transplant centre annual report 2008–09 · organ transplantation. ($25,539 2008−09). canadian...

SickKids

Healthier Children. A Better World.™

Transplant Centre

Annual Report 2008–09

“To strive, to seek, to find, and not to yield.”

- Alfred Tennyson Ulysses

Contents02 Executive Report

03 Strategic Plan

04 Clinical Activity

06 Programs

17 Strategic Initiatives

Research Directions Transplantation

Regenerative Medicine

Interprofessional Report

Education

Building the Brand

Fundraising

21 Partnerships

Trillium Gift of Life Network

University of Toronto Transplantation Institute

25 Selected Publications

28 Year in Review

2 THE TRANSPLANT CENTRE 2008-09 ANNUAL REPORT

Transplant Centre Executive Report

As the Executive Team, we have the privilege

of reporting the progress and accomplishments

of a highly committed interprofessional team, who

share the common goal to move the Transplant

Centre to the forefront of solid organ transplantation

and regenerative medicine internationally.

AdministrAtion

The Transplant Centre’s vision, mission and values

were developed at a facilitated retreat, and provide

the underpinnings for all of our Centre activities.

Our goals closely align with the organization’s vision

for “Healthier Children. A Better World.” Strategic

leads have been identified to develop and oversee

our key initiatives in clinical care, education,

research and fundraising.

CliniCAl CAre

The Transplant Centre has collaborated with

SickKids in its negotiation with the Ministry of Health

and Long-term Care (MOHLTC) to obtain additional

clinical funding. In 2008-09, the Hospital received

$500,000 as “one-time” funding to support the

clinical programs. The funding was used to enhance

interprofessional services across all programs within

the Transplant Centre.

The Hospital and MOHLTC also reached an agreement

to include intestine transplantation in the current

funding model. Finally, SickKids shifted resources to

create surge capacity on the inpatient unit by opening

beds on Unit 6B. These investments have enhanced

inpatient and ambulatory care, improved patient

access and promoted team satisfaction through

a better quality work-life.

eduCAtion

To improve our educational offering, we have

integrated transplantation education into the

Department of Paediatrics curriculum, developed a

new academic Transplant Centre Medical Fellowship

and created a Fellowship in Paediatric Transplant

Surgery. Dr. Solomon, working closely with the solid

organ program leaders and Dr. Adele Atkinson,

developed a program that provides paediatric

residents exposure to transplantation out-patient

and inpatient care. Dr. Fecteau has administered a

Surgical Fellowship. Our first graduate, Dr. Rodrigo

Iniguez, will return to Santiago, Chile where he

will play a key role in expanding the use of split

deceased donor livers and living donor livers.

reCruitment

We welcome recruitment of new medical, surgical

and interprofessional staff who will help us expand

and grow our evolving programs. New additions to

SickKids include: Dr. Rulan Parekh, Kidney Transplant

Program, Dr. Anand Ghanekar, Surgery, Dr. Yaron

Avitzur, Small Intestine Program and Dr. Benita

Kamath, Liver Transplant Program.

We have also added to our focus on health-related

quality of life research through two additions to our

interprofessional team: Stacey Pollock-BarZiv, PhD,

Paediatrics and Samantha Anthony, PhD (c). We are

grateful to the Department of Paediatrics, SickKids’

Research Institute, the Department of Surgery, the

Labatt Family Heart Centre and Liam’s Light

Foundation who supported these recruitments.

reseArCh

Our basic research capacity has been strengthened

through new projects in regenerative medicine that

will be partially funded by the Transplant Centre

(see Regenerative Medicine Research Report).

Translational research will be expanded by the

development of a Transplant Biobank. Under the

leadership of Drs. Seema Mital, Heart Transplantation

and Freda Miller, Regenerative Medicine, SickKids’

3THE TRANSPLANT CENTRE 2008-09 ANNUAL REPORT

Research Institute, the BioBank will not only

collect DNA and RNA for translational research

studies, but will also collect skin cells for research

on induced pluripotential stem (iPS) cells.

Our capacity and performance in clinical research

will substantially increase through participation

in three new NIH-funded clinical trials of liver and

heart transplantation and intestinal failure that

will start next year.

Future direCtions

In 2009/10, we will continue to explore innovative

and collaborative opportunities to enhance our Centre.

We will also work towards renaming oursleves as

the “Transplant and Regenerative Medicine Centre,”

to more closely reflect our shared vision.

Our Vision

We will become the international model of an

interdisciplinary paediatric academic transplant

centre, exhibiting superior clinical outcomes, new

knowledge creation and educational leadership.

Our Mission

We provide unsurpassed, measurable transplant

outcomes using expert interdisciplinary teams

in a family-centred environment that integrates

efficient, innovative and practice-changing

health care, education and research.

Our Values

Innovation … Excellence … Collaboration … Integrity

Strategies

• Buildourbrandthroughfundraisingandoutreach

• Elevateclinicalcarethroughinnovative

and evidence-based practice

• Enhanceknowledgediscoveryanddissemination

Partnerships

• TrilliumGiftofLife

• TorontoTransplantInstitute

Anne dipChAnd dAvid GrAnt FredA miller WAndA sChoonheyt


Clinical Activity Report

0

10

20

30

40

50

60

70

80

Heart Lung Liver Kidney

Liver and Small Bowel Small Bowel

2004-052005-06

2006-072007-08

2008-09

Year

Num

ber o

f Tra

nspl

ants

Organ transplantatiOn

Year of Listing

Min MedMax

Heart Kidney Liver

Lung Bowel

0

5

10

15

20

25

30

35

40

45

50

Mon

ths

2004-052005-06

2006-072007-08

2008-09

transplant wait times

SickKids remains one of the busier

transplant centres in North America

At SickKids, the length of time a child waits

for an organ transplant is decreasing over time


Clinical Activity Report

0.0

0

0.2

0.4

0.6

0.8

1.0

Cum

Sur

viva

l

Days from Primary OR to Death or Study End

Log Rank = 0.13

500 1000 1500 2000

Referral Year Recoded

PreGIFT 2003-05 2006-07

mOrtality frOm liver failure in gift patients Mortality from liver failure is reduced

and patient survival is improved

0 1 2 3 4 5

Surv

ival

Pro

babi

lity

Time After Transplant (Years)

*Lung transplant data reflects all program data(not past five year data)for the purposes of more stable survival curves.

0.200.250.300.350.400.450.500.550.600.650.700.750.800.850.900.951.00

Heart Kidney Liver Lung Bowel

transplant OutcOmesSickKids patient survival rates

match or exceed experience worldwide

medical directOr Paul Wales

gastrOenterOlOgist/clinic nutritiOn Paul B Pencharz

transplant HepatOlOgists Vicky Ng Simon Ling Nicola Jones

transplant surgeOns David Grant Annie Fecteau Anand Ghanekar

neOnatOlOgistsAideen Moore

nurse practitiOnersChristina Kosar Karen Lang Nicole de Silva Maria De Angelis Krista Murch

clinical dietitians Glenda Courtney-Martin Megan Carricato Kathryn Cormier Penni Kean Laura Coxson Joan Brennan Donnan

HOme tpn nurseDebra Harrison

sOcial wOrkers Julia Maxwell Dianne Fierheller


GIFT

cHild life specialist Jane Darch

pHysiOtHerapistsStephanie So Catherine Patterson

palliative care Lori Ives-Baine

OccupatiOnal tHerapistAlaine Rogers

administrative assistant Janice Bowers

teAm messAGe

The Group for Improvement of Intestine Function

and Treatment (GIFT) was developed to optimize the

treatment of intestinal failure, improve communication

and ensure continuity of care. Team members include:

paediatric surgeons, gastroenterologists, advanced

practice nurses, physiotherapists, occupational

therapists, dietitians/nutritionists, social workers,

psychiatrists, interventional radiologists and others.

