houston methodist transplant annual report 2013

LUNG KIDNEY PANCREAS HEART LIVER BONE ARROW LUNG STEM CELLS INTESTINE LUNG KIDNEY PANCREAS HEART LIVER BONE MARROW ISLET STEM CELLS LUNG BONE MARROW LUNG KIDNEY HEART LIVER ISLET STEM CELLS INTES-TINE LUNG KIDNEY PANCREAS HEART LIVER BONE MARROW ISLET STEM CELLS INTESTINE LUNG KIDNEY PANCREAS HEART LIVER BONE MARROW ISLET STEM CELLS INTESTINE LUNG KIDNEY PANCREAS HEART LIVER BONE MARROW ISLET STEM CELLS INTESTINE LUNG KIDNEY PANCREAS HEART LIVER BONE MARROW STEM CELLS INTESTINE STEM CELLS HEART LUNG KIDNEY KIDNEY HEART LIVER STEM CELLS ISLET STEM CELLS INTESTINE LUNG KIDNEY PANCREAS HEART LIVER BONE MARROW ISLET STEM CELLS

LEADING MEDICINEADVANCED ORGAN FAILURE AND TRANSPLANT

2013

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A PROUD TRADITION OF EXCELLENCE, WITH A NEW NAME.The Methodist Hospital is now Houston Methodist Hospital. This new name reflects the pride in who we are and where we are from. Our commitment to advancing medicine with global impact begins in Houston, Texas, where we pioneer a better tomorrow through research, cutting-edge innovation and breakthroughs to rewrite the future of health.

THAT’S THE DIFFERENCE BETWEEN PRACTICING MEDICINE AND LEADING IT.

LEADING MEDICINE: AN OVERVIEW 3

PULMONARY TRANSPLANT 8

RENAL TRANSPLANT 12

GASTROINTESTINAL CARE 16

LIVER TRANSPLANT 17

HEART TRANSPLANT 20

BONE MARROW & STEM CELL TRANSPLANT 24

10 13

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CONTENTS

2 J.C. Walter Jr. Transplant Center

MESSAGE FROM THE DIRECTOR

With the many changes in health care delivery, there is a significant need for organizations like ours to deliver innovative care to patients with chronic organ failure as well as transplant patients. At the Houston Methodist J.C. Walter Jr. Transplant Center, we are uniquely suited to lead this advance as we move into our sixth decade of service.

This past year has been spent strengthening the underpinnings of our program and laying the foundation for our next phase of expansion. Our focus for the entire next phase will remain on the patient, who is the center of our activity. We also are designing ways to better serve all of our other customers, both external and internal.

As I look from my vantage point on Houston Methodist and the transplant center, I see a true commitment to honor our patients and their donors by giving back to the remarkable community of caregivers, referring physicians, nurses, social workers and health plan providers who entrust us with family members, patients and clients. To this group we continue to give thanks and renew our long-lasting commitment to making patient care our central endeavor.

I also see the great strides we made this past year in establishing our translational research programs. Through partnership with the Houston Methodist Research Institute, as well as individual donors and foundations, we have made great discoveries in the areas of kidney and lung transplant biology, device therapy, liver care and diabetes treatment. These advances are made possible by aligning our laboratories and great scientists with our state-of-the-art patient care activities, putting us at the forefront of true translational medicine.

You will see in this report that we are also making strides in bringing our innovation and newly made discoveries to others through publications, training and education. We offer informative conferences on advances in transplantation management, fellowships for transplant physicians-in-training and a one-of-a-kind transplant coordinator training program, each enhanced by our intimate and inclusive patient and physician access to specialized treatment information and expertise.

We have expanded many programs and advanced the use of new tools, procedures and protocols, all in the spirit of healing those with organ failure and growing the pool of viable organs that can save the lives of patients in need.

A. Osama Gaber, MD, FACS

Leading Medicine: An Overview Pulmonary Transplant Renal Transplant GI Care & Liver Transplant Heart Transplant Bone Marrow & Stem Cell Transplant

LEADING MEDICINE: AN OVERVIEW ABOUT J.C. WALTER JR. TRANSPLANT CENTERHouston Methodist J.C. Walter Jr. Transplant Center combines world-class clinical expertise, innovative research programs and state-of-the-art technology with a comprehensive, multidisciplinary approach to the treatment of end-stage organ failure and transplantation. We strive to provide the highest-quality care and best clinical outcomes, and to advance knowledge and medical research. Our team is committed to educating the next generation of professionals and the public about organ failure management and organ and tissue transplantation.

322

HEART/ LUNG

KIDNEY/PANCREAS

OTHER COMBOS

STAFF MEMBERS16 INTERMEDIATE

CARE BEDS

TOTAL39

BEDS87

14

233

MULTI-ORGAN TRANSPLANTS

INPATIENT TRANSPLANT STATISTICS

TRANSPLANTS PERFORMED AT HOUSTON METHODIST BY YEAR

1963 1

1988 88

181968

871993

401973

821998

121978

1492003

251983

2342008

3962013



Houston Methodist was a sponsor of the 2014 Transplant Games of America, the multi-sport

event that promotes organ donation by demonstrating, through sporting competition,

that there is life after transplant. In 2012, Houston Methodist heart transplant recipient

and Team Texas manager, Brian Gilliam, took more than 100 recipients, donors, family

members and supporters to compete in the first games in Grand Rapids, MI. After winning

more than 60 medals, Gilliam, along with Houston Methodist transplant coordinator,

Donna Esposito, led the charge to bring the games to Houston and, after meeting with the

Harris County-Houston Sports Authority and submitting a bid, the city was awarded the

games that took place from July 11–15. Organ transplant recipients, living donors, bone

marrow recipients and a limited number of corneal and tissue transplant recipients will

compete in everything from track and field to basketball and ping pong. In the words

of Brian Gilliam, “While we want to win, these games are about fellowship as much

as competition. It’s just awesome.”

