The Michael e. DeBakey DeparTMenT of Surgery

inSiDe

2 Hepatitis C virus infection screening recommendations

2 Dr. O’Mahony named Section Chief

3 Presentations

3 Publications

ISSue 3 2013

aBDoMinal TranSplanT

St. Luke’s Medical Center and Baylor College of Medicine are partnering to launch an exciting

tele-health program, Project ECHO (Extension for Community Healthcare Outcomes), with world-

renowned hepatologist Norman Sussman, MD. Dr. Sussman is triple board certified, has over 30 years

of experience in hepatology, and has active interests in advancing the management of chronic hepatitis C

and fatty liver disease.

Project ECHO is a tele-health program in which Dr. Sussman will assist primary care providers throughout Texas

to identify and treat patients with chronic hepatitis C. The mission of this program is to enhance medical resources in

communities that currently lack specialized care. The program uses multipoint teleconferencing to connect with community

providers in a peer-to-peer format, and uses case-based learning to teach providers to deliver state-of-the-art medical care. The

end result is a sophisticated medical workforce and improved health and health care in communities across the state.

The program has broad applicability across many medical specialties, and other ECHO programs, including surgical consultation, tumor

boards, and psychiatry, are currently being evaluated.

For more information on our Project ECHO please refer to our web site at https://www.bcm.edu/departments/surgery/divisions/abdominal-

transplantation/echo

projecT echo

Advanced Liver Therapies (ALT) is a clinical research center for the study of liver diseases. ALT is affiliated with Baylor College of Medicine and St. Luke’s Medical Center, and the mission of the accomplished research team, led by principal investigator Dr. John Vierling, is to conduct clinical studies to advance the science and practice of hepatology and liver transplantation. ALT strives to overcome the lack of participation of women of child bearing potential and underserved minorities in clinical research. ALT is involved with St. Luke’s Liver Health Outreach, which raises critical awareness of the need for testing for hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and provides thousands of free screening tests per year throughout South Texas.

The ALT team includes the transplant hepatology faculty, a nurse practitioner, research coordinators, regulatory and financial coordinators, laboratory and pharmacy coordinators, and a data management specialist. ALT has the capacity for phase 1 studies requiring confinement of any duration. Over the past eight years we have conducted randomized, controlled therapeutic trials for chronic HCV and HBV infections, HCV-HIV coinfection, non-alcoholic fatty liver disease, primary biliary cirrhosis, primary sclerosing cholangitis, and hepatic encephalopathy. These studies have led to multiple publications and to the US Food and Drug Administration (FDA) approval of four new drugs to date. Upcoming studies will assess antiviral therapies for HCV-infected patients with unmet needs. These studies will include patients with end-stage renal disease (ESRD) on hemodialysis, decompensated cirrhotic patients, HCV-HIV coinfected patients, and patients both pre- and post-liver transplantation. In addition, ALT provides support for investigator-initiated clinical research protocols. For more information, please visit us online at: www.stlukeshouston.com/alt

aDvanceD liver TherapieS

christine o’Mahony, MDassociate professor of Surgery

By GRACIELA GUTIERREz

In an effort to prevent liver disease, doctors at Baylor College of Medicine are supporting the latest recommendations by

the Centers for Disease Control and Prevention regarding screening for hepatitis C virus infection.

The CDC’s recommendations, which are supported by the U.S. Preventive Services Task Force, state that all Americans born

between 1945 and 1965 go through a one-time screening for the disease with the goal of reducing the number of people at risk for

progression to cirrhosis, liver failure, and liver cancer. Screening will also reduce the number of patients competing on the waiting

list for a liver transplant.

focuS on age group

“Simply put, the baby boomer generation contains more than 75

percent of the estimated three million Americans infected with hepatitis

C [virus],” said Dr. John Vierling, professor of surgery and medicine at

BCM. “Since at least 70 percent of those infected have never been diagnosed, it

makes sense to focus screening on this age group.”

