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Children’s Hospital of Pittsburgh of UPMC Ranked Highest in the US for Liver Transplant Outcomes

PrintThe Hillman Center for Pediatric Transplantation at Children’s Hospital of Pittsburgh of UPMC is ranked highest in the United States for pediatric liver transplant outcomes, according to January data released from the Scientific Registry of Transplant Recipients (SRTR).

The SRTR, which manages and analyzes a wide range of transplant data as a service to the public, noted several achievements for Children’s in 2017. When comparing hazard ratio estimates, Children’s ranks as No. 1 out of 62 pediatric liver transplant centers in the U.S. in one-year overall patient survival as well as one-year overall graft survival.

Of the 29 centers performing pediatric living-donor liver transplants, Children’s hazard ratio estimates also rank first in one-year patient and graft survival, as well as three-year patient and graft survival. Children’s has performed over 135 living-donor liver transplants since 1997, and more than any pediatric transplant center in the last five years nationally.

The hazard ratio provides an estimate on how the results at Children’s compare with what was expected based on modeling the transplant outcomes from all U.S. programs. Based on the characteristics of patients transplanted at Children’s from July 2013 through December 2015, SRTR hazard ratio results indicate a 59 percent estimated lower risk of patient mortality and a 76 percent estimated lower risk of graft failure when compared to other pediatric liver transplant centers.

“This new data exemplifies the extraordinary talent and skill our surgeons, hepatologists and entire transplant team bring to hopeful patients and families around the world,” said George Mazariegos, MD, chief, pediatric transplantation at Children’s. “Our decades of experience are unparalleled—we have performed more pediatric liver transplants than any other center in the United States while achieving patient survival rates that are consistently among the best.”

Children’s has performed more than 1,700 pediatric liver transplants since the program’s inception in 1981 through December 2016. This includes:
•    70-plus transplants in children and young adults with maple syrup urine disease—more than any other center in the U.S., while achieving 100 percent patient and graft survival.
•    330-plus transplants for children and young adults with metabolic liver disease—more than any other transplant center, including adult facilities.
•    135-plus living-donor liver transplants since 1997. In the last five years of recorded data (2011 to 2016), Children’s has performed more living-donor liver transplants than any other pediatric liver transplant center in the country.
•    18 domino liver transplants—more than any other center in the nation, while achieving 100 percent patient and graft survival.

Children’s also is the first and only pediatric transplant center in the nation to expand the geographic reach of its program through a partnership with the University of Virginia Children’s Hospital in Charlottesville.

For more information about the pediatric liver transplant program at the Hillman Center for Pediatric Transplantation at Children’s, please visit www.chp.edu/livertransplant.

2017 AAP Annual Meeting — Feb. 7-11, Las Vegas, NV

The UPMC Department of Physical Medicine and Rehabilitation will be well represented at the 2017 AAP Annual Meeting in Las Vegas Feb. 7-11.  Several experts from the department will lead discussions and present posters during this five day conference, including a seminar by Gwendolyn Sowa, MD, PhD, Professor and Chair, Department of Physical Medicine and Rehabilitation. Dr. Sowa’s seminar will take place Thursday, Feb. 9, from 12:30 to 5:30 p.m. on the topic of Women  in Academic Physiatry: Pearls in Career Development


Shanti Pinto, MD, brain injury medicine fellow, will receive the Association of Academic Physiatrists‘ Best Paper Award for “Cost-Efficacy Analysis of Routine Venous Doppler Ultrasound for Diagnosis of Deep Venous Thrombosis at Admission to Inpatient Rehabilitation.” The award recognizes and seeks to encourage young researchers, while strengthening all investigation in the field of PM&R.

Joshua Rothenberg, DO, sports medicine fellow, will be awarded the McLean Outstanding Fellow Award from the Association of Academic Physiatrists. The award recognizes an AAP member fellow for outstanding academic performance in academic leadership, teaching and education, and research. Dr. Rothenberg will receive the award during the AAP Annual Meeting in February 2017.

To view a full list of UPMC presentations and presenters, click here and here.


Announcing Our New Co-Director of the Inflammatory Bowel Disease (IBD) Center — Sandra Kim, MD, Children’s Hospital of Pittsburgh of UPMC

PrintSandra Kim, MD, a nationally recognized expert in pediatric and adolescent inflammatory bowel disease, is the co-director of the Inflammatory Bowel Disease (IBD) Center, a part of the Division of Pediatric Gastroenterology, Hepatology, and Nutrition at Children’s Hospital of Pittsburgh of UPMC. Dr. Kim is also Associate Professor of Pediatrics at the University of Pittsburgh School of Medicine. Prior to joining Children’s Hospital, Dr. Kim was co-director of the Center for Pediatric and Adolescent Inflammatory Bowel Disease at Nationwide Children’s Hospital in Columbus, Ohio.