GIFT has significantly improved patient and family

outcomes. A retrospective analysis, conducted to

compare pre-GIFT (1997 to 1999) with GIFT (2003

to 2005) outcomes, demonstrated a decrease in

liver-related deaths that was attributable to earlier

assessment, increased rates of transplantation and

decreased mortality from liver failure. As a high

volume centre, we have been able to undertake and

evaluate specialized surgery and nutritional methods

of treating intestine failure. We have evaluated the

Serial Transverse Enteroplasty Procedure (STEP) and

have initiated a multi-centre Canadian study of

SMOFlipid® to prevent Parenteral Nutrition-Induced

liver injury. These clinical studies are complemented

by our basic research collaboration with Dr. Justine

Turner at the University of Alberta where we are

evaluating a neonatal pig model for novel therapies

to optimize intestinal function or reverse cholestasis.

In recognition of our expertise, we were invited to join

an NIH-funded consortium of paediatric intestinal

failure centres of excellence as the only participating

Canadian centre. A highlight of the year was the

second annual GIFT gala to celebrate our patients

and families. Our goal for next year is to complete

studies focused on health-related quality of life

and cost analysis of intestinal failure patients.

GrAnts (totAl = $1,100,014)

Fresenius-Kabi: Wales PW. Evaluation of a

Novel Parenteral Lipid Source in the Prevention

of PN Associated Cholestasis. ($159,850 2008)

Molly Towell Foundation for Prenatal Research:

Turner J, Wales PW. Characterizing the Role of

Intestinal Glucagon-Like Peptide 2 in Intestinal

Adaptation in Neonates with Short Bowel Syndrome:

Using Novel Animal Models. ($30,000 2008)

MRC/CIHR: Ball R, Pencharz PB. The use of

indicator amino acid oxidation to determine

amino acid requirements. ($152,967 2008)

MRC/CIHR Operating from 1975: Ball R,

Pencharz PB. Neonatal Protein and Energy

Metabolish. ($136,817 2008)

NIH: Squires R, Site PI, Wales PW. Intestinal

Failure in Children: A Contemporary Retrospective

Review By The Pediatric Intestinal Failure Consortium.

($456,000 2008)

Sickkids Foundation/CIHR: Turner J, PW Wales.

Short Bowel Syndrome, Neonatal Piglet Models.

($125,380 2008)

Stollery Children’s Hospital Foundation: Turner J,

Wales PW. Development of a Model of Surgical

Short Bowel Syndrome Utilizing the Neonatal Piglet.

($39,000 2008)

medical directOr Anne Dipchand

transplant cardiOlOgists Paul Kantor Seema Mital

nurse practitiOnerKathy Martin

Heart transplant nurses Mirna Seifert-Hansen Alison Drabble

transplant surgeOns Christopher Caldarone John Coles Glen Van Arsdell Osman Al-Radi

sOcial wOrkers Ruta Niedra Samantha Anthony

clinical dietitian Louise Bannister

staff psycHiatrist Arlette Lefebvre

OccupatiOnal tHerapist Maggie Harkness

pHysiOtHerapist Robin Deliva

transplant pHarmacists Anita Babu Cathryn Sibbald Cynthia LeungNadya Nalli


Heart Transplantation

teAm messAGe

The Heart Transplant Program at SickKids began

in 1990 and is one of the busiest in the world in

clinical, research and educational activities. The

year 2008 was a landmark year for academic

publications and the start of our first NIH-sponsored

clinical study. There has been an increasing focus

on the role of antibodies and rejection in newly-

transplanted patients. Many team members have

become actively involved in a number of national

and international transplant organizations and

societies. A highlight of the year was our Continuing

Medical Education accredited day-long symposium

for health care professionals focusing on community

collaborations. Challenges include: the ongoing

organ donor availability crisis and waitlist mortality,

particularly in the infant group. Future directions

include strengthening our clinical research program,

especially in regard to high-risk transplant

patients and health-related quality of life.

GrAnts (totAl = $320,039)

Astellas Research Grant: Pollock-BarZiv, Dipchand AI,

Solomon M, Hebert D, Ng V. A study of medication

nonadherence and late rejection in pediatric multi

organ transplantation. ($25,539 2008−09).

Canadian Society of Transplantation Research Grant:

Deliva R, Pellow V, McLister C, Patterson C, So S,

Manlhoit C, Pollock-BarZiv S, Drabble A, Dipchand A,

& Anthony SJ. Impact of Participation in the World

Transplant Games on Physical Fitness, Activity Patterns

and Quality of Life: A Study of Paediatric Solid Organ

Transplant Recipients. ($2,500 2009)

International Society for Heart and Lung

Transplantation, Research Grant in Nursing and Social

Sciences: Pollock-BarZiv S, Anthony SJ, Kaufman M,

Solomon M, & Dipchand AI. Personality, Body Image,

and Disordered Eating in Pediatric Heart and Lung

Transplant Recipients. ($12,000 2008)

Labatt Family Heart Centre Innovation Fund: |

Anthony SJ, Dipchand AI, Nicholas D, McCrindle BM.

Quality of Life Following Paediatric Heart

Transplantation. ($20,000 2008−10)

National Institutes of Health: Webber S, Dipchand AI,

Blume E, Canter C, Naftel D, Hsu D. CTOT-C

(Clinical Trials in Organ Transplantation in Children)

1U01AI077867-01: Alloantibodies in Cardiac

Transplantation: Intervention, Outcomes

and Mechanisms. ($260,000 2008−09)

adOlescent HealtH specialist Miriam Kaufman

researcH prOject investigatOr Stacey Pollock-BarZiv

clinical researcH nurse cOOrdinatOrTina Allain-Rooney

cHild life specialist Allison Pummell

psycHOlOgist Anna Gold

fellOwAbdullah Al-Wadai

administrative assistant Fatima Alas

infOrmatiOn cOOrdinatOr Michele Wright

medical directOrDiane Hebert

transplant nepHrOlOgistsValerie Langlois Lisa Robinson

nepHrOlOgistsDenis Geary Elizabeth Harvey Christoph Licht Tino Piscione Norman Rosenblum

nurse practitiOnerAngela Williams

transplant nursesMoira Korus Rita Pool

transplant urOlOgistsJoao Luiz (Pippi) Salle Armando Lorenzo Walid Farhat

sOcial wOrkersGail Picone Miriam Granger

clinical dietitianVivian Cornelius

staff psycHiatristArlette Lefebvre

transplant pHarmacistsNadya Nalli Anita Babu Cathryn Sibbald Cynthia Leung


Kidney Transplantation

teAm messAGe

The Kidney Transplant Program started at SickKids

in 1969 and is preparing to celebrate its 40th

anniversary this year. It remains one of the busiest in

North America with more than 760 kidney transplants

performed. After the departure of Dr. Antoine Khoury,

Dr. Joao Luiz (Pippi) Salle from the Division of Urology

became the surgical director of the program in April

2008. In December 2008, Dr. Rulan Parekh joined the

Division of Nephrology and has used her research

experience to enhance the clinical research of our

program. Moira Korus was the recipient of a SickKids

Nursing Centre Research Fellowship from 2008 to

2009. Social worker Gail Picone was the recipient

of the 2009 Beverly Antle Legacy of Hope Award.