Dr. Vierling, who is also director of Baylor Liver Health, chief of hepatology, and director of Advanced Liver Therapies at St. Luke’s

Medical Center, said this type of infection usually causes no symptoms until liver disease

is too far advanced and difficult to treat with antiviral therapies.

People with cirrhosis of the liver caused by hepatitis C infection have increased risks of liver failure and

liver cancers. For these patients, liver transplantation becomes the only hope of survival. In America, the number of people with cirrhosis, liver failure, and liver cancer caused by

hepatitis C infection has been dramatically increasing.

early anTiviral Therapy

“Screening allows for detection at the earliest possible time, which will increase the chance of successful antiviral therapy. This can result in a permanent cure of the infection,” Vierling

said. “Our research unit, Advanced Liver Therapies, has been active in studies of new antiviral drugs to treat these types of infections.” The new antiviral drugs could be approved by the

FDA in the coming months.

hepaTiTiS c viruS infecTion Screening

recoMMenDaTionSChristine O’Mahony, MD, was appointed section chief of Renal Transplant Surgery at Baylor College of Medicine. Dr. O’Mahony’s responsibilities within the Department and at our affiliate hospitals will enable her to maximize the growth and development of the Renal Transplant Program at BCM.

Dr. O’Mahony is an associate professor of surgery at BCM, surgical director of Kidney Transplantation at Texas Children’s Hospital, and surgical director of Kidney Transplant at St. Luke’s Medical Center. She joined the Department in 2004 after completing a fellowship at NyU Medical Center/SUNy Downstate New york and a surgery residency at UT-San Antonio.

john M. vierling, MDprofessor of Surgery and Medicine

2

A native Houstonian, Dr. Saira Khaderi earned her bachelor’s degree in biology in 1999 from the University of Houston. She went on to earn her medical doctorate from The University of Texas Medical Branch in Galveston in 2005 and a master’s degree in public health from The University of Texas School of Public Health at Houston in 2006.

She developed a strong interest in hepatology and liver transplantation in her intern year at the Cleveland Clinic Foundation in Cleveland, Ohio. During her residency, she was involved

in research related to complications of portal hypertension, and in 2006 she was honored with the American Association for the Study of Liver Diseases Travel Scholar Award—an award given to accomplished trainees with potential for a career in academic medicine. After completing her residency, she returned to Houston and continued working in transplant medicine at Methodist Hospital, where she was an active member of the liver and kidney transplant programs.

She began her Transplant Hepatology Fellowship at Baylor College of Medicine

last summer. Her research regarding outcomes of transplants in patients with portopulmonary hypertension has been presented at several major conferences, including the 48th Annual Meeting of the European Association for the Study of the Liver (EASL) in Amsterdam and in the Digestive Disease Week (DDW) in Orlando, Florida. Her current research interests include hepatitis C, complications of portal hypertension, and liver transplant outcomes. She joined the Division of Abdominal Transplantation this July as an assistant professor.

cynthia griffin, MBa

aDMiniSTraTor, DiviSion of aBDoMinal TranSplanTaTion Cynthia Griffin is responsible for the day-to-day operations of abdominal transplantation, which include the Kidney, Liver, Pancreas and HLA laboratory. She is responsible for faculty recruitment, financial analysis, budgeting, business development, and affiliate relationships.

Cynthia received her master’s degree in business administration from Texas Woman’s University. She joined BCM’s Department of Pediatrics, Hematology/Oncology as an administrative professional in 1997. In 2002, she moved to Texas Children’s Hospital as administrative manager for the Heart Center, and within a couple of years was promoted to the position of ambulatory manager for the Cardiology Clinic, where she managed the day-to-day clinical operations. Cynthia was later promoted to assistant director of business and research operations in the Critical Care Section, where she has spent the last three years.

Saira a. khaderi, MD, Mph assistant professor of Surgery

Dr. o’Mahony naMeD SecTion chief

Saira a. khaDeri, MD, MphAssistAnt Professor of surgery

f. Blaine hollinger, MD

Occult Hepatitis B (OHB): an Octopus with Innumerable Tentacles. Transforming Science to Clinical Practice APASL 2013 Liver Week, Republic of Singapore, June 6-10, 2013.

praSun jalal, MD

Hemochromatosis, Hepatology and Liver Transplantation Didactic Lecture, Baylor College of Medicine, Houston, Texas, August 14, 2013.

gagan SooD, MD

Hepatorenal Syndrome, Hepatology and Liver Transplantation Didactic Lecture, Baylor College of Medicine, Houston, Texas, August 7, 2013.

