MD

Surgical Options in Management of Hepatocellular Carcinoma, 13th Annual Hot Topics in Liver Disease, Houston, TX, October 13, 2012.

Cholangiocarcinoma - Current Diagnosis and Management, 13th Annual Hot Topics in Liver Disease, Houston, TX, October 13, 2012.

JOHN M. VIERLING, MD

Autoimmune Hepatitis, Hepatology and Liver Transplantation Didactic Lecture Series, Houston, TX, August 1, 2012.

Primary Sclerosing Cholangitis, Hepatology and Liver Transplantation Didactic Lecture Series, Houston, TX, August 6, 2012.

Direct-acting Antiviral (DAA) Therapy for Naïve Patients with Genotype-1 Hepatitis C, UC Irvine GI/Hepatology Course, Indian Wells, CA, September 15, 2012.

Newer Treatments in HCV, Johns Hopkins School of Medicine - CME Dinner Program, Houston, TX, October 9, 2012

Update on Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis, 13th Annual Hot Topics in Liver Disease, Houston, TX, October 12-13, 2012.

RONALD H. KERMAN, PHD

Post-Transplant Immune Monitoring of Solid Organ Transplant Recipients, Texas Transplant Society 25th Anniversary Annual Scientific Meeting, Galveston, TX, July 26, 2012.

JEROME SALTARRELLI, PHD

Poster: Immunologically High-Risk Recipients Display Persistent Post-Transplant DSA, 38th Annual ASHI Meeting, San Juan, Puerto Rico, October 8 - 12, 2012. Co-authors: Bihari LA, Lappin JA, Katz SM, Eaton J, Woolley N, McKissick E, Van Buren CT, Kerman RH.

KHOZEMA HUSSAIN, MD

Alcoholic Liver Disease, Hepatology and Liver Transplantation Didactic Lecture Series, Houston, TX, August 22, 2012.

Malignant Tumors: HCC and CCA, Hepatology and Liver Transplantation Didactic Lecture Series, Houston, TX, August 29, 2012.

Alcoholic Liver Disease, 13th Annual Hot Topics in Liver Disease, Houston, TX, October 13, 2012. PRASUN JALAL, MD

Hemochromatosis, Hepatology and Liver Transplantation Didactic Lecture Series, Houston, TX, August 8, 2012.

Wilson Disease and Alpha-1-Antitrypsin Deficiency, Hepatology and Liver Transplantation Didactic Lecture Series, Houston, TX, August 20, 2012.

Iron Storage Disorders, Hepatology and Liver Transplantation Didactic Lecture Series, Houston, TX, August 29, 2012.

Bile Acid Disorders, Hepatology and Liver Transplantation Conference, Baylor College of Medicine, Houston, TX, September 10, 2012.

Clinical Perspectives in the Management of Chronic HBV Infection: A Case-Based Approach, Simply Speaking, Woodlands, TX September 27, 2012.

GAGAN SOOD, MD

Portal Hypertension - Variceal Bleed, Hepatology and Liver Transplantation Didactic Lecture Series, Houston, TX, August 27, 2012.

Genetics of Non-alcoholic Fatty Liver Disease (NAFLD), Medicine Grand Rounds, Michael E. DeBakey Veteran’s Affairs Hospital, Houston, TX, October 22, 2012.

NORMAN SUSSMAN, MD

Acute Liver Failure, Hepatology and Liver Transplantation Didactic Lecture Series, Houston, TX, August 1, 2012.

Post Conference Update 2012: EASL, Educator Availability Clinical Viewpoints HCV Program, Houston, TX, August 7, 2012.

Non-Alcoholic Fatty Liver Disease, Hepatology and Liver Transplantation Didactic Lecture Series, Houston, TX, August 22, 2012.

Best Practices for the Management of Hepatitis C: Screening, Linkage to Care and Treatment, Educator Availability Clinical Viewpoints HCV Program, Bryans House/Dallas ANAC Chapter, Dallas, TX, September 17, 2012.

