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PRODUCED BY AND FOR MEMBERS OF THE DEPARTMENT OF SURGERY August 2013 | Archived Issues

Cedars-Sinai's First Paired Kidney Exchange: Another Instrument in Transplanting the Untransplantable

In a way, KM was a typical kidney transplant patient at Cedars-Sinai. He had three previous kidney transplants, all of which had failed, and as a result his immune system was highly sensitized to organs from other people. One glimmer of hope emerged as he languished on the deceased-donor waiting list.

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Blaha Promoted to Service Line Director

Jennifer Blaha, MBA, has been promoted to service line director for the Department of Surgery. She will oversee the administrative operations supporting the clinical and academic missions of the Department of Surgery.



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Cedars-Sinai Physicians Team Up for Editorial in Surgical Endoscopy

Several Cedars-Sinai surgeons collaborated on an editorial that has been published in the journal Surgical Endoscopy. "Laparoscopic Cholecystectomy: First, Do No Harm; Second, Take Care of Bile Duct Stones" was published online in January.

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Work Hard / Play Harder

Some succinct advice from Randy Sherman, MD, vice chair of the Department of Surgery.

 

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The Face Transplant: Modern Marvel of Medicine or Past Procedure ... Perfected?

Robert Lee Norris accidently shot himself at age 17. Charla Nash was mauled by a chimpanzee. Both suffered horrific facial injuries. And both were successful recipients of facial transplants. The stories of Norris and Nash are included in a display in the Medical Library that traces the progression of the face transplant from a simple procedure performed in ancient India to the complicated 36-hour procedure we know today.

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Medical Library Adds The Journal of Visualized Experiments

Cedars-Sinai Medical Library recently added The Journal of Visualized Experiments (JoVE) to its collection. JoVE is a peer-reviewed, PubMed-indexed journal that publishes biological, medical, chemical and physical research in video form.

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Circle of Friends Honorees for July

The Circle of Friends program honored 105 people in July. Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai. When a gift is made, the person being honored receives a custom lapel pin and a letter of acknowledgement.

» Read more

Marking the High Holidays at Cedars-Sinai

Senior Rabbi Jason Weiner, manager of Spiritual Care, will conduct services for the High Holidays at Cedars-Sinai. Services also will feature Cantor Jordan Gorfinkel.

» Read more

Cedars-Sinai's First Paired Kidney Exchange: Another Instrument in Transplanting the Untransplantable

In a way, KM was a typical kidney transplant patient at Cedars-Sinai. He had three previous kidney transplants, all of which had failed, and as a result his immune system was highly sensitized to organs from other people.

One glimmer of hope emerged as he languished on the deceased-donor waiting list. The patient had a willing and healthy living donor. However, despite undergoing intensive desensitization treatments, KM remained persistently sensitized to his potential donor, effectively eliminating the option of receiving a kidney from this individual.

"Incompatibility" can be as simple as incompatible blood typing with a donor (i.e., blood type O recipient with a blood type A donor), but for many of the patients at Cedars-Sinai, immunological incompatibility with elevated sensitization to HLA antigens, remains the largest obstacle to transplantation.

It is estimated that nearly 30 percent of patients on the kidney transplant waiting list are highly sensitized like KM. The desensitization protocol developed at Cedars-Sinai has enabled many of these patients to be transplanted successfully. Paired kidney exchange (PKE) is a strategy that has evolved in the U.S. over the past 10 years and generates compatible donor/recipient matches by exchanging or "swapping" organs between donor and recipient pairs that would otherwise be immunologically incompatible.

On June 14, Cedars-Sinai participated in its first successful paired kidney exchange, enabling the successful transplantation of two highly sensitized recipients. KM was found to be compatible with an altruistic living donor. Under PKE, KM's donor would then be available to provide a kidney to a second transplant recipient, who although also highly sensitized was compatible with KM's donor.

Under the guidance of Stanley Jordan, MD, and other members of the Transplant Nephrology team, the two highly sensitized recipients underwent desensitization treatment prior to the exchange, readying them for transplant. After many weeks of coordination, planning, and participation from members of the Cedars-Sinai nursing and operating room staff, four simultaneous operating rooms — two donor rooms and two recipient rooms — enabled the safe exchange of two living-donor kidney transplants.

Gerhard Fuchs, MD, and Christopher Ng, MD, performed the living-donor nephrectomy operations, and J. Louis Cohen, MD, and Donald Dafoe, MD, served as the implanting surgeons. The exchange occurred uneventfully and smoothly. The first words uttered from KM in recovery were barely audible, but clear. "How is my donor?" he asked the transplant staff, as the nurses hastened to replenish his IV fluid intake, trying to keep up with his torrential urine output.

Several months after the transplant, both donors and recipients are doing well.

Ellen Shukhman, RN, Kristen Cisneros, RN, the living-donor coordinators who planned much of the efforts in this first paired exchange, and Irene Kim, MD, the director of the Paired Exchange Program, are busy strategizing the next PKE.