2014 TRANSPLANT GAMES OF AMERICA


TRANSPLANT LEADERSHIPA. Osama Gaber, MD, FACS Director, Houston Methodist J.C. Walter Jr. Transplant Center George P. Noon, MD Director, Transplant Executive Council

CARDIAC TRANSPLANT & ASSIST DEVICES Matthias Loebe, MD, PhD,FACC, FCCP Surgical Director Jerry D. Estep, MD, FACC Medical Director Brian Bruckner, MD Associate Director, Mechanical Circulatory Support

HEART-LUNG TRANSPLANT Matthias Loebe, MD, PhD,FACC, FCCP Surgical Director Jerry D. Estep, MD, FACCMedical Director Thomas Kaleekal, MDMedical Director

PULMONARY TRANSPLANT Scott Scheinin, MD, FACS Surgical Director Thomas Kaleekal, MD Medical Director

ECMO Brian Bruckner, MDSurgical Director John Fetter, MDMedical Director

INTESTINAL FAILURE PROGRAM Sherilyn Gordon Burroughs, MD, FACS Director

RENAL & PANCREAS TRANSPLANT Richard Knight, MD, FACS Surgical Director, Kidney & Pancreas Juan Gonzalez, MD Co-Medical Director Horacio J. Adrogué, Sr., MD Co-Medical Director Ashish Saharia, MD Associate Director, Kidney & Pancreas Elie Saber, MD Living Donor Advocate

PROCUREMENT Hemangshu Podder, MD, PhD Director, Abdominal Dewei Ren, MD Director, Thoracic Brian James Dunkin,MD, FACS Co-Director, Living Donor Procurement Richard E. Link, MD, PhD Co-Director, Living Donor Procurement

LIVER TRANSPLANT R. Mark Ghobrial, MD, PhD,FACS, FRCS(Ed) Director, Houston Methodist Center for Liver Disease & Transplantation Victor Ankoma-Sey, MD Medical Director, Transplant Joseph S. Galati, MD, FACGT Medical Director, Houston Methodist Center for Liver Disease & Transplantation

Howard P. Monsour, Jr., MD Chief, Hepatology

BONE MARROW TRANSPLANT Helen Heslop, MD Director, Center for Cell & Gene Therapy George Carrum, MD Director, Adult Outpatient Clinic for Cell & Gene Therapy; Director, NMDP Collection Program

IMMUNOBIOLOGY RESEARCH CENTER Xian C. Li, MD Director/ScientistClinical Research Linda Moore, RDClinical Research

ADMINISTRATION David Bernard, MBA, MHA, FACHE Vice President Susan A. Zylicz, RN, BSN, MHA, CCTC Transplant Administrator Anna ArgyrisResearch Administrator Julie Corkrean, RN, BSN, CCTC Liver Transplant Manager Anthony Flores Financial Manager Jordan Jeon, BA, CTBS, CPTC Recovery Operations Manager Laurie Loza, RN, BSN, CCTC Heart Transplant Manager Marty Martin, RN, BSN Communication Center Manager Lisa Yoder, RN, BSN, CCTC Kidney & Pancreas Transplant Manager

NOTABLE ACCOMPLISHMENTS • Houston Methodist launched the first transplant coordinator training program for nurses. The one-year curriculum covers the entire continuum of care, ensuring key skills are mastered by those who undertake the intricate task of managing transplant protocols and care.• Houston Methodist is one of only a few facilities that performs bloodless lung transplants, due to the degree of difficulty associated with bloodless surgeries. The transplant center also performs bloodless kidney and kidney-pancreas transplants. • Houston Methodist is the first center in the world to implant a total artificial heart for a patient with a cardiac malignancy.• The Houston Methodist transplant team performed a domino liver transplant in September to save the life of a 31-year-old mother with liver cancer. She received a liver from a living donor with amyloidosis, who then received a donated liver to treat his disease. • The Transplant Center celebrated 50 years of advances in organ failure and transplantation management at a three-day conference. Featured speakers: ° Dr. Alan Langus, president of the American Society of Transplant Surgery ° Dr. Dan Salomon, president of the American Society of Transplantation ° Dr. Bruce Molitoris, president of the American Society of Nephrology• The Graham Guerrero Lecture in urology transplantation honored the physician’s 30 years of service. Featured speakers: ° Dr. Timothy Boon, chief of urology at Houston Methodist ° Dr. Stuart Flechner, professor of surgery at the Cleveland Clinic Lerner College of Medicine• The Optum Health Spotlight Series hosted Leading Innovative Care in Transplantation: A Spotlight on Houston Methodist J.C. Walter Jr. Transplant Center. ° 150+ referring physicians, nurses and allied health professionals attended.• The Shared Care Summit targeted community-based medical professionals with sessions on the identification, treatment and management of advanced heart failure, highlighting LVAD care.

TRANSPLANT PATIENTS’ HOME• Nora’s Home, honoring the memory of director Osama Gaber’s daughter, offers affordable lodging for transplant patients and their families who travel to the Texas Medical Center for treatment. Opened in 2013, it provides care, education and support in a loving, home-like environment. Visit norashome.org for more information.

NOTABLE AWARDS• Xian C. Li, MD, director of the Immunobiology and Transplantation Research Center, was awarded two NIH grants totaling over $2 million to study the role of OX40 in T regulatory cell exhaustion, which impacts transplant tolerance.• Houston Methodist and Baylor College of Medicine (BCM) received a Roche Organ Transplantation Research Foundation award for a study titled, “Compositional Changes That Cause Weight Gain after Kidney Transplantation.”• Houston Methodist, BCM and Rice University were awarded a $1.3 million research grant for decision making in VAD therapy.



The J.C. Walter Jr. Transplant Center offers world-class fellowships for surgeons

interested in kidney, liver and thoracic transplant. In addition, we have applied for

a pancreas transplant fellowship and expect it will be accredited soon.

Kidney and liver fellowships, which are accredited by the American Society of Transplant

Surgeons, are open for the 2014 match through the National Residency Matching Program.

We offer the opportunity for one fellow per year in kidney and one in liver. A yearly slot

for thoracic transplants is offered to cardiac surgeons who are finishing their cardiac

training and wish to increase their exposure to transplantation in one of the largest

thoracic programs in the country. It is a one-year extension to their cardiac training.

“With a large and vibrant transplant center, and some of the top transplant researchers

in the country, Houston Methodist is able to offer excellent opportunities for hands-on

learning and up-close exposure to research for those interested in the art and science

of transplant,” said Osama Gaber, MD, director of the Houston Methodist J.C. Walter Jr.

Transplant Center.

Fellows have close interaction with some of the nation’s top researchers, including

Xian C. Li, MD, scientific director of the Transplant Immunology Program.

His lab studies the fundamental mechanisms of transplant rejection and tolerance.

John P. Cooke, MD, is the chair of the Department of Cardiovascular Sciences at the

Houston Methodist Research Institute and the director of the Center for Cardiovascular

Regeneration in the Houston Methodist DeBakey Heart & Vascular Center. His lab

uses small molecules or stem cell therapies for vascular regeneration. Mauro Ferrari, MD,

president and CEO of the Houston Methodist Research Institute, has founded

several biomedical nanotechnology companies. His lab focuses on cell transplantation,

regenerative medicine and tissue engineering, among other specialties. We are

also currently recruiting for a national chair in outcomes research.