Our multidisciplinary team has been focused on

the adolescent renal transplant population, has

successfully organized the Transplant Transition Day

in collaboration with the University Health Network

(UHN) team and has hosted the first formal Renal

Transplant Transition Clinic at SickKids. Important

areas of clinical research have focused on Quality

of Life, special issues pertaining to the adolescent

renal transplant recipients and long-term outcomes.

Basic research has focused on inflammation and

regenerative medicine.

GrAnts (totAl = $878,495)

Astellas Research Grant. A study of medication


organ transplantation. Pollock-BarZiv, Dipchand AI,

Solomon M, Hebert D, Ng V. (25,539, 2008−09).

Canada Research Chair, Tier 2: Robinson L.

The Role of Slit/Robo Signaling in Renal

Inflammation. ($500,000 2004−09)

Conversion of stable renal transplant patients

from immediate-release tacrolimus (Prograf) to

extended release tacrolimus (Advagraf). Hebert,

Diane, Lisa Robinson, Valerie Langlois, Nadya Nalli,

Cynthia Leung, Stacey Pollock-BarZiv: Astellas

Pharma Canada, Inc. ($67,956 2009−10)

Early Researcher Award, Government of Ontario:

Robinson L. The Role of Slit/Robo Signaling Pathways

in Kidney Inflammation. ($100,000 2006−08)

Heart and Stroke Foundation of Ontario:

Robinson L. Regulation of the Membrane-

anchored Chemokine, Fractalkine, by

Thromboxane A2. ($268,452 2007−10)

Optimizing Influenza Vaccination in Pediatric Kidney

Transplant Recipients. Corina Nailescu, John Mahan,

Rudy Valentini, Diane Hebert, Jens Goebel. Mid

Westen Pediatric Nephrology Consortium. (2007−08)

The Kidney Foundation of Canada: Robinson L.

The Role of Slit-robo Signaling in Kidney Inflammation.

($100,000 2007−09)

The Kidney Foundation of Canada: Dettmer E,

Cullen-Dean G, Kaufman M, Lorber S, Schiff J,

D’Agostino N, McCurdy C, Horricks L, Pool R, Mitchell

M. Development and testing of a self-management

program for youth post kidney transplant: A pediatric

and adult collaboration. ($85,000 2008−10)

researcH prOject investigatOrStacey Pollock-BarZiv

adOlescent HealtH specialistMiriam Kaufman

OccupatiOnal tHerapistSharon Samaan

pHysical tHerapistDegen Southmayd

psycHOlOgistAnna Gold

infOrmatiOn cOOrdinatOrKathy Szmyd

medical directOrShaf Keshavjee

medical directOrMelinda Solomon

transplant respirOlOgistHartmut Grasemann

transplant surgeOnsAndrew Pierre Thomas WaddellMarc DePerrotKazuhiro Yasufuku

transplant nurseNatalie D’Amato

transplant pHarmacists Anita BabuCathryn SibbaldCynthia LeungNadya Nalli

clinical dietitianDaina Kalnins

pHysiOtHerapistsRobin DelivaBlythe Owen

sOcial wOrkersJean VinetteSamantha Anthony

staff psycHiatristArtlett, Lefebvre

psycHOlOgist Anna Gold

researcH prOject investigatOrStacey Pollock-BarZiv

infOrmatiOn cOOrdinatOrMichele Wright


Lung Transplantation

teAm messAGe

The Lung Transplant Program at SickKids began

in 1995 and is the largest paediatric program in

Canada performing more than 30 lung transplantations

in children to date. We are fortunate to have an

enthusiastic multidisciplinary team that provides

outstanding care for our patients and their families.

Highlights in 2008 included: the world’s first use

of an external lung device, Novalung®, to bridge

to lung transplantation in a child with pulmonary

hypertension, enhanced research collaborations

with the International Paediatric Lung Transplant

Collaborative and completion of an Ontario outreach

project to improve awareness of the SickKids lung

transplant program in the province. Future directions

include increased research activities focusing on the

detection and prevention of chronic graft failure.


Astellas Research Grant: Pollock-BarZiv S, Dipchand

AI, Solomon M, Hebert D, Ng V. A study of medication


organ transplantation. ($25,539, 2008−09)

Canadian Cystic Fibrosis Foundation: Keshavjee S.

Airway remodelling in bronchiolitis obliterans after lung

transplantation: The role of matrix metalloproteinases.

($270,000 2006−09)

Canadian Society of Transplantation: Deliva R.

Anthony S, Pellow V, McLister C, Patterson C,

So S, Manlhiot C, Pollock-BarZiv S, Drabble A,

Dipchand A. Impact of participation in the world

transplant games on physical fitness, activity patterns

and quality of life: A study of paediatric solid organ

transplant recipients. ($2,500 2009−10)

CIHR – Canadian Institutes of Health Research:

Keshavjee S. Gene therapeutic strategies for

transplant related lung injury. ($654,290 2003−09)

Cystic Fibrosis Transplant Centre Grant: Singer L,

Keshavjee S for the Toronto Lung Transplant

Program ($60,241 2008−09)

International Society of Heart and Lung

Transplantation: Pollock-BarZiv, S, Anthony SJ,

Solomon M, Dipchand AI. Personality, body image,

and disordered eating in pediatric heart and lung

transplant recipients. (US $12,000 2008−09)

University of Iowa / NIH Pilot Grant: Keshavjee S.

Repair of damaged lungs for transplantation using

an ex-vivo gene therapeutic strategy center for gene

therapy of cystic fibrosis and other genetic diseases.

($34,560 2007−08)

Wyeth Pharmaceuticals/CIHR Chair in Transplantation

Research: Keshavjee S. Ex-vivo gene repair of injured

donor lungs for transplantation. ($1,100,000 2008−13)

medical directOr Vicky Ng

surgical directOrDavid Grant

transplant surgeOns Anand Ghanekar Annie Fecteau Paul Greig

transplant gastrOenterOlOgists Nicola Jones Simon Ling

liver transplant nurses Natalie D’Amato

nurse practitiOnersMaria DeAngelis Krista Murch

sOcial wOrkers Emily Ghent Julia Maxwell

clinical dietitians Megan Carricato Glenda Courtney-Martin

OccupatiOnal tHerapist Alaine Rogers

staff psycHiatrist Arlette Lefebvre

pHysiOtHerapists Catherine Patterson Stephanie So


transplant pHarmacists Anita Babu Nadya Nalli

clinical researcH nurse cOOrdinatOrWendy Drew

cHild life specialist Jane Darch

psycHOlOgistAnna Gold

patient care cOOrdinatOr Gomatie Raghubar

Liver & Intestine Transplantation

teAm messAGe

The Liver Transplant program at SickKids began in

1986 and is the largest in Canada, performing over

325 isolated liver transplants in infants and children

to date. Our team’s superior outcomes are the result

of the combined attention, efforts and innovations

of our entire interdisciplinary team to the multi-

dimensional health care needs of our highly complex

patient population and their families. Highlights

in 2008 include funding of the Beanstalk program,

the infant development program for our youngest

transplant recipients, pre-transplant teaching doll

and preparation book for our toddler and child-aged

recipients, formalization of a transition day for

adolescents to the Toronto General Hospital adult

Small Liver Transplant program, parent coffee hour

for parents of our inpatient transplant recipients,

ongoing educational and mentorship initiatives for

our bedside nurses on Unit 6A and community

nursing and rehabilitation medicine colleagues.

