June 2012 Emory Surgery newsletter Department of Surgery of the Emory University School of Medicine

 

CONTENTS

Grady Burn Center receives certification

Dr. Walt Ingram and nurse treating a patient

Grady Memorial Hospital veteran Dr. Walter Ingram, director of Grady's Burn Center since 1992, is the embodiment of the patient-centered physician. Presiding over a program that admits over 500 burn patients per year and provides the vast majority of pediatric burn care in Georgia, he has dedicated himself to fine-tuning the center's capabilities. Throughout the years he has standardized wound care protocols, expanded hydrotherapy facilities, upgraded and refined pain control processes, initiated services for patients with complex wound problems secondary to burns, and developed his own patient registry and outcomes database.

Dr. Ingram's most recent focus has been to obtain verification from the American Burn Association (ABA), the highest recommendation a burn center can receive. Following a very successful site visit, verification was granted in late May, officially acknowledging the Grady Burn Center for providing high quality adult and pediatric patient care and meeting the ABA's demanding standards for organizational structure, personnel qualifications, facilities resources, and medical care services.

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Dr. Freitas
Dr. Freitas
Dr. Magliocca
Dr. Magliocca
Dr. Singh
Dr. Singh

Significant transplantation studies

The following research was presented at the International Society of Heart and Lung Transplantation Annual Meeting and the American Transplant Congress.

In a study led by allograft transplant surgeon Dr. Linda Cendales and presented by research fellow Dr. Alessandrina Freitas, it was determined that costimulation blockade-based regimens could support prolonged graft survival and prevention of rejection of vascularized composite allografts (multiple tissues transplanted as a functional unit) in non-human primates. The regimen that paired belatacept with short-term tacrolimus was particularly effective.

Results from the extension of the BENEFIT study—a randomized, phase III study of adults receiving kidney transplants from living or deceased donors—were presented by belatacept co-developer Dr. Chris Larsen. The results continued to describe belatacept as safe, effective, and having comparable patient and graft survival rates and better renal function rates than those of patients taking a cyclosporine-based regimen, although the rates and grades of acute rejection remained higher with the relatively new drug.

Many transplant centers nationally have adopted policies of reserving younger, more ideal organs for hepatitis C positive patients, who face a risk of an aggressive recurrence of HCV and worse outcomes. A study by liver transplant surgeon Dr. Joseph Magliocca suggests that while such allocation may be justified, more detailed research is needed to assess whether this policy translates into an overall increase in life years gained for recipients.

Dr. Karnail Singh is the first author of a study on methods of maintaining immunological tolerance following transplantation. Because regulatory T cells (Tregs), at the core of adaptive immunity, are difficult to produce in large scale, and their suppressive function can be difficult to maintain over time during culturing, the investigators have used a non-human primate model—rhesus macaques—for Treg production. Tregs may prove useful in prolonging the functioning of allografts.

Kidney and pancreas transplant surgeon Dr. Nicole Turgeon collaborated with GSU's economics department on two studies involving the effects of reports by the Scientific Registry of Transplant Recipients (SRTR) on physicians' treatment decisions. The studies concluded that the comparison of transplant centers' risk-adjusted expected values contained in the SRTR reports may influence physicians' decisions regarding the duration of wait times before potential recipients should receive renal transplants and for choosing the best candidate to receive a donor kidney. The studies suggested that while this information can provide guidance on how to improve outcomes, it can also lead to situations that are not necessarily in the patient's best interest, such as increased wait times or an unwillingness to accept deceased donor kidneys for higher risk patients.

Dr. David Vega, director of the heart transplant program at Emory, has conducted a groundbreaking outcome study that may change the way organs are allocated to heart failure patients. His study of survival rates at one-year and two-years post-transplant challenges the current practice of treating all status 1A cardiac patients on various types of support equally. Analysis of pre-transplant interventions and patient responses suggest that outcomes after heart transplantation and the risk of post-transplant mortality should be considered in developing a heart allocation score.