“We are honored to be able to offer surgeons an excellent education in an environment

that promotes respect, integrity and compassion for patients and donors who come to

us for care,” said Gaber.

TRANSPLANT FELLOWSHIPS PROVIDE HANDS-ON LEARNING & IMMERSION IN RESEARCHOrgan transplantation is a unique field, demanding skills and ethical considerations that are specific to this area of medicine. Houston Methodist has a deep legacy in transplant. We are committed to training the next generation of surgeons in the latest tools, procedures, research and philosophies of transplant, ensuring excellence and safety for patients and donors, now and in the future.



BREAKING NEW GROUND IN LUNG TRANSPLANTATIONThe Houston Methodist J.C. Walter Jr. Transplant Center continues to be a national leader in lung transplantation with one of the top five largest volumes of lung transplants in the country.

This level of experience provides the center’s physicians and other health professionals with the skill to expertly

handle complex lung transplants and to achieve the excellent outcomes associated with high-volume clinics.

We also have the experience that allows us to safely handle a higher level of risk, accepting patients who would

not be served at other centers because of associated comorbidities.

“We will perform bloodless transplants for certain patients, most of whom have been refused transplantation at other institutions. It’s rewarding to practice at an institution that will go the extra mile for patients and that embraces the knowledge, skill and experience to take on the most complicated cases.”

Scott Scheinin, MD, FACS surgical director, pulmonary transplant

TOP 5 IN THE NATION IN VOLUME IN 2013


TOP 5 IN THE NATION IN VOLUME IN 2013


A growing body of research shows that blood transfusions

themselves can cause complications such as sepsis or

circulatory overload. Surgeons like Scott Scheinin, MD,

surgical director of the lung transplant program, are

therefore limiting the amount of blood transfused by

perfecting pre-operative management, surgical techniques

and operating room protocols to prevent any unnecessary

blood loss during even the most complicated procedures,

including lung transplant.

Some of those cases involve Jehovah’s Witness patients

whose beliefs prevent them from accepting any blood

transfusions during surgery.

“We will perform bloodless transplants for certain patients,

most of whom have been refused transplantation at other

institutions. It’s rewarding to practice at an institution

that will go the extra mile for patients and that embraces

the knowledge, skill and experience to take on the most

complicated cases,” said Scheinin.

As part of the bloodless procedure, the patient is

given medications to stimulate blood cell production.

During surgery, blood that might be discarded as medical

waste is rerouted through a cell salvage machine that

washes and filters the blood. It is then sent back into the

patient’s circulatory system. We also use the technique

of acute normovolemic hemodilution to help conserve

the patient’s blood. We have been able to provide 14

patients with bloodless lung transplants to date.

BLOODLESS LUNG TRANSPLANTS: A SURGICAL BREAKTHROUGH

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LUNG TRANSPLANTS: THREE-YEAR PATIENT SURVIVAL

HMH ActualHMH Expected

J.C. Walter Jr. Transplant Center10

Matthias Loebe, MD, is spearheading a program in which

borderline donated lungs are to be “reconditioned” using

a process of ex vivo lung profusion (EVLP). By pumping

nutrients and oxygen through the donated lungs, we can

reverse previous damage to the lungs and make them suitable

for transplant, thus expanding the reach of donated organs

for patients on the waiting list. We hope to begin a clinical

trial soon to begin testing this life-saving therapy.

Soma Jyothula, MD, is also spearheading a new technique

that may expand the donor pool. This includes working with

organs that have been donated after cardiac death (DCD).

“Donation after cardiac death occurs when the family of a

terminal patient decides to withdraw life support and agrees

to donate the patient’s organs,” said Jyothula. This is a

common practice for kidneys and livers, yet it is a relatively

new procedure in lung transplantation. Very few institutions

utilize lungs from DCD donors. Most transplant centers

accept organs only from donors with cardiac function after

declaration of brain death. Jyothula and Dewei Ren, MD,

have worked with the team of pulmonologists, surgeons,

transplant and recovery coordinators, and organ procurement

organizations to establish a working protocol that could

allow successful use of these organs.

This new process can potentially lead to expanding the

number of lungs available for those awaiting lifesaving organs

for survival. Houston Methodist is in the early stages of

developing this program.

PIONEERING NEW TRANSPLANT OPTIONS TO INCREASE THE DONOR ORGAN POOLMuch has been done to educate the public on the value of organ donation. Still, patients die waiting for organs that never come. In some cases, donated organs are not medically suited for transplant due to pre-terminal injury, ischemia or other characteristics of the organ.

“Physicians and researchers at Houston Methodist are looking for new techniques to ensure that all donated organs are viable for transplant.”

Matthias Loebe, MD, PhD, FACC, FCCP, surgical director, thoracic transplant


“The center treats all patients with lung disease regardless

of their need for transplant. Our physicians tailor care to each patient’s disease progression. The care is multidisciplinary, organized around a core team that extends to all disciplines needed to care for the patient.”

Thomas Kaleekal, MD medical director, pulmonary transplant

DISCOVERING INNOVATIVE TREATMENTS TO MANAGE LUNG FAILURE

The number of people with chronic lung conditions is increasing. Houston Methodist’s advanced lung disease

program is multidisciplinary, tailoring treatment to individual patient’s needs and disease progression. “We provide

innovative treatments that may help delay the need for a lung transplant or offer treatment options to patients not

eligible for transplantation,” said Neeraj Sinha, MD, of the pulmonary transplant team.

• The Advanced Lung Disease Clinic offers specialized care to patients with complex lung diseases including

idiopathic pulmonary fibrosis, collagen vascular disease, sarcoidosis, COPD and bronchiectasis.

• The Pulmonary Hypertension Clinic provides state-of-the-art diagnostic evaluation and therapy for patients with

primary and secondary pulmonary hypertension.

SAVING LIVES THROUGH PULMONARY TREATMENTS

For patients with severe respiratory failure, extracorporeal life support (ECLS), also known as extracorporeal membrane

oxygenation (ECMO), is an advanced, lifesaving treatment in which the patient’s blood is passed through a machine

that helps oxygenate the blood while waiting for the lungs to heal or while the patient awaits a lung transplant.

Navigational bronchoscopy is a relatively new bronchoscopic diagnostic technique that uses CT data to help

navigate biopsies and improve the quality of diagnosis. Typically used for diagnosing smaller lung nodules,

this technique helps diagnose lung cancers early using outpatient bronchoscopy, which helps save lives. It also

helps avoid costly hospitalizations and open surgery. “We are very pleased to be one of the leading centers for

this treatment,” says Babith Mankidy, MD, of the Houston Methodist pulmonary transplant staff.