Maria De Angelis was the worthy 2008 recipient of

the Grace Evelyn Simpson Reeves Award for Advanced

Practice Nursing. Three new physicians were recruited

to our program: Dr. Anand Ghanekar, Liver Transplant

Surgeon and Clinician-Scientist, Dr. Binita Kamath,

Staff Hepatologist and Clinician-Investigator and

Dr. Yaron Avitzur, Transplant Gastroenterologist and

Medical Director, Small Bowel Transplant program.

The Small Bowel Transplant program has been rapidly

expanding since its 1999 inception into our program.

The addition of two NIH notices of awards will bring

our total up to five NIH-sponsored multi-center

clinical studies in liver transplantation at SickKids,

acknowledging the international presence and

leadership of our program.


Canadian Association for the Study of the Liver (CASL)/

Schering Canada Fellowship: Gutteman OR, Ng VL,

Roberts E. Innovative strategies for optimizing

management of infants with biliary atresia.

($55,000 2007−08)

Canadian Institutes of Health Research: Ling SC.

Non-invasive tests for the diagnosis of esophageal

varices. ($68,865 2008−09)

Canadian Institutes of Health Research: Otley AR, Ng VL.

Development and Validation of a Disease-Specific

Health-Related Quality of Life Questionnaire for Children

after Liver Transplantation. ($280,576 2005−09)


CIHR Phase 1 Clinician Scientist Award: Dick J, Dirks P,

Ghanekar A. Identification and Characterization of

Human Liver Cancer Stem Cells. ($157,500 2008−11).

Cystic Fibrosis Liver Disease Research Group:

Narkewicz M, Ling SC, Durie P, Navarro O.

($60,000 2009−13)

National Institutes of Health: Feng S, Bucuvalas J,

Ng VL. Immunosuppression Withdrawal after Pediatric

Liver Transplantation (iWITH). ($60,000 2009−12)

National Institutes of Health: Lindbladt A, Ng VL,

Fecteau AH. Studies of Pediatric Liver Transplantation

(SPLIT): Outcomes. ($75,000 2005−10).

National Institutes of Health: Ng VL, Ling S. Randomized

Controlled Trial of the Efficacy of Steroids for Infants

with Biliary Atresia post Kasai Portoenterostomy

(START Trial) on behalf of Childhood Liver Diseases

Research and Education Network (CHiLDREN).

($703,199 2009−14)

National Institutes of Health: Squires R, Ng VL, Fecteau

AH. A Double Blinded Placebo Controlled Randomized

Controlled Trial of the Safety and Efficacy of

N-acetylcysteine in Patients with Pediatric Acute Liver

Failure (PALF) on behalf of the PALF Study Group.

($79,800 2005−10).

National Institutes of Health NIH 1 R01 HD045694-

01A1: Alonso EA, Ng VL, Fecteau AH. Functional

Outcomes after Pediatric Liver Transplantation (FOG).

($18,000 2006−10)

Role of fg12 in transplantation and cardiac development.

Grant D, Levy G. Heart and Stroke Foundation of Canada.

($227,750 2005−08)

SickKids Liver Transplant Program Research Funds

Allocation Committee (RFAC): Ghent E, De Angelis M,

Murch K, Ng V, & Anthony SJ. Perceptions of

Transitional Care Needs and Experiences in Pediatric

Transplantation ($2,000 2009)

Social Work Endowment Fund, The Hospital for Sick

Children: Ghent E, Anthony SJ, DeAngelis M, Fecteau A,

Grant D & Ng V. The Experiences of Parents and

Caregivers Whose Child Received an Organ from

a Living Anonymous Liver Donor. ($2,000 2008)

So S, Rogers A, Patterson C, Darch J, Drew W,

Koziolek C, Maxwell J, Patterson S. Beanstalk Program:

Evaluating the paternal perception of a developmentally

focused care program during long term hospitalization

of their child. ($5,000 2008)


Strategic Initiatives

reseArCh direCtions trAnsplAntAtion

david grant – While solid organ transplantation is

life-saving in the short to intermediate term, many

patients experience significant morbidities attributable

to sustained immune suppression and/or suffer

the consequences of chronic graft failure.

The Transplant Centre is focused on finding better

ways to treat organ failure and to perform transplants

with longer function, less morbidity and a better

quality of life. Current research is outlined below.

a) Basic. Clinician scientists in the Transplant

Centre have diverse interests. Below are highlights.

• UptonAllen,DivisionofInfectiousDiseases,

is leading investigations of Post-transplant

Lymphoproliferative Disease (PTLD).

• AnandGhanekar,DivisionofGeneralSurgery,

holds a CIHR Career Scientist Award and is

focused on investigations of liver stem cells.

• DavidGrant,DirectoroftheTransplant

Centre, holds a Heart and Stroke Foundation

award to study xenotransplantation.

• HartmutGrasemann,Divisionof

Respiratory Medicine, investigates the role

of nitric oxide in later lung graft failure.

• ShafKeshavjee,Director,TorontoLung

Transplant Program, has CIHR funding to

study ways to repair damaged deceased

donor lungs for transplantation.

• MartinPost,ResearchInstitute,and

Tom Waddell, Thoracic Surgery, hold CIHR

awards to study lung regeneration and repair.

• LisaRobinson,DivisionofNephrology,holds

the Canada Research Chair in Leukocyte

Migration in Inflammation and Injury.

b) translation. The Transplant Centre, in

partnership with SickKids Foundation,

has secured funding for a Transplant

BioBank to collect and store DNA, RNA and

possibly skin samples for future iPS research,

an initiative led by Seema Mital. Research

will focus on graft reject, immune suppression

and vitamin D metabolism.

c) clinical research. Patient recruitment to clinical

trials will improve through our participation in

NIH-sponsored collaborative studies of the

effects of antibodies on heart graft rejection

(Anne Dipchand), immune suppression withdrawal

after liver transplantation (Vicky Ng) and the effect

of nutrition on liver function in patients with the

short gut syndrome (Paul Wales), as well as

investigator-initiated studies such as daily

Advagraf in renal transplant recipients

(Astellas®, Diane Hebert)

