Gladwin, Kaminski, Student Research Receive Honors at International Pulmonology Conference
Gladwin, Kaminski Awards
Honor for Pitt Student’s Research
UPMC Physician Resources
UPMC Physician Resources
PITTSBURGH, March 13, 2013 – UPMC surgeons have performed a “breathing lung” transplant using a portable machine that provides a constant supply of blood and nutrients to the donor organs, which doctors say has the potential to keep them healthier and viable for longer than ever before.
The double-lung transplant was performed March 4 at UPMC Presbyterian, using the Organ Care System, also known as the OCS lung, by TransMedics Inc. This is the first time the device has been used on the East Coast. The patient, a 53-year-old man from Moundsville, W.Va., had suffered from pulmonary fibrosis and pulmonary hypertension. He was in good condition Wednesday.
Traditionally, donor lungs are cooled and put on ice with no blood circulation, a process that essentially puts them to sleep. Once removed from a blood supply, though, the lungs can deteriorate rapidly, which can lead to complications for the recipient or, in some cases, the determination that the organs are no longer viable. Using the OCS device, the lungs are immediately placed in the machine after donation, where they are kept at body temperature and functioning while in transit to the recipient.
“Unfortunately, many people waiting for an organ transplant die because usable donor organs aren’t available. Using this method, we believe we can help more people and save lives,” said Christian Bermudez, M.D., UPMC’s chief of cardiothoracic transplantation who performed the transplant surgery and principal investigator of a study involving the OCS lung.
UPMC Surgeons hope to enroll 10 patients in the clinical trial, which will randomize five participants to get the OCS device and five to be treated using the traditional method of care. The goal is to assess whether perfusing the lungs in the machine will decrease the chances of early dysfunction of the transplanted organ, thus resulting in better long-term function for the recipient.
“This is an exciting technology breakthrough that has the potential to increase the organ donor pool and improve outcomes for those receiving these specially perfused lungs,” said James Luketich, M.D., chair of the Department of Cardiothoracic Surgery.
The OCS lung machine resembles a small cart on wheels. It can monitor the organ’s arterial pressure, gas exchange ratio, vascular resistance and other data through embedded sensors so doctors can get an immediate snapshot of the organ’s viability.
UPMC has a long history of innovation in transplantation, and surgeons have performed more than 3,000 heart and lung transplants. In 2007, UPMC surgeons were the first in the U.S. to perform a transplant in which a donor heart was maintained in a beating state for two hours and 45 minutes before being implanted into its recipient. That transplant used a similar perfusion machine developed for heart transplantation by TransMedics Inc.
A video with footage from the surgery and an interview with Dr. Bermudez will be available later today on YouTube and on the Inside Life Changing Medicine blog.
About UPMC’s transplant programs
UPMC’s transplant programs are among the world’s largest and are internationally renowned for their influence on the field of transplantation. For more than 30 years, UPMC has been providing care to adult and pediatric transplant patients through services at the Thomas E. Starzl Transplantation Institute, the UPMC Department of Cardiothoracic Surgery and the Children’s Hillman Center for Pediatric Transplantation. Today, UPMC has performed more than 17,000 transplants, including heart, lung, intestinal, kidney, liver, pancreas and multiple-organ transplants, along with heart assist device implantation. UPMC also partners with the University of Pittsburgh to advance basic science and clinically applied research, as well as to support the teaching and training of transplant specialists worldwide.
The 2012 conference will focus on Acute Lung Injury: New Mechanisms, Future Therapies, and the Translation to Clinical Care and will be held in Pittsburgh, Pennsylvania, October 5-6, 2012.
This exciting conference aims to provide a forum for the exchange of new and cutting-edge information about ARDS by bringing together leading regional, national, and international experts in the field.
View six presentations from the 2011 conference.