Endobronchial valves are devices that are placed in airways to help plug persistent airleaks and broncho-pleural fistulas.

Houston Methodist is able to offer this investigational treatment under the FDA’s humanitarian device exemption

process, providing relief to patients who have spent weeks waiting for these leaks to heal on their own.

Our specialists also have expertise in interventional bronchoscopy procedures including navigational bronchoscopy,

endobronchial ultrasound, placement of tracheal and endobronchial stents, endobronchial valves and other advanced

airway procedures.

“Our objective is to provide comprehensive, state-of-the-art pulmonary care to patients with advanced lung disease. This includes

supporting them through diagnosis, treatment, follow-up and transplant, if needed. We are fortunate in being able to bring

together the clinical resources, multidisciplinary teams, infrastructure, academic and administrative support to provide the best

possible care and quality of life for our patients,” said Thomas Kaleekal, MD, medical director of the lung transplant program.

98 LUNG TRANSPLANTS IN 2013


DELIVERING BETTER OUTCOMES IN RENAL TRANSPLANTHouston Methodist is one of the largest multi-organ transplant centers in the country. We are also one of the largest kidney transplant centers in the region In 2013, we provided 176 kidney transplants and 22 kidney-pancreas transplants to patients waiting for a new chance at life.

This experience gives us the expertise to perform some of the most advanced kidney transplant procedures and provides a good base to conduct outstanding research that will drive the practice forward.

“We understand the enormity of performing an operation on a perfectly healthy person who is taking on the risk of surgery simply to benefit a friend or family member. We want to make the process as painless as possible for these generous donors, just as if they were our own family.”

Wesley Mayer, MD, urologist and laparoscopic surgeon

ORGAN SWAPS

The transplant teams at Houston Methodist are able to

participate in the advanced logistics of nationwide organ

swaps to ensure that our patients receive the kidneys they need.

Because kidneys can come from living donors, friends

or family can offer kidneys to those who have matching

blood types. If a patient has a donor whose blood type

does not match, the donor and recipient are entered into

a nationwide database that greatly maximizes the use of

potential donors. The entire pool of potential donors

and recipients is analyzed, and matches are made to

accommodate compatibility.

SINGLE SITE DONOR NEPHRECTOMY

Our surgeons also do everything they can to make potential

donors as comfortable and safe as possible during and

after donation.

Houston Methodist has one of the largest series of

laparoendoscopic single site donor nephrectomies in

the world. These minimally invasive surgeries require

fewer incisions and result in very little scarring. We have

conducted more than 200 single site surgeries for people

willing to offer a kidney for donation.

Our surgeons have also published results on safety,

blood loss and ischemic time associated with a single

site technique compared to the traditional method,

demonstrating proven safety and a low complication rate

comparable to a more open technique.

During the procedure, the surgeon makes an approximately

two-inch incision near the navel. Through that single incision,

the team delicately dissects the major blood vessels from

the kidney, preserves the area from which the kidney is

taken and removes the kidney.

SUPERIOR EXPERTISE MAKES TRANSPLANTATION EASIER ON DONORS AND RECIPIENTS


SUPERIOR EXPERTISE MAKES TRANSPLANTATION EASIER ON DONORS AND RECIPIENTS


“Swaps can grow to huge numbers of people, and it takes experience and exceptional logistics to make them work. Having many large centers participate in the national registry is a substantial step forward for organ donation.”

Wadi Suki, MD, FACP, director of the nephrology training program and co-director of the kidney transplant program

13 KIDNEY SWAPS IN 2013


IMPROVING POST-TRANSPLANT PROTOCOLS FOR BETTER PAIN MANAGEMENTPain management is also an area we are interested in improving for our donors. We have several ongoing research studies looking at methods to control pain without the reliance on heavy narcotics. Through this research, we ultimately hope to decrease the amount of pain that patients experience and allow them to leave the hospital earlier.

RESEARCH FOR RECIPIENTS

Our renal experts are studying ways to prevent a particularly difficult type of rejection after kidney transplant

known as antibody-mediated rejection.

Because rejection is initiated in the bone marrow, this type of rejection demands a very specific type of treatment.

A research team led by Osama Gaber, MD, director of transplantation, and Richard Knight, MD, surgical director,

kidney and pancreas transplant, is looking at repurposing a drug that is approved for multiple myeloma – a cancer

of the bone marrow – and testing it as a treatment for antibody-mediated rejection.

Another area of research interest to our team is an opportunistic infection called the BK virus, which can be

deadly to a kidney transplant recipient, but typically undetectable to anyone who is not immunosuppressed.

A member of the polyomavirus, it attacks the kidney and urinary tract and can lead to kidney failure.

The team led by Knight is researching new medical regimens to attack the virus while maintaining protection

for the patient’s new kidney.

“Treatment of the BK virus demands a delicate balance between the potential for rejection and the need to reduce immunosuppression.”

Richard Knight, MD, FACS, surgical director, kidney and pancreas

176 KIDNEY TRANSPLANTS IN 2013

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KIDNEY TRANSPLANT: ONE-YEAR PATIENT SURVIVALHMH ActualNational


67 LIVING DONOR TRANSPLANTS IN 2013

176 KIDNEY TRANSPLANTS IN 2013

“Cell-mediated rejection is a well-understood process in which white blood cells attack the graft. Antibody-mediated rejection is a very different animal in which B-lymphocytes and plasma cells are the culprits.”

Wadi Suki, MD, FACP director of the nephrology training program and co-director of the kidney transplant program


DELIVERING BETTER OUTCOMES: BLAZING NEW TRAILS IN FIGHTING INTESTINAL FAILUREHouston Methodist Hospital has the only comprehensive treatment program available in Texas for patients

with intestinal failure, a complex disorder that results in an inability to absorb the nutrients patients need for survival.

If it is not properly diagnosed and treated, it can be deadly.

A high level of expertise is needed to effectively support patients with this debilitating disease. Houston Methodist

has developed a complete program, offering dietetic, medical and surgical support, and we conduct basic and

clinical research to find more effective treatments with fewer complications.

DIETETIC AND MEDICAL TREATMENT

Many patients with intestinal failure depend on a feeding and hydration system called total parenteral nutrition (TPN)

to sustain their lives. TPN provides all of the patient’s nutrients through a catheter in the arm, groin, neck or

chest. Long-term use of TPN can cause severe side effects, including bone disorders, vascular thrombosis, central

line infections and liver cirrhosis.

“Patients with intestinal failure on TPN require very intense and constant monitoring, demanding

repeat office visits and hospital admissions. The disease takes a huge toll on a patient’s quality of life.