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State-of-the-art-ICU opens at EUHM

New ICU at Midtown

Dr. Timothy Buchman's multi-disciplinary critical care team at Emory University Hospital Midtown designed, developed, and recently unveiled a modernized, highly efficient alternative to the traditional ICU suite. The 12-bed unit, known as Unit 11 ICU, is specifically for cardiothoracic and vascular patients.

The renovated space features patient rooms almost twice the size of previous ICU rooms, moveable power columns and computers, room cabinets that can be stocked from the outside, dialysis connections in all rooms, and lifts and oversized furniture for bariatric patients. Nursing stations are comprised of six pods supporting two ICU rooms each, and a team work center in the front of the space serves as a two-way communication link between all of the patient rooms and the center itself.

"Emory must model itself to standardize the delivery of cutting-edge critical care medicine across the system," says Dr. Buchman, "while integrating patient- and family-centered care, teaching, and research into its mission."

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Dr. David Lefer
Dr. Lefer

CTRL research team awarded NIH P20 grant

"Functional cardio-metabolomics" is a five-year consortium grant totaling $4,781,412 in direct costs and includes research teams at the Emory Cardiothoracic Research Lab (CTRL), Cleveland Clinic, and University of California-Davis. Dr. David Lefer is the PI at the Emory location.

The study will work to identify and characterize novel gut-derived metabolites that contribute to such cardiovascular diseases as atherosclerosis, acute myocardial infarction, and heart failure. Using animal model systems, the CTRL Research Team will work with the consortium group to evaluate the effects of the gut-derived metabolites on the severity of cardiovascular disease.

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Dr. Halkos with surgical robot
Dr. Halkos on the da Vinci robotic surgical system

Dr. Halkos and Dr. Lin: New degrees; Dr. Wood: New appointment

Dr. Edward Lin received his Master of Business Administration from Goizueta Business School and graduated with Beta Gamma Sigma academic honors in the top 10% of his class. As surgical director of the Emory Bariatric Center and director of the Emory Endosurgery Unit, he had many opportunities to apply his focus on organizations and finance to real-work situations.

Dr. Michael Halkos received a Master of Science in Clinical Research (MSCR) from the Laney Graduate School at Emory. The MSCR program provides didactic and mentored clinical and translational research training to participants who have demonstrated a commitment to a career in clinical investigation.

As the first academic dean of the international Pan-African Academy of Christian Surgeons (PAACS), Dr. William Wood will oversee the academic aspects of the eight PAACS-sponsored residencies that are currently training surgeons in Africa. He will also work with various African boards of surgery in the the process of evaluating several new residencies that have applied for acceptance as PAACS programs. Dr. Wood also serves on PAACS' Board of Directors. He has visited and lectured at several PAACS training centers over recent years, including Soddo Hospital, where Dr. Jon Pollock is assistant program director as well as founding director of the Emory Global Surgery Program.

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Dr. Andrew Adams
Dr. Adams

New arrival: Andrew Adams, MD, PhD

Assistant Professor of Surgery, Division of Transplantation, Department of Surgery, Emory University School of Medicine

Dr. Adams joins us after finishing his two-year Emory transplant surgery fellowship. An alumnus of Emory's MD/PhD program, he completed his graduate work in immunology under the direction of Drs. Larsen and Pearson, moved on to Massachusetts General Hospital to complete his general surgery training, then returned to Emory for the transplant fellowship. During the fellowship he re-integrated into the Emory Transplant Center's research laboratory and focused on basic immunology as well as translational models at Yerkes National Primate Center. His clinical time will be divided between the liver and kidney services, while his clinical research efforts will focus on resource utilization following solid organ transplantation.