In Pittsburgh, Dr. Kim, along with Sapana Shah, MD, will establish the hospital’s participation in Improved Care Now, a national consortium to improve the care of children with IBD. Dr. Kim’s clinical and research interests focus on pediatric inflammatory bowel diseases, including adolescent transitioning and quality improvement in pediatric IBD and the impact of the gastrointestinal microbiota in IBD. Her research has been funded by the National Institutes of Health and the Crohn’s and Colitis Foundation of America (CCFA). She has authored numerous studies on pediatric and adolescent inflammatory bowel diseases. Dr. Kim currently serves as past chair of Pediatric Affairs and current co – chair of Government Affairs/Advocacy for the CCFA nationally. In addition, she chairs the Clinical Practice and Adolescent Transitioning committees and serves on the Physician Leadership committee and Strategy Council for Improve Care Now. Dr. Kim also is involved as a member of the Medical Advisory Board for Flying Horse Farms and on the board of Directors for the Central Ohio CCFA chapter. As a reflection of her dedication to her profession, Dr. Kim was awarded the 2011 Rosenthal Award for her leadership in patient education and advocacy by the CCFA. She also was the 2015 faculty inductee at the Ohio State University College of Medicine chapters of Gold Humanism Honor Society and Alpha Omega Alpha.

Dr. Kim is a graduate of the University of Michigan’s Inteflex (Integrated Pre-medical/Medical) Program, earning bachelors’ degrees in Biomedical Sciences and Psychology as well as her medical degree. She completed clinical training in General Pediatrics and Pediatric Gastroenterology at Texas Children’s Hospital and the Baylor College of Medicine. She was a recipient of the Outstanding Clinical Fellow Award during her GI fellowship and was on the NIH/NIDDK-funded T32 grant for her research project investigating zinc metabolism in children with IBD. After her clinical training, she pursued additional training as a post-doctoral fellow at the NIH-funded Center for GI Biology and Disease at the University of North Carolina at Chapel Hill.

American Academy of Pediatrics Webinar Series on Zika Virus featuring Amy Houtrow, MD, PhD — Jan. 10, 2017

Recognizing Microcephaly and Other Presentations of Zika Virus Syndrome
Tuesday, Jan. 10, 2 p.m. ET
Registration is required.

Dial-In Information
Phone: 844-216-1726
Conference ID: 18985179
Registration Link: https://cc.readytalk.com/r/viw68r9pls12&eom

Over the past year, congenital Zika virus syndrome has captured the attention of the world because of the devastating effects it can have on infants’ development. In recognition that pediatricians (primary care providers, clinicians, and subspecialists) will require support and guidance, the American Academy of Pediatrics Webinar Series on Zika Virus Syndrome was created. During the first webinar in this series, expert speakers will provide an overview of the neurodevelopmental manifestations of congenital Zika virus syndrome. Experts will also describe how to monitor symptomatic and asymptomatic infants, including how to collaborate with specialists to ensure a continuum of care.

Amy Houtrow, MD, PhD, MPH, FAAP
Dr Houtrow is pediatric rehabilitation medicine physician and health services researcher.  She is an Associate Professor and Vice Chair in the Department of Physical Medicine and Rehabilitation for Pediatric Rehabilitation Medicine at the University of Pittsburgh School of Medicine. She directs the Pediatric Rehabilitation Medicine Fellowship and is the Chief of Pediatric Rehabilitation Medicine Services and the Medical Director of the Rehabilitation Institute at the Children’s Hospital of Pittsburgh. Dr Houtrow’s main clinical focus is caring for children with disabling conditions to help to improve functioning and quality of life to the greatest degree possible. Her research focuses on improving how children with disabilities and their families access health care to optimize health care delivery.

Edwin Trevathan, MD, MPH, FAAP
Dr. Trevathan is a child neurologist, an epidemiologist, and a public health leader, who is internationally known for his expertise in childhood epilepsy, disorders of the developing brain, developmental disabilities, and birth defects. Trevathan is a Professor of Pediatrics and Neurology at Vanderbilt University School of Medicine, and a pediatric neurologist at the Monroe Carell Jr. Children’s Hospital at Vanderbilt. Dr Trevathan has held a number of senior leadership positions in academia and in government. He has served as Executive Vice President and Provost at Baylor University; Dean of the College for Public Health and Social Justice at Saint Louis University; Director of the Division of Pediatric and Developmental Neurology at Washington University in St. Louis, MO; and Director of the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention.