Our goal is to rehabilitate a patient’s intestinal function and eliminate the need for TPN and its devastating

effects,” said Sherilyn Gordon Burroughs, MD, director of the Intestinal Failure and Rehabilitation Clinic.

RESEARCH

Our patients have access to novel drugs, such as teduglutide, a GLP-2 agonist, that was granted orphan drug

status by the FDA in December 2012 to help improve nutrient absorption in the small bowel. We are also

partnering with pharmaceutical companies to expand new clinical studies, and we have access to the

outstanding facilities of the Houston Methodist Research Institute, where we conduct research with a goal of

reducing the need for TPN.

SURGERY

Our surgical arm provides revisional surgery, when possible, to add bowel for patients with a short gut due to

previous bowel resection or congenital conditions. We also offer serial transverse enteroplasty, a lengthening

of the bowel that is done by using a surgical stapler to extend the absorptive area of the bowel. Both of these

techniques effectively increase the time food has contact with the intestine, improving chances for absorption.


“Patients with intestinal failure require very intense and constant monitoring, demanding repeat office visits and hospital admissions. The disease takes a huge toll on a patient’s quality of life. Our goal is to rehabilitate a patient’s intestinal function and eliminate the need for TPN and its devastating effects.”

Sherilyn Gordon Burroughs, MD, FACS, director of the Intestinal Failure and Rehabilitation Clinic


“What used to be one of the more dangerous surgeries not long ago, pancreatic resection, is now as safe as everyday operations like coronary bypass or hip replacement.”

Wade Rosenberg, MD, pancreatic surgeon

The Houston Methodist Center for Liver Disease & Transplantation is an experienced, high-volume center for patients

with a wide variety of liver diseases, from benign tumors to liver cancer to fatty liver disease.

Specialists at the center regularly treat patients with hepatitis C, cirrhosis, fatty liver disease, benign liver tumors,

metastatic colorectal liver cancer and primary liver cancers including cholangiocarcinoma, or cancer of the bile duct,

and hepatocellular carcinoma (HCC), the most common form of liver cancer.

A WIDE RANGE OF CARE WITH MULTIDISCIPLINARY EXPERTISE

Depending upon the patient’s unique diagnosis, treatments range from medication to radiological interventions to surgical

resection and transplant. Our surgeons are experienced in performing whole organ, domino liver, split-liver and

multi-organ transplants. To date we have performed one of the largest series of combined lung-liver transplants.

Houston Methodist works with patients in a multidisciplinary setting, providing teams of oncologists, hepatologists,

radiologists, interventionalists, transplant surgeons and intensive care specialists. The center provides multi-review

panels for each patient’s personalized treatment.

Physicians at Houston Methodist are employing the use of innovative medications that work faster and more effectively

on hepatitis C, a virus that is a known cause of liver disease. The center also has an established and recognized collaborative

cholangiocarcinoma program, which has resulted in transplanting a large number of patients that previously would not

have had the option of transplantation.

PROVIDING PERSONALIZED CAREFOR SPECIAL CASE LIVER PATIENTS

PANCREATIC RESECTION

Houston Methodist Hospital’s highly advanced imaging

capabilities help surgeons plan resections in a way that

safely preserves more healthy tissue. In addition, expertise

using new surgical instrumentation helps reduce blood

loss and decrease operating times, lessening the need for

blood transfusions and their associated complications.

The average blood loss for removing the head of the

pancreas at Houston Methodist was only 400 cc in 2012,

and the average operating time of three hours is less than

half the average published time.


EXPANDING TREATMENT OPTIONS FOR PATIENTS

“We are working with colleagues at MD Anderson Cancer

Center to expand the indications for treatment of liver cancer,”

said Mark Ghobrial, MD, director of the Houston Methodist

Center for Liver Disease & Transplantation.

"Traditionally, centers will perform a transplant only

in patients with tumors of four to five centimeters,"

Ghobrial said. Our center has expanded its efforts to

patients with large HCC tumors, some larger than six

centimeters in diameter, that are outside UCSF criteria.

"We have high survival and low recurrence rates after

transplantation in these patients," says Ghobrial.

“We are committed to each patient’s care. This focus has

translated into excellent outcomes, low recurrence rates and

the privilege of working with patients with all types of liver

disease. Our goal is to get our patients back to productive,

fruitful lives as quickly as possible," Ghobrial emphasizes.

LEADING INNOVATION IN LIVER TRANSPLANTATIONDOMINO LIVER TRANSPLANTS: SAVING TWO LIVES WITH ONE DONATIONIn 2013, Houston Methodist Hospital joined a small group

of leading hospitals around the world that have performed

successful domino liver transplant surgeries. A domino

liver transplantation allows two patients to receive a new

liver from a single donation.

At Houston Methodist, a new liver and heart recipient –

a 60-year-old male suffering from amyloidosis that attacked

his liver and heart – donated his liver to a 30-year-old woman

with cholangiocarcinoma, a rare form of liver cancer.

Although the patient with cholangiocarcinoma had a

good chemotherapeutic response, the strict rules that

govern organ allocation presented a barrier.

“If we had waited for her liver to deteriorate to the point of

transplantation qualification, her cancer would have metastasized

beyond treatment,” said Howard P. Monsour, Jr., MD, chief of

hepatology and associate professor of medicine.

Only a small percentage of patients with amyloidosis

will manifest the disease, which provides the rationale

for using these livers for transplantation.

“While the diseased liver was not working for the

amyloidosis patient, we determined it was a viable organ

for the patient with cholangiocarcinoma. It will take 20

to 30 years to develop amyloidosis, if at all. If that occurs,

the patient can get another liver transplant. In this instance,

it was really the only option for saving her life,” said

Mark Ghobrial, MD, director of the Houston Methodist

Center for Liver Disease & Transplantation.

“There has been a national push to use more of these

so-called ‘marginal organs.’ If we can catch these cancers

early, I believe we can save many more lives through

domino transplants,” said Monsour.


“This is a 12-hour-plus procedure that involves a large transplant team of 4 liver surgeons, 2 cardiac surgeons, 2 anesthesia teams, 2 perfusion teams, 2 procurement teams, 6 transplant coordinators and at least 10 operating room nurses. It is a very rare procedure.”

Mark Ghobrial, MD, PhD, FACS, FRCS(Ed) director, Houston Methodist Center for Liver Disease & Transplantation

100

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Jan 10 Jul 10 Jan 11 Jul 11 Jan 12 Jul 12 Jan 13 Jul 13 Jan 14

LIVER TRANSPLANT: ONE-YEAR PATIENT SURVIVAL

HMH ActualNational

70 LIVER TRANSPLANTS


Organ recipient Tiffany Schwantes visits organ donor Vernon Roberson at Houston Methodist Hospital. Roberson received a new liver and heart and donated his liver to Schwantes in a domino transplant.

