sutures newsletter

PRODUCED BY AND FOR MEMBERS OF THE DEPARTMENT OF SURGERY August 2016 | Archived Issues

Pharmacy and Therapeutics Committee Approvals

Pharmacy Focus

Highlights of the June meeting of the Pharmacy and Therapeutics Committee are summarized in the PDF link below.

P and T Approvals - June 2016 (PDF)


Mark Your Calendar


Surgery Grand Rounds

Click the "read more" to see information about upcoming Surgery Grand Rounds.


Grand Rounds

Click here to view a schedule of all upcoming grand rounds.


Education Schedule

Click the PDF links below to see the Department of Surgery's education schedule.

Education Schedule - August 2016 (PDF)

Education Schedule - September 2016 (PDF)  


Surgery Scheduling

Click the "read more" for hours and contact information for surgery scheduling.

Share Your News

Know an interesting colleague we should profile? A story we should tell? Submit your ideas, meetings and events for consideration.

Click here to submit your news to Sutures

Liver Transplant Program Sets New Marks

By Nicholas Nissen, MD

The Liver Transplant Program continues to break new ground with both its clinical volume and outcomes. The program performed 66 liver transplants in 2015-16, its highest volume ever and an increase of 44 transplants from 2014-15. In addition, patient and graft survival, which are the two benchmarks most commonly reported in transplant programs, both exceeded 90 percent.

As with all other solid organs, liver transplantation volume is driven primarily through a waitlist process. Unlike kidney transplant allocation, in which organ allocation depends on how long a patient is on the waitlist and how closely the donor organ and the recipient match, the liver transplant waitlist is driven primarily through severity of illness.

The MELD score, which is a mathematical formula taking into account bilirubin, INR and creatinine, is used to rank patients on the liver transplant waitlist. As such, sicker patients (those with a higher MELD score) are higher on the waitlist and are more likely to undergo transplantation. The increase in transplant volume seen recently is in part due to collaborative measures between the transplant team, the surgical intensive care unit team and the transfer center aimed at facilitating transfer and optimizing care of the critically ill liver patients.

The challenges presented by these patients have also led to research opportunities for the transplant group. Alagappan Annamalai, MD, has published research on mechanism of ascites formation in sick patients, and on predictors of outcome in intensive care unit transplant patients. Irene Kim, MD, is studying mechanisms of immunosuppression and the unique aspects of immunosuppression in critically ill liver patients. The newest member of the liver transplant surgical faculty, Tsuyoshi Todo, is working jointly with hepatology faculty in defining factors leading to fatty liver disease and redefining the MELD-exception system.

The last two years have been witness to incredible advances in the field of liver transplant and hepatobiliary surgery. Hepatitis C, formerly almost impossible to treat and the leading cause of graft loss after transplantation, has been nearly eradicated with a new generation of new medications. Fatty liver disease is now recognized as the leading cause of cirrhosis and will be the etiology for liver transplantation in the decades to come. New treatments for hepatocellular cancer have led to increased access for liver transplant for these patients and increased ability to control disease at all stages, even in those who recur after transplant.

For more information on the liver transplant or hepatobiliary surgery, please contact the surgical director, Nicholas Nissen, MD, at nicholas.nissen@cshs.org.