July 2013 Emory Surgery newsletter Department of Surgery of the Emory University School of Medicine


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Troy Milford and Robert Poole, participants in the 2nd largest kidney swap in history.

Emory transplant surgeons participate in second largest kidney swap in history

Dr. Nicole Turgeon with kidney swap recipient Troy Milford (left) and donor Robert Poole (right).
Dr. Nicole Turgeon with kidney swap recipient Troy Milford (left) and donor Robert Poole (right).

The world's second largest kidney swap, and the largest kidney swap to be concluded in less than 40 days, began in Memphis, TN, on April 30, 2013, with a donation from an altruistic donor, and ended just five weeks later, on June 5, in Cleveland, OH. Named "Chain 221" by the National Kidney Registry, the swap involved 56 participants and resulted in 28 transplants in 19 transplant centers across the U.S., including the Emory Transplant Center (ETC).

According to the National Kidney Registry, this chain exemplifies the great progress that's been made to shorten set-up times for large swaps, reducing the time patients must wait for a kidney transplant. Large swaps like these also increase the ability to find matches for highly sensitized patients who are very difficult to match.

"Emory began its kidney paired donor exchange program in 2010, and we have been participating in the National Kidney Registry since 2012," says Dr. Nicole Turgeon, a transplant faculty surgeon of the Department of Surgery of the Emory University School of Medicine and surgical director of Emory's paired donor exchange program. "Paired donor exchange gives patients an opportunity to receive a living donor kidney transplant from a loved one or friend, despite incompatible blood types and positive crossmatches. In paired donation, a donor and recipient are matched with another incompatible donor and recipient pair, and the kidneys are exchanged between the pairs. This was the case with our patients Mr. Poole and Mr. Milford, and the basis of how Chain 221 worked."

For 10 years, Troy Milford had been battling polycystic kidney disease, a genetic disorder characterized by the growth of numerous cysts in the kidneys. He began dialysis in 2009 and was placed on the kidney transplant wait list in 2010. Several of Mr. Milford's family members and his friend Robert Poole were tested as potential donors, but none were matches. After Mr. Poole learned about Emory's kidney paired donor exchange program, he registered as a donor.

On April 30, both Mr. Milford and Mr. Poole had surgery at Emory University Hospital as part of Chain 221. Dr. Turgeon transplanted Mr. Milford's new kidney, while Dr. Paul Tso removed Mr. Poole's kidney, which was donated to another person half way across the country. Both men are doing well after their surgeries.

"Words can't say how it made me feel that Robert, who's not even related to me, would do this for me," says Mr. Milford. "I am one of 28 people who has a new kidney and a new outlook on life, thanks to this swap."

"Troy is a good friend and special person," says Mr. Poole. "He was too proud to ask for help, even when he was sick, so I am really happy I could assist."

"Mr. Poole and Mr. Milford had two previous offers in chains that were cancelled," says Dr. Turgeon. "We are happy this swap went to successful completion with 28 people donating kidneys and 28 people receiving kidney transplants."

According to Dr. Turgeon, there are currently over 100,000 people on the kidney transplant waiting list, and the discrepancy between the number of organs available and the number of people on the waiting list continues to grow. "Ultimately, we want to bring awareness to living and deceased donation with this story," she explains.

Since the kidney paired donor exchange program began at ETC, surgeons of the division of transplantation of the Emory Department of Surgery have performed 27 kidney transplants.

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Dr. David Kooby
Dr. Kooby
Dr. Monica Rizzo
Dr. Rizzo
Dr. Ken Cardona
Dr. Cardona

"Seamless patient care" offered by Emory/Saint Joseph's Hospital surgical oncology collaboration

As director of surgical oncology, Emory/Saint Joseph's Hospital, Dr. David Kooby looks forward to furthering the complementary strengths of both institutions. "It's an opportunity to help develop something new and exciting alongside great colleagues," he says.