Mayra Beltran © Houston Chronicle. Used with permission.

LIVER TRANSPLANT WAIT LIST SINCE 2009

WAIT LIST AT END OF YEAR:

2009 176211

243264

310

2010201120122013


ADVANCING HEART FAILURE TECHNOLOGY:LEADING TRANSPLANT CAREHEART TRANSPLANT AND ADVANCED HEART FAILURE

Heart transplant is one of many options available to treat

advanced heart failure. The limited supply of donor

organs is a catalyst, pushing physicians and researchers

at Houston Methodist to adopt new and more effective

ways to free patients from the burdens of heart failure.

The advanced heart failure team at Houston Methodist

Hospital is a collaboration between the J.C. Walter Jr. Transplant

Center and the DeBakey Heart & Vascular Center. The focus of

the team is to continually improve treatments for patients

with heart failure, using medical and mechanical intervention,

either as therapy or bridge to transplant.

“Our advanced heart failure team is committed to pushing

the field of heart failure research and treatment forward,” said

Jerry D. Estep, MD, medical director, heart transplant and

LVAD program. “We pursue promising new ideas, and we use

novel approaches with existing technology to improve care and

outcomes for patients. The Shared Care program is a good example.”

SHARED CARE

As heart failure therapies continue to improve, more and more

patients are able to go home with lifesaving mechanical assist

devices such as the left ventricular assist device (LVAD).

Estep and his colleagues are creating ways to allow cardiologists

to remotely monitor their patients, post-procedure, in the

patient’s own home.

To facilitate this effort, Houston Methodist hosted a

Shared Care Summit Meeting, designed for physicians

and other health care professionals who are committed

to treating LVAD patients in their communities.

The advanced heart failure team provided hands-on

education at Houston Methodist’s MITIE lab, complete

with demonstrations using a volunteer LVAD patient.

“The goal is to create partnerships with providers from

the region – and eventually the world – during all three

stages of LVAD care – pre-intervention, intervention,

and long-term follow-up care,” said Brian Bruckner, MD,

surgical director, ECMO, and associate director, mechanical

circulatory support. “We believe this can become a best

practices model.”


“We can now offer a comprehensive program for patients with advanced heart disease, thanks to our multidisciplinary team and our innovative technologies. Now there is hope where there wasn’t any before.”

Matthias Loebe, MD, PhD, FACC, FCCP surgical director, thoracic transplant

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60

40

2008 2009 2010 2011 2012 2013

Long Term LVAD/TAH

All Surgical VAD Implants

0

20

3835 35

26

62 63

51

45

40

5658

48


SURGICAL TREATMENT OF ADVANCED HEART FAILURE100

80

60

40

20

0

92% Transplant

87%LVAD

HEALING BEYOND MEDICINEHouston Methodist is a place of healing, and real healing takes more than just medicine, research and technology –

it takes heart. It addresses each patient as a whole person, not just a number.

Timothy Lewis, 48, was admitted on Dec. 3, 2013, with end-stage congestive heart failure. His cardiovascular

team quickly determined that he needed a transplant. He was implanted with an intra-aortic balloon pump,

an advanced measure that would support his cardiac function while he was on the donor list.

As his family kept vigil at his hospital bedside, plans for an imminent family celebration were reevaluated.

Lewis’s youngest daughter, Lolaycia, was planning her wedding for March 2014, and she wanted her father to

walk her down the aisle. Knowing that transplant prospects were uncertain, Lolaycia changed the wedding

date and location. On December 22, Lewis was there to see his daughter marry her fiancé, Melmiah Walker,

in the chapel at Houston Methodist Hospital.

With nurses minding his equipment, Lewis walked his daughter down the 40-foot aisle and danced with her

after the ceremony.

“Because of the severity of my illness, I didn’t think I would be able to participate in a day that was so

meaningful to my little girl and our whole family,” Lewis said afterward.“I thank God for giving me the

strength to walk her down the aisle.”

A donor heart became available soon after the wedding, and Lewis was transplanted on Jan. 4, 2014.

He’s now doing well and getting stronger by the day.

“Thankfully, Mr. Lewis was successfully transplanted and has been free of rejection and free of infection. Here, we individualize therapy, taking into consideration the best long-term benefit versus risk.”

Jerry D. Estep, MD, FACC, medical director, heart transplant

PHOTO: ©Houston Chronicle/Brett Coomer. Used with permission.


LEADING CARDIOLOGY RESEARCH AND EDUCATION

• In 2013, the advanced heart failure group, as a joint cardiology and CV thoracic

surgery effort, made over 20 presentations at various annual meetings

including the ISHLT (International Society of Heart and Lung Transplantation),

HFSA (Heart Failure Society of America), ACC (American College of Cardiology)

and AHA (American Heart Association).

• The advanced heart failure group published several manuscripts in high impact

journals on various topics including novel ambulatory percutaneous IABP

support as a bridge to heart transplant, the use of ventricular assist devices in

patients with cardiac tumors and the role of echocardiography in predicting

RV failure after LVAD support.

• The group participated in several multi-center studies and was at the top in recruitment

in the ROADMAP trial (risk assessment and comparative effectiveness of left

ventricular assist device and medical management in ambulatory heart failure patients),

a study to evaluate the effectiveness of the Thoratec® HeartMate II® Left Ventricular

Assist System (LVAS) versus Optimal Medical Management (OMM).

• In 2013, the group enrolled patients in several multi-center studies with the

aim of evaluating novel therapies in advanced heart failure patients like CELL-004

(CELLADON) to test whether an experimental gene transfer, performed in the cath

lab using an agent called MYDICAR®, helps to improve the clinical outcome in subjects

with heart failure by reducing the frequency of heart failure related hospitalizations.

• The advanced heart failure group recruited several patients in a first-of-its-kind

stem cell initiated trial (AASTROM) to show that stem cells can be safely given

back to a person, through an injection catheter, with heart failure due to ischemic

dilated cardiomyopathy (IDCM).

• In 2013, the group was an active participant in an NIH-based trial to test the hypothesis

that B-cell depletion using anti-CD20 (Rituximab) as induction therapy in unsensitized

cardiac transplant recipients would attenuate the development of coronary allograft

vasculopathy (CAV) and improve cardiac transplant function.