Additional Information
Please email DisasterReady@aap.org with any questions prior to the webinar.



Reducing the Duration of Antibiotics Does More Harm than Good When Treating Ear Infections in Young Children

PrintIn a landmark trial conducted at Children’s Hospital of Pittsburgh of UPMC and the University of Pittsburgh School of Medicine, researchers have demonstrated that when treating children between 6 and 23 months of age with antibiotics for ear infections, a shortened course has worse clinical outcomes without reducing the risk of antibiotic resistance or adverse events.

The results of the trial are published today in the New England Journal of Medicine and highlighted by an accompanying commentary.

Acute otitis media is a bacterial infection of the middle ear behind the ear drum which causes it to become painfully inflamed. Three out of four children experience this infection within their first year. Consequently, it is the most common reason why children are prescribed an antibiotic.

“Given significant concerns regarding overuse of antibiotics and increased antibiotic resistance, we conducted this trial to see if reducing the duration of antibiotic treatment would be equally effective along with decreased antibiotic resistance and fewer adverse reactions,” said Alejandro Hoberman, MD, chief, Division of General Academic Pediatrics at Children’s, and the Jack L. Paradise Endowed Professor of Pediatric Research at Pitt’s School of Medicine.

In the current trial, 520 children with acute otitis media were randomly assigned to either a standard 10-day regimen of the antibiotic amoxicillin-clavulanate or a shortened 5-day treatment followed by five days of placebo. Neither the study participants nor the physicians knew which group the participant was assigned to.

Children were followed starting in October through the rest of the annual respiratory-infection season, and had a final visit during the following September.

They found that the risk of treatment failure in the 5-day group (34 percent) was more than twice as much the risk in the 10-day group (16 percent). The results were significant when considering the trial design which was set up to find out whether the 5-day treatment would be as good as the 10-day regimen, Dr. Hoberman said. Instead, the results clearly showed that not only was their initial assumption proven wrong, but the 10-day treatment was far more effective.

When they tested the presence of antibiotic-resistant bacteria through nasopharyngeal (back of the nose) swabs, there was no decrease in the 5-day group as might have been expected with a shorter duration of antibiotics. Also, reduced-duration antibiotics did not decrease the risk of frequent adverse events like diarrhea or diaper rash.

When testing the risk of a recurrent infection, they found that it was higher when children were exposed to three or more children for 10 or more hours per week, such as in a day care setting, or if the initial infection occurred in both ears as opposed to just one ear.

Importantly, the study also showed for the first time that almost one in two children in whom residual fluid was observed in the middle ear after treatment had a recurring infection, a significantly higher percentage when compared to children without any residual fluid in the middle ear.

The marked superiority of the 10-day regimen over the 5-day regimen led the independent safety monitoring board overseeing the trial to conclude it prematurely as the primary end point was achieved.

“The results of this study clearly show that for treating ear infections in children between 6 and 23 months of age, a 5-day course of antibiotic offers no benefit in terms of adverse events or antibiotic resistance. Though we should be rightly concerned about the emergence of resistance overall for this condition, the benefits of the 10-day regimen greatly outweigh the risks,” said Dr. Hoberman.

The study was supported by a contract (HHSN272201000047C) from the National Institute of Allergy and Infectious Diseases and by University of Pittsburgh Clinical and Translational Science Awards (UL1RR024153 and UL1TR000005) from the National Center for Research Resources, now at the National Center for Advancing Translational Sciences, National Institutes of Health.

Other authors include Jack L. Paradise, MD, Howard E. Rockette, PhD, Diana H. Kearney, RN, CCRC, Sonika Bhatnagar, MD, MPH, Timothy R. Shope, MD, MPH, Judith M. Martin, MD, Marcia Kurs-Lasky, MS, Susan J. Copelli, BS, D. Kathleen Colborn, BS, Stan L. Block, MD, John J. Labella, MD, Thomas G. Lynch, MD, Norman L. Cohen, MD, MaryAnn Haralam, CRNP, Marcia A. Pope, RN, Jennifer P. Nagg, RN, Michael D. Green, MD, MPH, and Nader Shaikh, MD, MPH, all from Children’s Hospital of Pittsburgh of UPMC and the University of Pittsburgh.

Learn more about Shorter Antibiotic Treatment for Otitis Media from The New England Journal of Medicine.