Together, Saint Joseph's and Emory doctors provide a wealth of expertise and knowledge, along with innovative treatment options and clinical services. In 2002, Saint Joseph's became the first hospital in Georgia to perform robotic, totally-endoscopic, closed-chest heart surgery. The hospital is one of only five training sites in the world for the robotic da Vinci Surgical System. Dr. Kooby, an international leader in minimally invasive pancreatic surgery who has been performing robotic pancreatectomies at Emory University Hospital since 2011, is delighted to have additional access at Saint Joseph's to state-of-the-art surgical robots. "With more resources at the Saint Joseph's location, there is better throughput potential."

Currently, Emory surgical oncology colleagues Dr. Monica Rizzo, associate professor, and Dr. Ken Cardona, assistant professor and director of the core curriculum for Emory's general surgery residency, work with Dr. Kooby at St. Joseph's. In August, they will be joined by new Emory surgical oncology faculty member Dr. Joshua Winer (see bio-summary below).

While Saint Joseph's has not been traditionally a teaching hospital, one Emory resident will be rotating with the team. In time, the residency effort may grow with the program. "There will be a teaching component which will be invaluable for the residency and for the community," says Dr. Kooby.

The team also brings a commitment to research and development. As an ACS Commission on Cancer Liaison Physician at Emory University Hospital Midtown, Dr. Rizzo is actively involved in quality measures and initiatives to assure excellence in cancer care at the hospital. Dr. Kooby, who directed a national study of the efficacy of laparoscopic pancreatectomy, has conducted notable prospective and retrospective assessments of open and laparoscopic methods of pancreas, liver, and biliary tract resection. Dr. Cardona is on multiple national scientific committees and has a strong basic science and clinical research background. According to Dr. Kooby, "Saint Joe's patients will certainly be included in future outcome studies."

The doctors' patients can be seen at Saint Joseph's and Emory. "We can provide seamless care for the patient," says Dr. Kooby. Current patients, especially those living northwest and northeast of Atlanta, can choose to receive services at the most easily accessible location.

Dr. Kooby is pleased with the program. "The Saint Joseph's location will provide the same quality of care, with perhaps a more personal feel. It's a facility that will be preferred by some patients. This addition opens doors to further collaboration with the community."

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Atlanta Magazine Top Doctors 2013

Seventeen Emory Surgery faculty named to Atlanta's Top Doctors

Atlanta magazine's July 2013 "Top Doctors" issue, an annual listing compiled by the New York-based research firm Castle Connolly Medical Ltd., included 17 faculty of the Department of Surgery of the Emory University School of Medicine. Congratulations to Timothy Buchman, Linda Cendales, Seth Force, Sheryl Gabram, John Galloway, Robert Guyton, T. Roderick Hester, Kirk Kanter, Stuart Knechtle, Albert Losken, Daniel Miller, Foad Nahai, Kenneth Newell, Charles Staley, John Sweeney, Collin Weber, and Mark Wulkan.

Nearly half of the physicians recognized in this year's "Top Doctors" issue are Emory Healthcare doctors, Emory Healthcare affiliated doctors, or Emory University School of Medicine faculty.

Castle Connolly uses a survey and research process involving tens of thousands of top doctors across America and the medical leadership of leading hospitals. Atlanta's top doctors were selected after peer nomination, extensive research, and careful review and screening by Castle Connolly's doctor-directed research team. Atlanta magazine uses the research by Castle Connolly to provide detailed information about education, training, and special expertise of Atlanta doctors.

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Dr. Eric Sarin
Dr. Sarin
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Dr. Joshua Winer
Dr. Winer
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Dr. B. Daniel Campos
Dr. Campos

New arrivals: Dr. B. Daniel Campos, Dr. Eric Sarin, and Dr. Joshua Winer

Division of Cardiothoracic Surgery

(Assistant Professor of Surgery) Eric L. Sarin, MD, returns to Emory after three years in private practice at the INOVA Heart and Vascular Institute in Fairfax, VA. His clinical interests include structural heart disease and diseases of the thoracic aorta. After receiving his MD from the George Washington University School of Medicine in 1998, Dr. Sarin completed a general surgery residency and a fellowship in surgical critical care at the University of Colorado Health Sciences Center. He then came to Emory for his cardiothoracic surgery residency and an advanced transcatheter/structural heart disease fellowship supervised by Dr. Vinod Thourani.