Cedars-Sinai is a participant in the National Kidney Registry, the largest kidney exchange network in the United States, and the team is eager to coordinate the next PKE. After all, the Cedars-Sinai kidney transplant team is dedicated to any strategy that enables the gift of life.

Blaha Promoted to Service Line Director

Jennifer Blaha, MBA, has been promoted to service line director for the Department of Surgery.

She will oversee the administrative operations supporting the clinical and academic missions of the Department of Surgery. Her responsibilities will encompass directing and supporting quality, service and performance improvement activities in all areas of the department and across the medical center.

Blaha has been a part of the Cedars-Sinai team for six years, having served in Performance Improvement, Research, Surgery and Interventional Services. She has a record of improving clinical quality, patient satisfaction and operational efficiency with strategies that supported both safety and financial objectives.

Before joining Cedars-Sinai, Blaha worked for General Electric, where she held management roles in both Finance and Operations. She also spent two years as a management consultant for GE, implementing strategic and operational improvements in medical centers around the country, including Cedars-Sinai.

The announcement — from Bryan Croft, vice president of Service Line Operations, and Bruce L. Gewertz, MD, chair of the Department of Surgery and surgeon in chief — comes after an exhaustive search of strong internal and external applicants by members of the academic faculty, administrators, directors and managers.

Cedars-Sinai Physicians Team Up for Editorial in Surgical Endoscopy

Several Cedars-Sinai surgeons collaborated on an editorial that has been published in the journal Surgical Endoscopy. "Laparoscopic Cholecystectomy: First, Do No Harm; Second, Take Care of Bile Duct Stones" was published online in January.

Cedars-Sinai surgeons listed among the 18 authors are George Berci, MD, the late Leon Morgenstern, MD, Brendan Carroll, MD, David Fermelia, MD, Edward Phillips, MD, and Harry Sax, MD.

Berci, who is listed first, calls the editorial "a very important paper to draw attention to the increased incidence of ductal injuries after laparoscopic cholecystectomy and the need for well-trained surgeons to remove ductal stones in the first operative session."

Work Hard / Play Harder

Randy Sherman, MD, surgeon and pilot

Some succinct advice from Randy Sherman, MD, vice chair of the Department of Surgery:

"Work hard / play harder."

The Face Transplant: Modern Marvel of Medicine or Past Procedure ... Perfected?

Nick Auricchio, a summer intern from UCLA, put together the Medical Library's display on face transplants.

Robert Lee Norris accidently shot himself at age 17. Charla Nash was mauled by a chimpanzee. Both suffered horrific facial injuries. And both were successful recipients of facial transplants.

The stories of Norris and Nash are included in a display in the Medical Library that traces the progression of the face transplant from a simple procedure performed in ancient India to the complicated 36-hour procedure we know today.

Although successful organ transplants have been carried out since 1950, facial transplantation wasn't even considered to be a feasible procedure until 2002; and the first full facial transplant wasn't performed until 2010. Yet, the idea of using living facial tissue for reconstructive purposes has been around for centuries.

In 1815, Joseph Constantine Carpue, inspired by reconstructive procedures from the 15th century and ancient Indian surgical techniques, was able to rebuild the noses of two British men by using skin from their foreheads — the first published account of a reconstructive procedure. As knowledge within the medical field continued to expand, such procedures, coupled with modern medicine, made it possible for doctors to complete partial and full facial transplants.

The library display, courtesy of Nick Auricchio, a summer intern from the UCLA Department of Information Studies, features text, a copy of Carpue's revolutionary publication, 19th-century surgical instruments, and illustrations of current and past procedures.

The display is on view in the Medical Library in Room 2815 on the South Tower's Plaza Level between 8 a.m. and 8 p.m., Monday-Friday, through Sept. 30.

Medical Library Adds The Journal of Visualized Experiments

JoVECedars-Sinai Medical Library recently added The Journal of Visualized Experiments (JoVE) to its collection. JoVE is a peer-reviewed, PubMed-indexed journal that publishes biological, medical, chemical and physical research in video form.

By taking advantage of recent advances in video-sharing technology, JoVE is able to effectively capture and transmit the multiple intricacies that characterize life-science research. The library currently subscribes to the General section.

JoVE represents a new movement in scientific publishing. By using the video format to publish research, JoVE is creating a new parameter for the communication of experimental data and scientific research results within the field. JoVE also provides users access to a PDF article that accompanies many of the videos.

Search The Journal of Visualized Experiments or JOVE in the library's A-Z list of electronic journals on its main Intranet page.

Circle of Friends Honorees for July

The Circle of Friends program honored 105 people in July.

Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai. When a gift is made, the person being honored receives a custom lapel pin and a letter of acknowledgement.

Click here for more information about the program and for a list of past honorees.