WHO SHOULD ATTEND
The target audience for this conference is critical care and pulmonary physicians, doctors in general medical fields, and allied health professionals (e.g., nurses, nurse practitioners, respiratory therapists). Because of the emphasis on clinical and scientific investigation, the seminars also will target basic, translational, and clinical investigators with interests in ARDS, pneumonia, and sepsis research, as well as biomedical researchers from around the United States, internationally, and within industry.
Mark T. Gladwin, MD
Division Chief, Pulmonary, Allergy, and Critical Care Medicine
Director, Vascular Medical Center
Rama K. Mallampalli, MD
Professor of Medicine, Cell Biology, and Physiology
Director, Acute Lung Injury Center of Excellence
Chief, Pulmonary Division of VA Pittsburgh Healthcare System
Click here to hear about the conference from the 2012 course directors.
CONTINUING MEDICAL EDUCATION
The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The University of Pittsburgh School of Medicine designates this live activity for a maximum of 14.0 AMA PRA Category 1 Credit(s)™. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded 1.4 continuing education units (CEU’s) which are equal to 14.0 contact hours.
Five to 10 percent of patients with asthma have disease that can be classified as severe, meaning it is difficult to treat and often causes life-threatening breathing problems, said lead author Sally E. Wenzel, M.D., professor, Division of Pulmonary, Allergy and Critical Care Medicine, Pitt School of Medicine, and director of the University of Pittsburgh Asthma Institute at UPMC and the University of Pittsburgh School of Medicine. Typically these patients are treated with the aim of reducing lung inflammation, but treatment often leads to devastating consequences due to steroid side effects.
For the study, the team examined a group of patients with severe asthma who were being treated at the Difficult Asthma Clinic at the UPMC Comprehensive Lung Center during a four-year period. Each of the patients met with a certified asthma educator; were taking high doses of inhaled steroids, with or without ingested steroids; and had been monitored for three to 24 months to optimize therapy.
PITTSBURGH – UPMC rose to 10th place in U.S. News & World Report’s annual Honor Roll of America’s Best Hospitals – making it the highest-ranked medical center in Pennsylvania. U.S. News & World Report ranked UPMC first in the state and first in Pittsburgh.
“This national recognition is a testament to the skill and dedication of our physicians, nurses and staff and to the superb care they provide every day at UPMC. Our patients and our community have come to expect this level of excellence and we are committed to assuring we deliver. Our proudest achievements come when we make a difference in the lives and health of our patients,” said Elizabeth Concordia, executive vice president of UPMC and president of the Hospital and Community Services Division. “When patients require care, the choice is clear; the nation’s best care is here at UPMC.”
Nationally, UPMC is ranked for excellence in 15 adult specialty areas and is among the top 10 in nine specialty areas: Ear, Nose & Throat; Gastroenterology; Geriatrics; Gynecology; Nephrology; Neurology and Neurosurgery; Orthopaedics; Psychiatry and Pulmonology.
Last month, U.S. News named its 2012 Honor Roll of America’s Best Children’s Hospitals, on which Children’s Hospital of Pittsburgh of UPMC ranked ninth. This year marks UPMC’s 13th appearance on the Honor Roll. Last year, the list placed UPMC 12th nationally.
“A stellar ranking such as this validates what we know to be true – that UPMC is one of the very few academic medical centers in the nation that brings together the best in patient care, top-notch facilities and superior scientists,” added Steven Shapiro, M.D., senior vice president and chief medical and scientific officer, UPMC. “The exceptional clinical services that UPMC provides, fortified by Pitt’s academic research, work hand-in-hand to help us care for patients when they need us.”
UPMC is a $10 billion global health enterprise with more than 55,000 employees headquartered in Pittsburgh, Pa., and is transforming health care by integrating more than 20 hospitals, 400 doctors’ offices and outpatient sites, a health insurance services division, and international and commercial services. Affiliated with the University of Pittsburgh Schools of the Health Sciences, UPMC is redefining health care by using innovative science, technology and medicine to invent new models of accountable, cost-efficient and patient-centered care. For more information on how UPMC is taking medicine from where it is to where it needs to be, go to UPMC.com.