Portal Hypertension I and Portal Hypertension II, Hepatology and Liver Transplantation Didactic Lecture, Baylor College of Medicine, Houston, Texas, July 24, 2013.

riSe STriBling, MD

The ABC’s of Hepatitis, Texas Transplantation Society 2013 Annual Meeting, Irving, Texas, July 26, 2013.

Liver Disease and Pregnancy - Part II, Hepatology/Liver Transplantation Conference, Baylor College of Medicine, Houston, Texas, June 24, 2013.

norMan SuSSMan, MD

HCV Screening & Linkage, Hispanic American Medical Association of Houston, Simply Speaking CME Program, The Woodlands, TX, June 27, 2013.

Cirrhosis, Resident’s Lecture, St. Luke’s Episcopal Hospital, Houston, TX, July 12, 2013.

What the Liver Tests are Telling you, Hepatology and Liver Transplantation Didactic Lecture, Baylor College of Medicine, Houston, TX, July 15, 2013.

Complications of Cirrhosis and Pulmonary Complications of Portal Hypertension, Hepatology and Liver Transplantation Didactic Lecture, Baylor College of Medicine, Houston, TX, July 17, 2013.

Pulmonary Complications, Hepatology and Liver Transplantation Didactic Lecture, Baylor College of Medicine, Houston, TX, July 22, 2013.

Obesity, Metabolic Syndrome, and Fatty Liver Disease – Why you Should Consider a Future in Hepatology, Department of Medicine Grand Rounds, Baylor College of Medicine, Houston, TX, August 1, 2013.

Non-Alcoholic Fatty Liver Disease, Hepatology and Liver Transplantation Didactic Lecture, Baylor College of Medicine, Houston, TX, August 12, 2013.

john M. vierling, MD, facp

Autoimmune Hepatitis: When First Line Therapy Does Not Work, 1st Annual GALA Conference, Texas Liver Institute and GI Health Foundation, Austin, TX, June 21-22, 2013.

Autoimmune Hepatitis: When First Line Therapy Does Not Work, National B and C Training Program and Treatment Update 2013, Scripps Clinic Liver Research Consortium, Houston, TX, June 22, 2013.

Introduction to HBV, Hepatology and Liver Transplantation Didactic Lecture, Baylor College of Medicine, Houston, TX, July 8, 2013.

Hepatitis B Continued and Hepatitis B Cases, Hepatology and Liver Transplantation Didactic Lectures, Baylor College of Medicine, Houston, TX, July 10, 2013.

HCV - Part I, Hepatology and Liver Transplantation Didactic Lectures, Baylor College of Medicine, Houston, TX, July 29, 2013.

HCV - Part II and Autoimmune Hepatitis, Hepatology and Liver Transplantation Didactic Lectures, Baylor College of Medicine, Houston, TX, July 31, 2013.

Introduction to Immunosuppression, Hepatology and Liver Transplantation Didactic Lectures, Baylor College of Medicine, Houston, TX, August 7, 2013. 3

Huang X, Qin y, Li W, Shi Q, Xue y, Li J, Liu C, hollinger fB,

Shen Q. Molecular analysis of the hepatitis B virus presurface

and surface gene in patients from eastern China with occult hepatitis

B. J Med Virol. 2013 June;85:979-86

hollinger fB and Martin A. Hepatitis A Virus. In: Knipe DM and Howley

PM (Eds). Fields Virology, 6th Edition. Philadelphia: Lippincott Williams &

Wilkins, 2013. PP 550-81 (Chapter 19)

Raza A, Mittal S, Sood gk. Interferon-associated retinopathy during the treatment

of chronic hepatitis C: systematic review. J Viral Hepat 2013;20:593-99.