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Residency/Fellowship Transitions

BREAST FELLOWSHIP

Outgoing fellow Jared Linebarger will be an attending breast surgical oncologist and general surgeon at Gundersen Lutheran Medical Center, La Crosse, WI. The incoming fellow is Erin Bowman, who did her general surgery residency at Morehouse.

CARDIOTHORACIC SURGERY

Outgoing residents

Bryon Boulton, Carolina Cardiovascular Associates, Raleigh, NC; Azeem Khan, CVT Surgical Group, Baton Rouge, affiliated with Louisiana State University Health Sciences Center in New Orleans.

Incoming three-year residents

Shair Uddin Ahmed, Brown University, Rhode Island Hospital, Providence; Farshad Anvari, George Washington University, Washington, DC; Jared Murdock, Allegheny General Hospital, Pittsburgh; Jay Balvant Patel, Indiana University School of Medicine, Indianapolis.

Incoming six-year integrated program residents

Michael Kayatta, PGY-2 general surgery resident, Emory; Christina Saikus, PGY-1 MD/PhD student, Emory/Georgia Institute of Technology.

Incoming fellows

Emmanuel Moss, University of Montreal Department of Cardiac Surgery (Montreal Heart Institute); Tom Nguyen, Columbia Presbyterian Hospital.

ENDOSURGERY FELLOWSHIP

Outgoing fellows

Rebecca Coefield and Miller Hamrick, new affiliations unknown at press-time.

Incoming fellows

Nathaniel Lytle, University of Tennessee, Memphis; Ankit Patel, Emory.

GENERAL SURGERY

Outgoing chief residents

Charles Bailey, vascular surgery fellowship, University of South Florida; Carrie Chu, plastic surgery fellowship, Emory; Geoffrey Lam, cardiac surgery fellowship, NYU; Kelly McDonald, returning to military service; Ankit Patel, endosurgery fellowship, Emory; Gabriela Velazquez, vascular surgery fellowship, University of South Florida; Maksym Yezhelyev, plastic surgery fellowship, Vanderbilt; John Zink, trauma/critical care fellowship, UT Southwestern.

Incoming categorical residents

Barath Badrinathan Albert Diehl Maggie Diller
Barath Badrinathan, University of Illinois College of Medicine at Peoria   Albert Diehl, Emory University School of Medicine   Maggie Diller, University of Arizona College of Medicine at Tucson
Benjamin Flink Laura Higginbotham Nathan Klingensmith
Benjamin Flink, Duke University School of Medicine   Laura Higginbotham, University of Virginia School of Medicine   Nathan Klingensmith, West Virginia University School of Medicine at Morgantown
Rebecca Lopez Lauren McLendon Heather Short
Rebecca Lopez, Medical University of South Carolina College of Medicine   Lauren McLendon, Emory University School of Medicine   Heather Short, Mercer University School of Medicine at Macon

Incoming non-designated, preliminary residents

Olayinka Ajayi Anand Dayama Sabine Lovell
Olayinka Ajayi, University of Ibadan of Nigeria   Anand Dayama, Institute of Medical Sciences, Varanasi, India  

Sabine Lovell, University of Texas Medical School – Houston

 
Ashley Rogers Ravi Ruhil  
Ashley Rogers, Mercer University School of Medicine at Macon   Ravi Ruhil, University College of Medical Sciences, India    

Incoming surgical subspecialty urology residents

Jonathan Huang, University of Illinois College of Medicine; Ilan Safi, David Geffen School of Medicine at UCLA; David Samuel, University of Nebraska College of Medicine.

Incoming surgical subspecialty oral surgery resident

Ajay Ganti, Emory.

ORAL AND MAXILLOFACIAL SURGERY

Outgoing residents

Michael Demo, North West Oral and Maxillofacial Surgery, Marietta, GA; Mimi Park, Flushing Dental Implants, Oral and Facial Surgery, Flushing New York; Manhattan Oral Facial Surgery, Manhattan, NYC; Robert Cory Ryan, Cool Smiles, Austin, TX; Jonathan Threadgill, North West Oral and Maxillofacial Surgery, Marietta.