PITTSBURGH, May 30 – Researchers at the University of Pittsburgh School of Medicine have identified an agent that in lab tests protected the skin and lungs from fibrosis, a process that can ultimately end in organ failure and even death because the damaged tissue becomes scarred and can no longer function properly. The findings were published today in Science Translational Medicine.
There are no effective therapies for life-threatening illnesses such as idiopathic pulmonary fibrosis and systemic sclerosis, which cause progressive organ scarring and failure, said senior author Carol A. Feghali-Bostwick, Ph.D., associate professor, Division of Pulmonary, Allergy and Critical Care Medicine, and co-Director of the Scleroderma Center, Pitt School of Medicine.
“It’s estimated that tissue fibrosis contributes to 45 percent of all deaths in developed countries because organ failure is the final common pathway for numerous diseases,” she said. “Identifying a way to stop this process from happening could have enormous impact on mortality and quality of life.”
The research team evaluated E4, a piece of protein or peptide derived from endostatin, a component of collagen known for its inhibition of new blood vessel growth. In lab tests, healthy human skin cells that were treated to become fibrotic remained normal when E4 was present. The skin and lungs of mice were protected from cell death and tissue scarring by a single injection of E4 administered five or eight days after they were given the cancer drug bleomycin, which is known to induce fibrosis. The peptide also could reverse scarring that had already occurred, the researchers found.
In a unique approach, the investigators also tested E4 in human skin maintained in the laboratory to confirm it would be effective in treating fibrosis in a human tissue. E4 blocked new and ongoing fibrosis in human skin.
The agent might work by stalling the cross-linking of collagen needed to form thick scars, Dr. Feghali-Bostwick said. While the body naturally produces endostatin, it appears that it cannot make sufficient amounts to counteract fibrosis development in some diseases.
“This endostatin peptide passes two important hurdles that suggest it is a promising candidate drug for development for patients with idiopathic pulmonary fibrosis and systemic sclerosis” said Mark T. Gladwin, M.D., chief, Division of Pulmonary, Allergy and Critical Care Medicine at UPMC and Pitt. “It reverses established disease in animal models and it reverses fibrosis in the human skin fibrosis model.”
In a case of serendipity, the researchers discovered E4 while exploring the process of fibrosis. Post-doctoral fellow and study co-author Yukie Yamaguchi, M.D., Ph.D., was conducting some experiments with proteins thought to facilitate the scarring process.
“Dr. Yamaguchi showed me the tests that showed endostatin wasn’t working to increase fibrosis, but in fact shut it down,” Dr. Feghali-Bostwick said. “It was the opposite of what we expected and I was very excited about our finding. As Louis Pasteur once said, ‘chance favors the prepared mind.’”
Other co-authors include Takahisa Takihara, M.D., Roger A. Chambers, B.S., and Kristen L. Veraldi, M.D., Ph.D., of the Division of Pulmonary, Allergy and Critical Care Medicine, the Department of Pathology, and the Scleroderma Center, Pitt School of Medicine; and Adriana T. Larregina, M.D., Ph.D., of the Departments of Dermatology and Immunology, Pitt School of Medicine, and the McGowan Institute for Regenerative Medicine.
The project was funded by National Institutes of Health grant AR050840.
On May 4 and 5, 2012, join the lively discussion at the Surgical Pathology of Organ Transplantation Conference in Pittsburgh, Pa.
Organ procurement and the care of the transplanted patient occurs all over the world, in facilities large and small, academic and rural. The body of knowledge is growing exponentially. This event is designed for:
You can view the conference brochure and agenda here.
The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The University of Pittsburgh designates this live activity for a maximum of 11.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Other health care professionals are awarded 1.1 continuing education units (CEU’s) which are equal to 11.25 contact hours.