Our focus on health-related quality of life and

long-term outcomes support the Transplant

Centre’s mission of striving to achieve superior

clinical outcomes, new knowledge creation and

educational leadership. Current grant-supported

initiatives include the development of a health-

related quality of life tool to measure paediatric

liver disease (CIHR, Vicky Ng), research on body

image and disordered eating in solid organ transplant

recipients (ISHLT, Stacey Pollock-BarZiv), qualitative

and quantitative studies on quality of life after heart

and lung transplantation (Heart Centre Innovation

Fund, CIHR doctoral award, Samantha Anthony),

research on multidimensional quality of life in

renal transplant recipients (Stacey Pollock- BarZiv,

Samantha Anthony), prospective studies of quality

of life in paediatric haemotopoeitic stem-cell

transplant recipients (Canadian Blood & Marrow

Transplant Group, Tal Finkelstein, Stacey Pollock-

BarZiv) and studies on non-adherence (Astellas®,

Stacey Pollock- BarZiv).

dr. david grant staff surgeon and medical director transplant centre


reGenerAtive mediCine

freda miller – Significant progress has been

made into the Transplant Centre Executive’s goal

to develop an integrated regenerating initiative

and merge it into the Centre. We will focus on the

generation or use of stem cells for therapeutic uses,

building on current strengths and developing new

initiatives as outlined below.

a) stem cells for lung transplantation. This

collaborative effort involves scientists and

surgeons who are attempting to use stem cells

to generate lung cells for transplantation. This

initiative builds upon our established excellence

in lung biology and lung transplantation and our

recent successes in differentiating stem cells into

lung epithelial cells. Key individuals in this initiative

are Tom Waddell (UHN), Martin Post, and Janet

Rossant, who are combining their expertise in lung

development, lung transplantation and stem cells

to create novel approaches for cell-based lung

transplantation. Notably, this group, together

with a number of other Ontario scientists, are

the successful recipients of a CIHR Regenerative

Medicine Emerging Team Grant.

relevant publications

Seguin CA, Draper JS, Nagy A, Rossant J.

Establishment of endoderm progenitors by SOX

transcription factor expression in human embryonic

stem cells. Cell Stem Cell 3, 182-195, 2008.

Wong AP, Keating A, Lu WY, Duchesneau P,

Wang X, Sacher A, Hu J, Waddell TK. Identification

of a bone marrow-derived epithelial-like population

capable of repopulation injured mouse airway

epithelium. J. Clin. Invest. 119, 336-348, 2009.

Cao L, Wang J, Tseu I, Luo D, Post M. Maternal

exposure to endotoxin delays alveolarization during

postnatal rat lung development. Am J Physiol

Lung Cell Mol Physiol. 296, 726-737, 2009.

b) Biobanking stem cells for screening and

discovery. The Transplant Centre will become the

home for the human iPS cell (induced pluripotent

stem cell) initiative, supported by funds from the

Ontario Ministry of Research and Innovation. The

development of an iPS bank takes advantage of

newly-developed technology allowing generation

of embryonic stem cell-type cells from human skin

samples and spare surgical skin samples that

are generated during treatment of patients with

genetic disorders. By collecting and generating a

bank of stem cells that represent these various

genetic disorders, scientists and clinicians will be

able to study these disorders in completely new

ways, encouraging new ideas and approaches

to develop novel therapies. This highly unique

initiative places SickKids at the forefront in

the research and application of stem cell.

Key individuals in this initiative are James Ellis,

Bill Stanford (U of T) and Janet Rossant.


Hotta A, Cheung AY, Farra N, Vijayaragavan K, Seguin

CA, Draper JS, Pasceri P, Maksakova IA, Mager DL,

Rossant J, Bhatia M, Ellis J. Isolation of human iPS

cells using EOS lentiviral vectors to select for

pluripotency. Nature Methods 6, 370-376, 2009.

c) endogenous stem cells for tissue regeneration.

The idea that the stem cells that reside within the

human body can be recruited to repair and/or

regenerate tissues is one of the most exciting

therapeutic ideas to come from this research

area. To pursue this idea, the Transplant Centre

has brought together a group of developmental

biologists and clinicians to pioneer this approach

at SickKids. Key individuals in this initiative are

Freda Miller, Norman Rosenblum, Sevan Hopyan,

dr. freda d miller senior scientist developmental & stem cell Biology


Chi-Chung Hui, Benjamin Alman, Darius Bagli and

Janet Rossant. Together, members of this group

have brainstormed a number of unique projects

that they hope will pave the way for treatment

of problems as diverse as spinal cord injury,

wound-healing, bladder and kidney regeneration

and even limb regeneration. Notably, members

of this group successfully obtained a CIHR

Regenerative Medicine Emerging Team Grant

for the spinal cord injury work.


Paris M, Su X, Gi YJ, Cho MS, Lin Y, Lin L,

Biernaskie JA, Sinha S, Prives C, Miller FD,

Flores ER. Tap63 prevents premature aging

by promoting adult stem cell maintenance.

Cell Stem Cell (in press).

Wyngaarden LA, Hopyan S. Plasticity of

proximal-distal cell fate in the mammalian

limb bud. Dev. Biol. 313, 225-233, 2008.

Bridgewater D, Cox B, Cain J, Lau A, Athaide V,

Bill PS, Kuure S, Sainio K, Rosenblum ND.

Dev. Biol. 317, 83-94, 2008.

Lavoie JF, Biernaskie JA, Chen Y, Bagli D, Alman B,

Kaplan DR, Miller FD. Skin-derived precursors

differentiate into skeletogenic cell types and contribute

to bone repair. Stem Cells Dev. (2008; e-pub).

interproFessionAl report

stacey pollock-BarZiv – The Transplant Centre’s

vision is to become the international model of a

multidisciplinary academic paediatric transplant

centre integrating efficient, innovative and practice-

changing health care models. SickKids plays an

important advocacy role through its emphasis on

the full recovery and rehabilitation of transplant

recipients. Catherine Patterson and Stephanie So

are assessing physical activity in children following

a combined liver, small bowel transplant. Robin Deliva

and Alison Hassal are conducting qualitative studies

on exercise perception and behaviors after heart

or lung transplant, and comparing home- versus

hospital-attended rehabilitation.

Robin Deliva, Samantha Anthony and others are

exploring the impact of participation in the World

Transplant Games in Australia in August 2009 on

physical fitness, activity and quality of life. Other

initiatives seek to improve the delivery of patient care

by understanding the lived experiences of patients.

Examples include studies on informational needs

of renal transplant patients and their families (Moira

Korus), the experiences of parents/caregivers whose

child has received an organ from a living anonymous

donor (Emily Ghent), development and testing of

a self-management program for youth post-kidney

transplant (Elizabeth Dettmer, Miriam Kaufman, Rita

Pool) and exploring the parent perspectives of infant

ABO-incompatible heart transplantation (Samantha

Anthony). Kathy Martin and Samantha Anthony

are leading research on transition to adult care in

transplant recipients. This has recently expanded

with the assistance of Maria De Angelis, Emily Ghent

and Krista Murch to include the liver transplant

population. Stephanie So, Catherine Patterson,

Alaine Rogers and their colleagues have begun

an ambitious research project evaluating parental

perceptions of a developmentally-focused care

program during long-term hospitalization.

dr. stacey pollock-BarZiv researcher transplant centre


It is recognized that adolescents have higher rates

of graft loss due to non-adherence. We are striving

to address this patient population through research

initiatives such as funded studies on non-adherence

(Stacey Pollock-BarZiv), implementation of the Good

2 Go Transition Program and by hosting a Transition

Day with representation from both SickKids and the

Toronto General Hospital. Our team members also

strive to improve patient outcomes. Noteworthy

examples include: the prevalence of vitamin D

deficiency in the paediatric kidney transplant

patient population (Vivien Cornelieus), research on

enteral tube feeding and growth in heart transplant

recipients (Louise Bannister), and work defining

clinical pathways for collaborative child life services

(Sarah Patterson). Our staff encourage paediatric

transplant recipients to live life to the fullest. About

10 staff members have volunteered this summer to

work at the CNIB Lake Joseph Center, offering a

summer camp week to children and teens who have

received solid organ transplantation at SickKids and

who would otherwise not have such an opportunity.