54LVAD IMPLANTS IN 2013

HEART AND HEART-LUNG TRANSPLANTS IN 2013

27NEW PATIENT EVALUATIONS IN 2013

179HEART TRANSPLANT IN 2013

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Jan 10 Jul 10 Jan 11 Jul 11 Jan 12 Jul 12 Jan 13 Jul 13 Jan 14 Jul 14 Jan 15

HEART TRANSPLANT: THREE-YEAR PATIENT SURVIVALHMH ActualHMH ExpectedNational

LEADING CARDIOLOGY RESEARCH AND EDUCATION



PURSUING MEDICAL DISCOVERIES IN BONE MARROW & STEM CELL TRANSPLANTTHE CENTER FOR CELL & GENE THERAPY REPROGRAMS PATIENTS’ CELLS

The Center for Cell & Gene Therapy (CAGT), a partnership of

Houston Methodist Hospital, Baylor College of Medicine and

Texas Children’s Hospital, is one of the country’s leading centers

for the development of cellular and genetic treatments for adults

and children with cancer and diseases of the bone marrow.

At CAGT, researchers genetically engineer patients’

own immune system t cells to selectively attack and kill

lymphomas, leukemias, brain cancers and cancers of the

bone marrow. The early phase trials are showing promise.

Helen Heslop, MD, director of the Adult Stem Cell Transplant

Program, and her team are advancing this type of research

by adding new growth factors to make modified cells

more active and to reduce side effects for patients. With 11

ongoing trials and more than 50 patients participating in

genetically-modified t-cell studies, Houston Methodist is one

of the top three sites in the country for this type of research.

AT A GLANCENATIONAL MARROW DONOR PROGRAM TOTALS

189 161125

BONE MARROW TRANSPLANTS IN 2013 EVALUATED AND

SCREENED IN 2013

HARVESTED AND COLLECTED IN 2013

patients received cell therapy treatments at HMH on 23 investigator-initiated studies in 2013

45 PATIENT SATISFACTION % - INPATIENT AND OUTPATIENT

93%90%IP

OP


GRANTSThe Leukemia and Lymphoma Society awarded CAGT a $6.25 million grant as a Specialized Center of Research (SCOR). The NCI renewed an $11 million grant to the CAGT for the study of pancreas, nasopharyngeal and sarcoma cancers.

THE CENTER HAS SEVERAL MAJOR PROGRAMMATIC GRANTS INCLUDING:

• National Cancer Institute – T-Cell Therapy for Cancer Project

• National Cancer Institute – Specialized Programs of Research Excellence (SPORE) in lymphoma

• Cancer Research and Prevention Institute of Texas – Texas Assistance for Cancer Cell Therapy

• Leukemia & Lymphoma Society – Specialized Center of Research Program (SCOR)

• National Heart Lung and Blood Institute – Production Assistance for Cellular Therapies Center (PACT)



TRANSPLANT LEADERSHIP & TEAM MEMBERSDIRECTOR A. Osama Gaber, MD, FACS

CARDIOLOGY Guha Ashrith, MDArvind Bhimaraj, MDJerry D. Estep, MD, FACCDanelle McLain, NPLoren Semones, NPGuillermo Torre-Amione, MD, PhD, FACCBarry Trachtenberg, MD

HEART TRANSPLANT SURGERY Brian Bruckner, MDMatthias Loebe, MD, PhD, FACC, FCCPDewei Ren, MD Scott Scheinin, MD, FACSErik Suarez, MD

PULMONOLOGY Soma Jyothula, MDThomas Kaleekal, MDBabith Mankidy, MDNeeraj Sinha, MD

LUNG TRANSPLANT SURGERY Brian Bruckner, MDMatthias Loebe, MD, PhD, FACC, FCCPDewei Ren, MD Scott Scheinin, MD, FACSErik Suarez, MD

NEPHROLOGY Abdul Abdellatif, MDHoracio J. Adrogué, Sr., MDMario Assouad, MDStephen Brennan, MDJoey Buquing, MD Joslyn Campbell, MDLazaro Cherem, MD

Juan Gonzalez, MDNamrata Goel, MDAnna Kagan, MD, PhD, FASNA. Jabbar Khan, MDMehreen Khan, MDUday Khosla, MDSreedhar Mandayam, MDJustin Merszei, MDGeorge Nassar, MD, FASNPeter Tuan Nguyen, MD, FASNRahman Noor, MDJuan Jose Olivero, MD, FACP, FASNJuan Jorge Olivero, MD, FASNRupal Patel, MDVenkataraman Ramanathan, MDEdward Rhee, MDAnand Saranathan, MDWadi N. Suki, MD, FACP

KIDNEY TRANSPLANT SURGERY Laura Lessard, NPEmad Asham, MDBrian James Dunkin, MD, FACSA. Osama Gaber, MD, FACSAlvin Goh, MD R. Mark Ghobrial, MD, PhD, FACS, FRCS(Ed)Sherilyn Gordon Burroughs, MD, FACSRichard Knight, MD, FACSRichard E. Link, MD, PhDWesley A. Mayer, MDHemangshu Podder, MD, PhD Ashish Saharia, MD

HEPATOLOGY Victor Ankoma-Sey, MD Chukwuma Egwim, MDJoseph S. Galati, MD, FACGTRobert McFadden, MDHoward P. Monsour, Jr., MD Ky-Dieu Tran, MD

David Victor, MDDeborah Calares, PAVeronica Carreon, NPJanine Hyden, NPHung Nguyen, NP Rochelle Nguyen, NP

LIVER TRANSPLANT SURGERY A. Osama Gaber, MD, FACSR. Mark Ghobrial, MD, PhD, FACS, FRCS(Ed)Sherilyn Gordon Burroughs, MD, FACS Hemangshu Podder, MD, PhDAshish Saharia, MD Janine Hyden, NPNancy Yarbrough, NP

ANESTHESIOLOGY Mohamad Abdalla, MDNidal Abdel-Rahman, MDNicolas Athanassiou, MDSteve Boozalis, MDJessica Brown, MDGhazala Butt, MDJames Carter, MDJane Carter, MDFrancis Falbey, MDPatrick Giam, MDDiane Gibson, MDAlfred Groen, MDElizabeth Herrera, MDChristopher L. Hutson, MDSaras Karri, MDScott Lindberg, MDLingen Lu, MDGary Monteiro, MDJoseph Naples, MDAlejandro Rosas, MDHany Samir, MDKaranbir Singh, MDLuis Velez-Pestana, MDZbigniew Wojciechowski, MD

BONE MARROW TRANSPLANTMalcolm Brenner, MD, PhDGeorge Carrum, MDHelen Heslop, MDRammurti Kamble, MDRobert Krance, MDCarlos Ramos, MD