Pockros PJ, Jensen D, Tsai N, Taylor R, Ramji A, Cooper C, Dickson R, Tice A, Kulkarni R, vierling

jM, Lou Munson M, Chen yC, Najera I, Thommes J; JUMP-C: a randomized trial of mericitabine plus

pegylated interferon alpha-2a/ribavirin for 24 weeks in treatment-naïve HCV genotype 1/4 patients.

Hepatology 2013; 58:514-23.

Wedemeyer H, Jensen D, Herring Jr. R, Ferenci P, Ma M-M, zeuzem S, Rodríguez-Torres M, Bzowej N, Pockros P,

vierling j, Ipe D, Munson ML, Chen yC, Najera I, Thommes J, PROPEL Investigators. PROPEL: a randomized trial of

mericitabine plus peginterferon alfa-2a/ribavirin therapy in treatment-naïve HCV genotype 1/4 patients. Hepatology.

2013;58:524-37.

Ogert RA, Howe JA, vierling jM, Kwo Py, Lawitz EJ, McCone J, Schiff ER, Pound D, Davis MN, Gordon SC, Ravendhran N, Rossaro

L, Jacobson IM, Ralston R, Chaudhri E, Qiu P, Pedicone LD, Brass CA, Albrecht JK, Barnard RJ, Hazuda DJ, Howe Ay. Resistance-

associated amino acid variants associated with boceprevir plus pegylated interferon-α2b and ribavirin in patients with chronic

hepatitis C in the SPRINT-1 trial. Antivir Ther 2013;18:387-97.

Ghabril M, zupanets IA, vierling j, Mantry P, Rockey D, Wolf D, O’Shea R, Dickinson K, Gillaspy H, Norris C, Coakley DF, Mokhtarani

M, Scharschmidt BF. Glycerol phenylbutyrate in patients with cirrhosis and episodic hepatic encephalopathy: a pilot study of safety and effect

on venous ammonia concentration. Clinical Pharmacology in Drug Development 2013;2:278-84.

Kowdley KV, Lawitz E, Crespo I, Hassanein T, Davis MN, DeMicco M, Bernstein DE, Afdhal N, vierling jM, Gordon SC, Anderson JK, Hyland RH, Dvory-Sobol

H, An D, Hindes RG, Albanis E, Symonds WT, Berrey MM, Nelson DR, Jacobson IM. Sofosbuvir with pegylated interferon alfa-2a and ribavirin in treatment-

naïve patients with hepatitis C genotype-1 infection (ATOMIC): an open-label, randomized, multicenter, phase 2 trial. Lancet 2013;381:2100-107.

preSenTaTionS

puBlicaTionS

clinicS & cenTerS

ST. luke’S cooley TranSplanT cenTer

LIVER Baylor Clinic Building

6620 Main, Suite 1450Houston, TX 77030

Appointments: 877.685.0361Patients: 832.355.6461

KIDNEy/PANCREASO’Quinn Medical Tower

6624 Fannin Street, Suite 1610Houston, TX 77030

Appointments: 877.685.0361Patients: 713.798.7330

ST. luke’S cenTer for liver DiSeaSe

6620 Main, Suite 1450Houston, Texas 77030

Main Number: 832.355.1400New Patients: 832.355.1471

Follow-up Patients: 832.355.1495

TeXaS chilDren’S TranSplanT ServiceS

11th floor, Clinical Care Center6621 Fannin Street

Houston, Texas 77030Appointments: 866.683.8032

For referral or other information: 832.822.1551

Michael e. DeBakey va MeDical cenTer

2002 Holcombe BoulevardHouston, Texas 77030

Appointments: 713.791.1414, Ext. 6524Toll-Free: 800.639.5137

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 Holmes, CMI

One Baylor Plaza, MS: BCM 390Houston, Texas 77030

or e-mail: surgerynews@bcm.edu

editor-in-ChiefJohn A. Goss, MD

editorsScott C. Holmes, CMI

Ana María Rodríguez, PhD

© 2013 Baylor College of Medicine