The inaugural camp session will be held July 26 to

August 1, 2009.

enhAnCinG eduCAtion

melinda solomon – With the opening of the

Transplant Centre at SickKids comes exciting

opportunities for education. We have taken advantage

of this opportunity to integrate transplant education

into the SickKids Paediatric Residency Program.

Lectures from each of the solid organ program

heads, the transplant fellows and pharmacists have

provided a solid foundation on which exposure to

transplant patients in both the ambulatory and

inpatients settings have been added. The residents

are able to consolidate their understanding of

transplantation which will enhance the care of these

patients in the Hospital and in the community.

Adele Atkinson has been an avid supporter

and collaborator in this endeavour. Under the

leadership of Anne Dipchand, we have strong

Transplant Centre fellows who represent each

of the solid organs. Our goal is to develop an

academic fellowship that includes a formal

education curriculum for these trainees.

Our dedicated education committee continues to

organize the weekly Transplant Centre Rounds

that have included guest speakers and lectures

ranging from basic science to ethics. Future directions

for the Transplant Centre include: improving the

education- and transplant-related academic

contributions of the fellows, integration of

educational seminars with the University of Toronto

Transplant Institute and increasing community health

caregivers’ understanding of transplantation.

dr. melinda solomon staff respirologist respiratory medicine


BuildinG the BrAnd

vicky ng – Two key initiatives in 2008 are

worth highlighting:

Our program is one of the busiest in North America,

providing solid organ transplantation for children with

end-stage organ failure. Our wealth of accumulated

experience will be shared in an upcoming special

issue devoted entirely to paediatric solid organ

transplantation in the widely-acclaimed Pediatric

Clinics of North America.

The issue will serve to enhance the outcomes and

care of paediatric transplant recipients locally,

nationally and internationally, and will help establish

the presence of the SickKids Transplant Center

nationally and internationally.

We reviewed the needs of our many community

partners within Ontario to facilitate their ability

to efficiently keep our paediatric solid organ

transplant recipients within their home environments

for as long as possible. A pilot program is

exploring opportunities for access to selected

information technology resources, working with

our SickKids confidentiality office and information

technology colleagues.

Longer-term plans include granting access to

these resources to other community partners

across Canada.

Our goal for 2009 is to build upon these pilot

opportunities to involve more long-term and durable

commitments. We will also explore additional

outreach tools including: stakeholder workshops,

education and awareness programs and novel

communication technologies for our families.

dr. vicky ng gastroenterologist gastroenterology, Hepatology and nutrition


FundrAisinG

anne dipchand – The establishment of the

SickKids Transplant Centre has opened new doors

for fundraising initiatives to support our vision and

mission. During the course of the year, our team has

raised more than $1.5 million dollars. Over the next

year, these funds will be allocated to enhance our

clinical programs and develop the four prioritized foci

on our approved “wish list” – a Biobank seed funding

for novel projects and initiatives, clinical trials

research infrastructure and two Chairs.

We greatly appreciate the longstanding and ongoing

assistance of the Liam’s Light Foundation which has

become a key supporter of our health-related quality

of life initiatives and the “BYB4B Event” in Pakenham,

Ottawa which generously raised money to support

clinical initiatives in the liver transplant program.

We would also like to acknowledge the great

success of the annual GIFT gala which has provided

key funds to support team and patient education.

The high point of the year was an extremely

generous gift from the Minot Foundation which

will support the establishment of the Transplant

Biobank and provide seed funding for exciting

new research projects including the Regenerative

Medicine initiatives. This support will certainly

help take our Centre to new heights.

Our goal for 2009 is to build upon prior successes and

establish partnerships with long-term commitments

that will allow sustainability of our programs as we

move forward. Next year, we will work with the SickKids

Foundation to focus on opportunities to collaborate

with corporate partners and family-centered initiatives.

In the fall of 2009, the establishment of a Fund

Allocation Advisory Committee (with interdisciplinary

membership from across the Centre) will enable

transparency and accountability in the use of

donated funds as we move forward as a team.

dr. anne i dipchand staff cardiologist Heart centre


Partnerships

trillium GiFt oF liFe netWork

frank markel – As the primary paediatric transplant

centre in Ontario, SickKids is committed to working

closely with Trillium Gift of Life Network, Ontario’s

agency with the mandate to plan, promote and

co-ordinate activities relating to the donation of

organ and tissue for transplant. Together we strive

to maximize the number of transplants each year

for paediatric patients in the province and across

North America.

In 2008/09, 65 young lives were saved or enhanced

through heart, lung, liver, pancreas, kidney and small

bowel transplants at SickKids.

The Hospital’s own organ and tissue donation program

is a model of partnership and best practice. Strong

organ and tissue donation champions at SickKids, led

by Dr. Brian Kavanaugh, Staff Physician and Research

Director of Critical Care Medicine, involve the Trillium

Gift of Life Network Organ and Tissue Donation

Co-ordinator in every conversation with families

about organ and tissue donation. SickKids achieved

a six per cent higher conversion rate than the target

conversion benchmark of 53 per cent for Tier 1

hospitals. Donors at SickKids made 35 transplants

possible in or outside of Ontario in 2008/09.

frank markel ceO trillium gift of life network


university oF toronto

trAnsplAntAtion institute

gary levy – As Director of the University of Toronto

Transplantation Institute, I look forward to working

with my colleagues at SickKids and other University of

Toronto partners to advance the academic and clinical

programs in transplantation to the highest level.

SickKids will provide the Institute with unique

expertise in paediatric transplant issues and

paediatric transplantation, stem cell research,

including access to the Ontario induced progenitor

stem cell facility (iPSC), bio-banking and health-

related quality of life measurement.

Working together, the formation of the Transplantation

Institute (EDU-C) at the University of Toronto will

provide unparalleled academic and clinical

opportunities, including the ability to:

• Developnewandinnovativenationaland

international education programs such

as a collaborative graduate program in

Transplantation and Regenerative Medicine

• Advanceresearchbydevelopingmoreeffective

partnerships with members of the basic science

Department of Immunology, Department of

Laboratory Medicine and Pathobiology and

the Institute of Biomaterials and Biomedical

Engineering and Clinical Departments including

Medicine, Surgery and Paediatrics within the

Faculty of Medicine, the Faculties of Nursing

and Pharmacy, the Joint Centre for Bioethics

and fully-affiliated hospitals (UHN, SickKids,

Sunnybrook Health Sciences Centre and

St. Michael’s Hospital) to achieve international

stature as the world’s foremost transplant program.