Division of Surgical Oncology

(Assistant Professor of Surgery) After obtaining his medical degree in 2004 at the University of Maryland, Joshua A. Winer, MD, completed his general surgery residency and surgical critical care fellowship at Brigham and Women’s Hospital. Prior to joining our faculty, he completed his surgical oncology fellowship at the University of Pittsburgh Medical Center. Dr. Winer’s specialties at Emory will include the performance of hyperthermic intraperitoneal chemoperfusion (HIPEC), a new and innovative cancer treatment that delivers highly concentrated, heated chemotherapy directly to the abdomen, which allows for higher doses of chemotherapy than systemic chemotherapy delivery.

Division of Transplantation

(Assistant Professor of Surgery) B. Daniel Campos, MD, a native of La Paz, Bolivia, joins our transplant surgery faculty upon completion of a two year abdominal organ transplant fellowship at Stanford University's adult and pediatric hospitals. After receiving his medical degree from the Tecnológico de Monterrey in Mexico in 2000, Dr. Campos completed a year of research in experimental surgery in transplantation at the Medical Science Institute (INCMNSZ), Mexico City. His 2001-2007 general surgery residency at the University of Nebraska Medical Center in Omaha included a one-year clinical research fellowship in transplantation. Following his residency, Dr. Campos served as a general surgeon at Prowers Medical Center in Lamar, CO, from 2007-2010. He specializes in liver transplantation, liver surgery, and kidney transplantation, and has research interests in adult and pediatric living donor liver transplantation as well as clinical outcomes of liver transplantation for hepatocellular carcinoma.

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Upcoming events

Surgery Faculty Meeting 5:30 - 7:00 p.m., July 30, 2013 TEC, B6300
Department of Surgery Research Seminar: Learning the Basics of Research, Funding Sources, Effort Reporting, Conflict of Interest, Compliance
Presented by
Allan Kirk, MD, PhD
– Vice Chair of Research, Department of Surgery, Emory University School of Medicine
Lisa Carlson, MPH, MCHES
– Director of Academic Affairs, Department of Surgery, Emory University School of Medicine
5:00 - 6:30 p.m., August 13, 2013 EUH H-Wing Surgery Education Classroom
Multimodality Therapy for Soft Tissue Sarcoma: Too Much, Too Often, and Not Enough
Presented by Kenneth Cardona, MD
– Assistant Professor of Surgery, Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine
– Director of Core Curriculum, General Surgery Residency, Department of Surgery, Emory University School of Medicine
7:00 - 8:00 a.m., August 1, 2013 EUH auditorium
Endoluminal Surgery: The Next Frontier?
Presented by Jamil Stetler, MD
– Chief Resident, Department of Surgery, Emory University School of Medicine
7:00 - 8:00 a.m., August 8, 2013 EUH auditorium
Sepsis: Current Strategies, Future Directions
Presented by Kevin McConnell, MD
– Assistant Professor of Surgery, Acute and Critical Care Surgery, Department of Surgery, Emory University School of Medicine
7:00 - 8:00 a.m., August 15, 2013 EUH auditorium
Multidisciplinary Collaboration to Produce a High Quality CTICU
Presented by Jay G. Shake, MD, MS
– Director, Cardiothoracic Intensive Care Unit, Scott and White Memorial Hospital, Temple, TX
7:00 - 8:00 a.m., August 22, 2013 EUH auditorium
Surgery Division Chiefs Meeting 5:30 - 7:00 p.m., August 27, 2013 EUH Whitehead Room
Topic to be confirmed
Presented by Roger Williams, DO
– Assistant Professor, Interventional Radiology and Image-Guided Medicine, Department of Radiology, Emory University School of Medicine
7:00 - 8:00 a.m., August 29, 2013 EUH auditorium
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