  • Daniel C. Allison, MD
  • Farin Amersi, MD
  • Parvaneh Bahmani, MD
  • Jason A. Berkley, DO
  • Selvyn B. Bleifer, MD
  • Mathew H. Bui, MD
  • Miguel A. Burch, MD
  • Ilana Cass, MD
  • Michael L. Chaikin, MD
  • Christopher Chang, MD, PhD
  • Alice P. Chung, MD
  • J. Louis Cohen, MD
  • Stephen R. Corday, MD
  • Bryan Croft
  • Catherine M. Dang, MD
  • Mark M. Davidson, MD
  • Arnelyn D. De Las Armas, RN
  • Lorna R. Dean
  • Doniel Drazin, MD
  • Noam Z. Drazin, MD
  • J. Kevin Drury, MD
  • Marla C. Dubinsky, MD
  • Brian G. Durie, MD
  • Joshua D. Ellenhorn, MD
  • Karen Fabac, RN, MSN/ED, ONC
  • Charles A. Forscher, MD
  • Stuart Friedman, MD
  • Philip K. Frykman, MD, PhD
  • Gerhard J. Fuchs, MD
  • Ivor L. Geft, MD
  • Ilya Gelman, MD
  • Armando E. Giuliano, MD
  • Judy R. Glover, RN
  • Theodore B. Goldstein, MD
  • Martin N. Gordon, MD
  • Richard E. Gould, MD
  • Paul J. Grodan, MD
  • Scout Hebinck, RN, MSN
  • Andrew E. Hendifar, MD
  • Kristie A. Hier, RN
  • Antoinette Hubenette, MD
  • Robin R. Hudson, RN, CPAN
  • Leonel A. Hunt, MD
  • Griselda Islas, RN
  • William T. Jacobs
  • J. Patrick Johnson, MD
  • Stanley C. Jordan, MD
  • Peter Julien, MD
  • Saibal Kar, MD
  • Sousan Karimi, MD
  • Beth Y. Karlan, MD
  • David Kattan, MD
  • David Kawashiri, MD
  • Ali Khoynezhad, MD, PhD
  • Angela Khurdajian
  • Keith J. Kimble, MD
  • Michelle M. Kittleson, MD, PhD
  • Ellen B. Klapper, MD
  • Dee Dee L. Klute-Evans, RN, MSN, CIC
  • Jon A. Kobashigawa, MD
  • Jodi Ladge, PA-C
  • Mykel V. LeCheminant, RN, BSN
  • Madeline S. Lerman, RN, BSN
  • Ronald S. Leuchter, MD
  • Michael S. Levine, MD
  • Andrew J. Li, MD
  • Yong-Jian Lin, MD
  • Jessi L. Lopez
  • Rajendra Makkar, MD
  • Adam N. Mamelak, MD
  • Roxanne A. Masserat, RN, BSN, PHN
  • Jaci M. Mastrandrea, RN, BSN
  • David N. Matsumura, MD
  • Robert J. McKenna, Jr., MD
  • Gil Y. Melmed, MD, MS
  • Ronald B. Natale, MD
  • Nicholas N. Nissen, MD
  • Guy D. Paiement, MD
  • Sunny L. Peltier, RN
  • Edwin M. Posadas, MD
  • Alexandre Rasouli, MD
  • Kenneth E. Robison
  • Barry E. Rosenbloom, MD
  • Regina Rozenblat, RN
  • Tracy Salseth, ACNP-BC
  • Ashley M. Samaniego, RN
  • Howard M. Sandler, MD, MS
  • Prediman K. Shah, MD
  • Allan W. Silberman, MD, PhD
  • Steven M. Simons, MD
  • Shirley Sinclair
  • Melinda Sobel
  • Daniel J. Stone, MD, MPH, MBA
  • Alfredo Trento, MD
  • Richard Tuli, MD, PhD
  • Rafael Villicana, MD
  • Anna Volkov, RN
  • Daniel J. Wallace, MD
  • Elizabeth Whiting, RN, MSN
  • Logan M. Williams
  • Janet H. Wulf
  • Payam R. Yashar, MD
  • Amara Yob, RN, BSN, OCN
  • Rachel Zabner, MD
  • Christopher Zarembinski, MD

Marking the High Holidays at Cedars-Sinai

Senior Rabbi Jason Weiner, manager of Spiritual Care, will conduct services for the High Holidays at Cedars-Sinai. Services also will feature Cantor Jordan Gorfinkel.

  • Rosh Hashanah
    Sept. 5 at 10 a.m. in Harvey Morse Auditorium
  • Kol Nidre
    Sept. 13 at 7 p.m. in Harvey Morse Auditorium
  • Yom Kippur
    Sept. 14 at 10 a.m. in Harvey Morse Auditorium

Services will be available for viewing on channel 50 via the inpatient TV system. Rosh Hashanah services will be rebroadcast Sept. 6 at 10 a.m.

Jewish High Holidays Services - September (PDF)