• Recruitandretainthebrightestandthebest

faculty and students

• Advance,commercializeandtranslatescientific

discoveries through the Industrial BioDevelopment

Lab, MaRS Innovation and our industrial partners

• Increasefundraisingthroughprivatesectorpartnerships

• PartnerwiththeMinistriesofHealthofOntario

and Canada to develop health care policy for

significantly-enhanced delivery of transplantation

services both provincially and nationally

With the funding of the strategic training program

in Regenerative Medicine (2009 to 2015), we will

be able to provide cutting-edge training program

opportunities to undergraduate and graduate students.

Furthermore, we have been invited to submit a

proposal to establish a National Centre of Excellence

Program in Transplantation and Regenerative

Medicine (TransNet) with the University of Toronto

and its partner institutions including SickKids serving

as host institutions. SickKids will lead this initiative

through its expertise in stem cells, biobanking

and paediatric clinical trials design.

In conclusion, the development of the Transplantation

Institute at the University of Toronto will be another

important step in achieving international stature

as the world’s foremost transplant program.

The future in transplantation has never looked

brighter in Toronto and I look forward to working

with all members of the transplant community to

achieve our joint academic and clinical goals.

dr. gary levy, director university of toronto, transplantation institute


Selected Publications

GiFt

Courtney-Martin G, Chapman KP, Moore AM, Kim JH,

Ball RO, Pencharz PB. Total sulphur amino acid

requirement and metabolism in the parenterally fed

human neonate. Am J Clin Nutr. 88: 115-124, 2008.

Diamond IR, Sterescu A, Pencharz PB, Wales PW.

The Rationale for the Use of Parenteral Omega-3

Lipids in Children with Short Bowel Syndrome and

Liver Disease. Pediatric Surgery International.

24 (7): 773-778, 2008

Diamond IR, Wales PW. Advantages of the Distal

Sigmoid Colostomy in the Management of Infants

with Short Bowel Syndrome. Journal of Pediatric

Surgery. 43 (8): 1464-1467, 2008.

Mager DR, Marcon M, Wales PW, Pencharz PB. Use

of N-Acetyl Cysteine for The Treatment of Parenteral

Nutrition (PN) induced Liver Disease in Children on

Home PN. Journal of Pediatric Gastroenterology and

Nutrition. 46 (2): 220-223, 2008.

Sivagnanam M, Mueller JL, Lee H, Chen Z,

Nelson SF, Turner D, Zlotkin SH, Pencharz PB,

et al. Rapid identification of EpCAM as the gene

for congenital tufting enteropathy. Gastroenterology.

135: 429-437, 2008.

heArt trAnsplAntAtion

Anthony SJ, Kaufman M, Drabble A, Seifert-Hanson M,

Dipchand AI, Martin K. Perceptions of Transitional

Care Needs and Experiences in Pediatric Heart

Transplantation. American Journal of Transplantation.

9, 2009.

Auerbach SR, Manlhiot C, Reddy S, Kinnear C,

Richmond ME, Gruber D, McCrindle BW, Deng L,

Chen JM, Addonizio LJ, Chung WK, Mital S.

Recipient genotype is a predictor of allograft cytokine

expression and outcomes after pediatric cardiac

transplantation. Journal of the American College

of Cardiology. 53(20): 1909-1917, 19 May 2009.

Benden C, Dipchand AI, Danzinger-Isakov LA,

Esquivel CO, Ringden O, Wray J, Marks SD. Pediatric

Transplantation: Ten years on (invited editorial).

Pediatric Transplantation, 2008.

BernsteinD, Williams GE, Eisen H, Mital S,Wohlgemuth

JG, Klingler TM, Fang KC, Deng MC, Kobashigawa J.

Gene expression profiling distinguishes a molecular

signature for grade 1B mildacute cellular rejection in

cardiac allograft recipients. The Journal of Heart and

Lung Transplantation. 26(12): 1270-1280, Dec 2007.

Bharat W, Manlhiot C, McCrindle BW, Pollock-BarZiv

SM, Dipchand AI. The profile of renal function

over time in a cohort of paediatric heart

transplant recipients. Pediatric Transplantation.

13: 111-118, 2009.

Davies RR, Russo MJ, Hong KN, O’Byrne ML, Cork DP,

Moskowitz AJ, Gelijns AC, Mital S, Mosca RS,

Chen JM. The use of mechanical circulatory support

as a bridge to transplantation in pediatric patients:

an analysis of the United Network for Organ Sharing

database. The Journal of Thoracic and Cardiovascular

Surgery. 135(2): 421-427, Feb 2008

Davies RR, Russo MJ, Mital S, Martens TM, Sorabella

RS,Hong KN, Gelijns AC, Moskowitz AJ, Quaegebeur

JM, Mosca RS, Chen JM. Predicting survival among

high-risk pediatric cardiac transplant recipients: an

analysis of the United Network for Organ Sharing

database. The Journal of Thoracic and Cardiovascular

Surgery. 135(1): 147-155, Jan 2008.

Dipchand AI, Bharat W, Manlhiot C, Safi M, Lobach NE,

McCrindle BW. A prospective study of dobutamine

stress echocardiography for the assessment of

cardiac allograft vasculopathy in pediatric heart

transplant recipients. Pediatric Transplantation.

12(5): 570-576, 2008.


Pollock-BarZiv SM, Allain-Rooney T, Manlhiot C,

Babu A, Nalli N, McCrindle BW, Dipchand AI.

Continuous infusion of thymoglobulin for induction

therapy in pediatric heart transplant recipients:

experience and outcomes with a novel strategy for

administration. Pediatric Transplantation, 2008.

Pollock-BarZiv SM, McCrindle BW, West LJ,

Dipchand AI. Waiting before birth: outcomes after

fetal listing for heart transplantation. American

Journal of Transplantation. 8: 412-428, 2008.

Roche SL, Kaufman J, Dipchand AI, Kantor PF.

Hypertension after pediatric heart transplantation

is primarily associated with immunosuppressive

regimen. The Journal of Heart and Lung

Transplantation. 27(5):501-507, 2008

Roche SL, O’Sullivan, J, Kantor PF. Hypertension

After Pediatric Cardiac Transplantation: Detection,

Etiology, Implications and Management. Pediatric

Transplantation, 2009. (In Press)

kidney trAnsplAntAtion

Anthony SJ, Hebert D, Todd L, Korus M, Langlois V,

Pool R, Robinson LA, Williams A, Pollock-BarZiv S.

Child and parental perspectives of multidimensional

quality of life outcomes after kidney transplantation.

Pediatric Transplantation (accepted, June 2009)

Barton M, Wasfy S, Melbourne T, Hébert D, Moore D,

Robinson J, Marchese RD, Allen UD. Sustainability of

humoral responses to varicella vaccine in pediatric

transplant recipients following a pretransplantation

immunization strategy. Pediatric Transplantation,

15 Dec 2008. (eEpub ahead of print)

Cochat P, Hébert D. Demographics of Pediatric

Renal Transplantation. In: Comprehensive Pediatric

Nephrology (Geary DG, Schaefer F, eds). Elsevier,

Philadelphia, Pennsylvania. 895-904, 2008.

Dave S, Farhat W, Pace K, Navarro O, Hébert D,

Khoury AE. Effect of donor pneumoperitoneum on

early allograft perfusion following renal transplantation

in pediatric patients: an intraoperative Doppler

ultrasound study. Pediatric Transplantation.