ISLET TRANSPLANTA. Osama Gaber, MD, FACSDan Fraga, MDOmaima Sabek, MDWade Rosenberg, MD

CRITICAL CAREJohn Fetter, MDSheikh Hai, MDFaisal Masud, MD, FCCP, FCCMTariq Nabil, MDRobert Ochoa, MDLaurie Punch, MDIqbal Ratnani, MDKamlesh Thaker, MDDavina Tuazon, MDFaisal Uddin, MDSaleem Zaidi, MDAsma Zainab, MD

ENDOCRINOLOGYDale J. Hamilton, MD, FACe, FACPWilla Hsueh, MDAbishek Kansara, MDArchana Sadhu, MDSaundra Hendricks, NPEunice Ihaza, NPDena Rose, NPFang Ye, NPJohn Mucha, PA

INFECTIOUS DISEASEDipti Agrawal, MDAshley Drews, MD, FACPVictor Fainstein, MD, FACP

Kevin Grimes, MD, MPHRichard Harris, MD

DONOR ADVOCATEElie Saber, MD

INTERVENTIONAL RADIOLOGYJett R. Brady, MDMark Brodie, MDJerry Gibbs, MDThomas D. Hedrick, MDJohn S. Labis, MDChenwei Lee, MDDavid W. Light, MDLucho Rossman, MDSteve L. Sax, MDMorris A. Weiner, MDAdrian Wong, MDNam Yu, MD

PATHOLOGY & LABORATORY Roberto Barrios, MDSmaroula Dilioglou, PhDTodd Eagar, PhDLillian Gaber, MDGeoffrey Land, PhD, HCLDLuan Truoung, MD

RESEARCHWenhao Chen, PhDDaniel Fraga, BSMalgorzata Kloc, PhD, D.Sc.Xian C. Li, MDLinda W. Moore, RD, CCRPTadashi Motomura, MD, PhDOmaima Sabek, PhDRoger Sciammas, PhDNeelam Tejpal, M.Sc.Xiang (Johnny) Xiao, PhDJunping You, MD, PhDZhiqiang Zhang, PhD

26SURGICAL SPECIALTIES FROM ACROSS THE WORLD

SQUARE FEET OF EDUCATION AND RESEARCH SPACE

40,000

20,000MORE THAN

LEARNERS SINCE INCEPTION

HOUSTON METHODIST INSTITUTE FOR TECHNOLOGY, INNOVATION & EDUCATION2013 AT A GLANCE

6,300MORE THAN

LEARNERS IN 2013

SIMULATING THE TRANSPLANT EXPERIENCE

Houston Methodist and the local organ procurement organization conduct joint training simulations on organ procurement, donation after cardiac death (DCD) and managing the complex operating room environment.MITIE offers multidisciplinary, hands-on training using advanced imaging and robotics. Surgeons, nurses,

fellows, coordinators and practicing physicians continually refine and acquire new skills to perform at optimal

levels throughout their careers. Using procedural laboratories and sophisticated simulation tools, researchers at

MITIE focus on the development and assessment of emerging technologies and skills that improve patient care

through less invasive therapies. At MITIE, the finest researchers and clinicians are building on our legacy

of ingenuity and accelerating the discovery and delivery of better care and better cures.

HOUSTON METHODIST INSTITUTE FOR TECHNOLOGY, INNOVATION & EDUCATION (MITIESM)

One of the largest and most comprehensive medical education and research facilities in the world, MITIE is

utilized to train complete transplant teams on complex procedures using real-time operating room simulations.

For more information, visit mitietexas.com

At Houston Methodist, we’ve built a legacy of ingenuity that spans multiple decades and disciplines. In the last 95 years, we’ve transformed from a humble 19-bed community hospital to a global leader in health care, treating patients from 90 countries in more than 8,150 visits last year. In 2004, Houston Methodist established a long-term affiliation with Weill Cornell Medical College and New York-Presbyterian Hospital in New York City. Through this affiliation, three internationally renowned institutions collaborate to bring tomorrow’s advances to our patients today. Together, we provide cutting-edge clinical and biomedical research, and education and training for future physicians and scientists. One of the nation’s top research medical schools, Weill Cornell Medical College ranked No. 15 in the 2015 U.S. News & World Report Best Medical Schools list. For Houston Methodist clinicians and researchers, “leading medicine” is a holistic call for excellence in every aspect of patient care. We consistently rank among the best hospitals in the country. In 2013, U.S. News & World Report named Houston Methodist the “Best Hospital in Texas” for the second consecutive year, with 12 specialties recognized in the Best Hospitals list. Houston Methodist is consistently recertified to Magnet status for exceptional nursing. Because of our reputation, the finest researchers and clinicians from around the world are joining us to build on our legacy of ingenuity and accelerate the discovery and delivery of better care and better cures. That’s the difference between practicing medicine and leading it.

FAST FACTS73Operating Rooms

1,119Licensed Beds(824 operating beds)

1,862Affiliated Physicians

6,101Employees

8,150International Patient Encounters (from 90 foreign countries)

36,310Inpatients in 2013

61,043Emergency Room Visits in 2013

301,478Outpatient Visits in 2013

HOUSTON METHODIST HOSPITAL LEADING MEDICINE YESTERDAY, TODAY AND TOMORROW

FORTUNE is a registered trademark of Time Inc. and is used under license. From FORTUNE Magazine, February 3, 2014 ©2014 Time Inc. FORTUNE and Time Inc. are not affiliated with, and do not endorse products or services of, Licensee.

Accelerating discovery and delivery to patientsAt Houston Methodist, we are dedicated to defining the future of medicine. We engineer discoveries in the lab to become clinically useful products, channel the best innovations through early stage clinical trials and actively transition those innovations to our industry partners. Our commitment to the full cycle of discovery and delivery sets us apart as leaders who provide patients from around the world access to the latest health care advances.

LEADERS IN RESEARCH

More than 840 active clinical protocols$55m TOTAL RESEARCH FUNDING IN 2013

Photo courtesy of WHR Architects, Inc. © Aker/Zvonkovic Photography, Houston, Texas

See all the ways we’re leading medicine at hmleadingmedicine.com

Houston Methodist Hospital6565 Fannin Street Houston Texas 77030 houstonmethodist.org/transplant

LEADING MEDICINE YESTERDAY, TODAY AND TOMORROW.At Houston Methodist we have a proud tradition of revolutionizing medicine. Our past achievements have built a legacy that spans multiple decades and disciplines, and that same culture of excellence inspires us to be the pioneers of tomorrow.

houston methodist transplant annual report 2013

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