Incoming residents

Shenan Bradshaw, University of North Carolina at Chapel Hill; Brandon Christensen, University of Nevada, Las Vegas; Brian Kinard, Harvard Dental School of Medicine; Daniel Martin, University of Nevada.

PEDIATRIC SURGERY

Thomas Schmelzer, the outgoing fellow, is going to Carolinas HealthCare System in Charlotte. Incoming fellow Matthew Santore is from the University of Pennsylvania.

PLASTIC SURGERY

Outgoing residents

Bahair Ghazi, private practice, Savannah; Garrett Harper, private practice, Charlotte, NC; Hunter Moyer, Atlanta Plastic Surgery.

Incoming residents

Brian Arslanian, Beth Israel Deaconess Medical Center; Carrie Chu, Emory; Claire Duggal, Emory.

TRANSPLANTATION FELLOWSHIP

The outgoing fellows are Andrew Adams, who has joined our division of transplantation (see New Arrival feature), and Wasim Dar, who has taken a faculty position at the University of Texas Health Sciences Center in Houston. The new fellows are Raymond Lynch, University of Michigan, and Malcolm MacConmara, Washington University of St. Louis.

TRAUMA/SURGICAL CRITICAL CARE

Outgoing surgical critical care residents

Brian Brewer, Sinai Hospital, Baltimore; Jamie Jones Coleman, Indiana University; Laura Johnson, Washington Hospital Center.

Incoming trauma fellows

Elaine Chan, St. Luke's Roosevelt Hospital Center, New York; Marco Hoesel, St. Joseph Mercy Hospital, Ann Arbor; Darren Hunt, University of Tennessee, Chattanooga.

Former trauma fellows, now surgical critical care residents

Alisa Cavitt, Britani Hill, and Gregory Lance Peck.

VASCULAR SURGERY AND ENDOVASCULAR THERAPY

Outgoing residents

Dorian DeFreitas, Rex Hospital, Raleigh, NC; Paul Riesenman, University Hospital, Augusta, GA.

Incoming residents

Jean Marie Ruddy, Medical University of South Carolina, Charleston; Kevin Brown, National Naval Medical Center, Bethesda.

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Emory reception at the ACS Clinical Congress

ACS Clinical Congress

Emory Department of Surgery alumni, faculty, and trainees are invited to attend a buffet reception hosted by the Department during the 98th Annual Clinical Congress of the American College of Surgeons in Chicago. The reception will be held on Tuesday, October 2, 2012, from 6:00-8:00 p.m. at the Chicago Firehouse Restaurant, 1401 South Michigan Avenue. Please RSVP by September 21, 2012, to surgeryeventsrsvp@emoryhealthcare.org.

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Upcoming events

EVENT DATE/TIME LOCATION
J.D. Martin Professorship Reception 6:00-9:00 p.m., July 11, 2012 Miller Ward Alumni House, 815 Houston Mill Road
SURGICAL GRAND ROUNDS
36th Annual J.D. Martin Visiting Professorship
Strategies for Improving the Qualities of Surgical Care

Presented by John D. Birkmeyer, MD
–George D. Zuidema Professor of Surgery
–Director, Center for Healthcare Outcomes and Policy, University of Michigan
7:00-8:00 a.m., July 12, 2012 EUH Auditorium
SURGICAL GRAND ROUNDS
Current Challenges in Thoracic Aortic Endografting

Presented by Bradley G. Leshnower, MD
– Assistant Professor of Surgery, Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine
7:00-8:00 a.m., July 19, 2012 EUH Auditorium
Surgery Faculty Meeting 5:30-7:00 p.m., July 31, 2012 EUH Auditorium
Surgery Division Chiefs Meeting 5:30-7:00 p.m., August 28, 2012 Whitehead Room, EUH
     
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