12(5): 522-526, Aug 2008.

Durkan AM, Alexander RT, Liu GY, Rui M, Femia G,

Robinson L. Expression and targeting of CX3CL1

(Fractalkine) in Renal Tubular Epithelial Cells. Journal of

the American Society of Nephrology. 18: 74-83, 2007.

Durkan AM, Robinson L. Acute Allograft Dysfunction.

In: Comprehensive Pediatric Nephrology (Geary DG,

Schaefer F, eds). Elsevier, Philadelphia, Pennsylvania.

931-946, 2008.

Farhat WA, Chen J, Haig J, Antoon R, Litman J,

Sherman C, Derwin K, Yeger H. Porcine bladder

acellular matrix (ACM): protein expression,

mechanical properties. Journal of Biomedical

Materials Research. 3(2):25015, Jun 2008.

Farhat WA, Yeger H. Does mechanical stimulation

have any role in urinary bladder tissue engineering?

World Journal of Urology. (4): 301-305, Aug 2008.

Koshy SM, Guttmann A, Hébert D, Parkes RK, Logan AG.

Incidence and risk factors for cardiovascular events

and death in pediatric renal transplant patients:

A single center long-term outcome study. Pediatric

Transplantation, 9 Dec 2008. [Epub ahead of print]

Koshy SM, Hébert D, Lam K, Stukel TA, Guttmann A.

Renal allograft loss during transition to adult healthcare

services among pediatric renal transplant patients.

Transplantation. 87(11):1733-1736, 15 Jun 2009.

Wallis MC, Yeger H, Cartwright L, Shou Z, Radisic M,

Haig J, Suoub M, Antoon R, Farhat WA. Feasibility

study of a novel urinary bladder bioreactor. Tissue

Engineering Part A. 14(3):339-348, Mar 2008.

Warady B, Secker D (work group co-chairs). National

Kidney Foundation. KDOQI Clinical Practice Guideline for

Nutrition in Children with CKD: 2008 Update. American

Journal of Kidney Diseases. 53:S1-S124, 2009 (suppl 2).


liver & intestine trAnsplAntAtion

Draper H, Diamond IR, Temple M, John P, Ng VL,

Fecteau A. Multimodal management of endangering

hepatic hemangioma - Impact on transplant

avoidance: a descriptive case series. Journal

of Pediatric Surgery. 3(1): 120-126, 2008.

Ling SC, Pfeiffer A, Fecteau A, Grant D, Ng VL.

Long-term follow-up of portal hypertension after liver

transplantation in children. Pediatric Transplantation.

13: 206-209, 2009

Ng VL, Anand R, Martz K, Fecteau A. Liver

retransplantation in children: SPLIT database analysis

of outcome and predictive factors for survival. American


Ng VL, Fecteau A, Shepherd R, Magee J, Bucuvalas J,

Alonso E, McDiarmid S, Cohen G, Anand R. Outcomes

of 5-year survivors after pediatric liver transplantation:

Report from a North American multi-center registry.

Pediatrics. 122: e1128-e1135, 2008.

Ng VL, Otley AR. Understanding quality of life

for children after liver transplantation: a work in

progress. [Invited Editorial]. Liver Transplantation.

14(4): 415-417, 2008.

Noli K, Solomon M, Golding F, Charron M, Ling SC.

The prevalence of hepatopulmonary syndrome in

children. Pediatrics. 121(3): e522-527, 2008.

lunG trAnsplAntAtion

Danziger-Isakov LA, Worley S, Arrigain S, Aurora P,

Ballmann M, Boyer D, Conrad C, Eichler I, Elidemir O,

Goldfarb S, Mallory GB, Michaels MG, Michelson P,

Mogayzel PJ, Parakininkas D, Solomon M, Visner G,

Sweet S, Faro A. Increased mortality after pulmonary

fungal infection within the first year after paediatric

lung transplantation. Journal of Heart and Lung

Transplantation. 27: 655-661, 2008.

Danziger-Isakov LA, Worley S, Michaels MG, Arrigain S,

Aurora P, Ballmann M, Boyer D, Conrad C, Eichler I,

Elidemir O, Goldfarb S, Mallory GB, Mogayzel PJ,

Parakininkas D, Solomon M, Visner G, Sweet S

and Faro A. The risk, prevention & outcome of

cytomegalovirus after paediatric lung transplantation.


Anraku M, Cameron MJ, Waddell TK, Liu M, Arenovich

T, Sato M, Cypel M, Pierre AF, de Perrot M, Kelvin DJ,

Keshavjee S. Impact of human donor lung gene

expression profiles on survival after Lung

Transplantation: A Case-Control Study. American


Sato M, Keshavjee S. Bronchiolitis obliterans syndrome:

alloimmune-dependent and independent injury with

aberrant tissue remodeling. Seminars in Thoracic

and Cardiovascular Surgery. 20: 173-182, 2008.

Cypel M, Yeung JC, Hirayama S, Rubacha M, Fischer S,

Anraku M, Sato M, Harwood S, Pierre A, Waddell TK,

de Perrot M, Liu N, Keshavjee S. Technique for

prolonged normothermic ex vivo lung perfusion.

The Journal of Heart and Lung Transplantation. 27:

1319-1325, 2008.

Christie J, Keshavjee S, Orens J, Arcasoy S, De Perrot

M, Barr M, Van Raemdonock D; ISHLT Working Group

on PGD. Potential refinements of the International

Society for Heart and Lung Transplantation primary

graft dysfunction grading system. The Journal of

Heart and Lung Transplantation. 27: 138, 2008.

Boasquevisque CH, Yildirim E, Waddell TK,

Keshavjee S. Surgical techniques: lung transplant

and lung volume reduction. Proceedings of the

American Thoracic Society. 6: 66-78, 2009.

Ng YL, Paul N, Patsios D, Walsham A, Chung TB,

Keshavjee S, Weisbrod G. Imaging of lung

transplantation: review. American Journal

of Roentgenology. 192: S1-13, 2009.

Fundraising Gala Events:

liam’s light

GiFt

Total Grants to Transplant Centre:

$6,186,718

•GIFT:$1,100,014

•Heart:$280,000

•Kidney:$852,956

•Lung:$2,119,091

• Liver:$1,794,690

• MultipleOrgan: $40,039

Investing in Clinical Care

Access: 6B Opens June 2008

human resources: Recruitment of new faculty and enhancements to allied health

education: Transplantation training

curriculum for

Paediatric Medicine

research: NIH-sponsored multi-centre

clinical trials in GIFT, heart

and liver transplantation

partnerships: Toronto General Hospital

hosted a Transition Day

Major donation from the

Minto Foundation

$1,000,000

Relevant Publications

in 2008/09:

37

Ministry of Health Support:

small Bowel transplantation

incorporated in

the funding model

Innovative Care

in Transplantation:

The First paediatric

novalung® bridging to a

double lung transplant.

Year in Review

A special thank you to Jacquelyn Briggs

and Arlene Zaldivar for their assistance

with the production of this annual report.

Transplant Centre

555 University AvenueToronto, ON, Canada M5G 1X8 Tel: 416-813-2233

For electronic versions of SickKids annual reports, please visit www.sickkids.ca

transplant centre annual report 2008–09 · organ transplantation. ($25,539 2008−09). canadian...

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