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ST. LUKE'S COOLEY TRANSPLANT CENTER

LiverBaylor Clinic Building 6620 Main, Suite 1450 Houston, TX 77030 Appointments: 877.685.0361Patients: 832.355.6461

Kidney/PancreasO’Quinn Medical Tower 6624 Fannin Street, Suite 1610 Houston, TX 77030 Appointments: 877.685.0361 Patients: 713.798.7330

ST. LUKE’S CENTER FOR LIVER DISEASE6620 Main, Suite 1450 Houston, Texas 77030 Main Number: 832.355.1400 New Patients: 832.355.1471 Follow-up Patients: 832.355.1495

TEXAS CHILDREN’S TRANSPLANT SERVICES11th floor, Clinical Care Center 6621 Fannin Street Houston, Texas 77030 Appointments: 866.683.8032 For referral or other information: 832.822.1551

MICHAEL E. DEBAKEY VA MEDICAL CENTER2002 Holcombe Boulevard Houston, Texas 77030 Appointments: 713.791.1414, Ext. 6524 Toll-Free: 800.639.5137

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Obesity Related Liver Disease: Getting Your Just Desserts, Philippine Nurses Association of Metropolitan Houston, Memorial Hermann Southwest Hospital, Houston, TX, October 20, 2012.

A Case of Acute Liver Failure, Hepatology/Liver Transplantation Conference, Baylor College of Medicine, Houston, TX, October 22, 2012.

PublicationsNguyen NTT, Harring TR, Liu H, Goss JA, O’Mahony CA. Transplanting Whole Livers from Donors Less than 6 Kilograms—is it prudent? J Surg Res. 2012 Oct;177(2): 348-58.

Harring TR, Nguyen NT, Liu H, Goss JA, O’Mahony CA. Caroli disease patients have excellent survival after liver transplant. J Surg Res. 2012 Oct;177(2):365-72.

Englesbe MJ, Kelly B, Goss J, Fecteau A, Mitchell J, Andrews W, Krapohl G, Magee JC, Mazariegos G, Horslen S, Bucuvalas J. Reducing Pediatric Liver Transplant Complications: A Potential Roadmap for Transplant Quality Improvement Initiatives Within North America. Am J Transplant. 2012 Sep;12(9):2301-2306.

Remien CH, Adler FR, Waddoups L, Box TD, Sussman NL. Mathematical modeling of liver injury and dysfunction after acetaminophen overdose: early discrimination between survival and death. Hepatology. 2012 Aug;56(2):727-34.

Harrison SA, Hamzeh FM, Han J, Pandya PK, Sheikh MY, Vierling JM. Chronic hepatitis C genotype 1 patients with insulin resistance treated with pioglitazone and peginterferon alpha-2a plus ribavirin. Hepatology. 2012 Aug;56(2):464-73.

Clinics and CentersPresentations Continued from page 4

The Abdominal Transplant newsletter is a publication of The Michael E. DeBakey Department of Surgery at Baylor College of Medicine

To be added to the Newsletter e-mail database please write to:

Scott HolmesOne Baylor Plaza, MS: BCM 504

Houston, Texas 77030or e-mail: surgerynews@bcm.edu

Editor-in-ChiefJohn Goss, MD

Editor Scott C. Holmes

© 2012 Baylor College of Medicine

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Donate Life TexasDONATE LIFE TEXAS, a nonprofit corporation, has

been created with the support of the state’s three organ

procurement organizations (OPOs). Donate Life Texas

is now responsible for managing the state’s organ,

tissue, and eye donor registry—the Glenda Dawson

Donate Life - Texas Registry—in an effort to increase

the number of Texans who commit to donation. State

Representative Glenda Dawson, a kidney transplant

recipient herself, led the effort to create the registry

before her passing in 2006. Individuals who wish to

be an organ/tissue donor no longer need to fill out a

donor card or have a sticker affixed to their license; they

can simply register online at www.donatelifetexas.org.