Children’s, Pitt Researchers Explain Cancer Gene Role in Growth of Pediatric Liver Tumors

PrintResearchers at the University of Pittsburgh School of Medicine and Children’s Hospital of Pittsburgh of UPMC have uncovered how a key cancer gene works to accelerate cell growth in a mouse model of pediatric liver tumors. The results provide a better understanding of how inhibition of this gene can be used to combat the disease, and also suggest that doing so may be associated with fewer side effects than originally assumed. The findings were published in the Journal of Biological Chemistry, and selected as one of the journal’s “Papers of the Week.”

The new research focuses on one of cancer’s key genetic players, a gene called Myc.

“Understanding how Myc leads to tumor growth can provide valuable insight we can use to treat the disease, since at least 50 percent of all cancers overexpress Myc in some way,” explained lead study investigator Edward Prochownik, MD, PhD, director of oncology research, Children’s Hospital, and the Paul C. Gaffney Professor of Microbiology and Molecular Genetics at Pitt’s School of Medicine.

Dr. Prochownik’s research concentrates on the role of Myc in liver tumors. His team previously showed that although Myc plays a variety of roles in healthy dividing cells, it is not important for normal liver cell growth and regeneration. In fact, the Myc gene can be completely deleted from normal liver cells without affecting their long-term regenerative potential, as Dr. Prochownik and his colleagues reported in other work earlier this year.

In the current study, researchers studied the gene’s role in a mouse model of hepatoblastoma, a form of liver cancer that occurs in children, typically under the age of 3. Using genetic engineering techniques, the team induced hepatoblastoma tumors in mice that either did or did not have Myc in their liver cells. They found that mice lacking Myc in their liver cells generated tumors more slowly and survived longer than expected.

“Mice lacking liver Myc still developed tumors, but the tumors grew more slowly, suggesting that tumor growth, but not initiation, is dependent on Myc,” explained Dr. Prochownik.

Subsequent experiments showed that Myc promotes tumor growth by turning up the cell’s thermostat, raising its rate of metabolism so it can supply all of the metabolic building blocks and energy needed for rapid tumor growth. Prochownik and his colleagues believe that the different needs for Myc in normal versus tumor growth may be due to the fact that, in the latter case, this “metabolic thermostat” is turned up higher and therefore is more Myc-dependent. The more controlled conditions that exist with normal liver regeneration are therefore much less Myc-dependent.

Given that Myc plays such an important role in many cancers, a drug that inhibits it is an attractive therapeutic, explained Dr. Prochownik. However, because Myc is expressed in normal cells as well as cancerous ones, there have been concerns in the field that inhibiting the gene would produce too many detrimental side effects.

“Our research strongly suggests that this is not the case. Normal cells are not dependent on Myc the way that tumor cells are, so a Myc inhibitor could selectively target cancer cells while sparing healthy cells,” he added.

Over the past several years the team has developed several Myc inhibitors and they are now working to improve the drugs’ efficacy in cell culture and animal models of cancer. So far, they are proving to be effective in models of multiple myeloma and neuroblastoma, Dr. Prochownik said.

“Although they are not quite ready to give to patients yet, these compounds are a very exciting approach to treating a variety of cancers,” he added.

This research was supported by National Institutes of Health grants 5RO1 CA174713, 1R01 CA204586, and 1R01 DK100287.

Additional co-authors of the new paper include Huabo Wang, PhD, Jie Lu, BS, Lia R. Edmunds, PhD, Sucheta Kulkarni, PhD, James Dolezal, BA, Junyan Tao, PhD, Sarangarajan Ranganathan, MD, Laura Jackson, MD, Marc Fromherz, BA, Donna Beer Stolz, PhD, Radha Uppala, BS, Sivakama Bharathi, PhD, Satdarshan P. Monga, MD, and Eric S. Goetzman, PhD, all of the University of Pittsburgh.

2017 Society of Robotic Surgery Meeting

Call for abstracts and registration are Now Open for the 2017 Society of Robotic Surgery Meeting. This year’s meeting is being held at The Hilton Miami Downtown from February 24-26, 2017.

The SRS 2017 Annual Meeting will be a comprehensive robotic symposium featuring internationally-renowned faculty who are dedicated experts in their fields of study. The meeting will feature step-by-step techniques with in-depth commentary by the world’s leading robotic surgeons. This meeting is for everyone from surgeons new to robotic surgery, to first assists, as well as advanced robotic surgeons who want to improve their techniques.

The conference features presentations by leading experts in robotic surgery and will include specialty breakout sessions for:
o    Colorectal
o    ENT
o    General Surgery
o    Gynecology
o    Hernia & Single Site
o    Pediatric
o    Thoracic & Cardiac
o    Urology

See the latest advancements in robotic surgery with video sessions that are panel-narrated by leading faculty in the field with detailed procedural overviews. In addition, attendees of this three-day program will learn the latest advances in robotic surgery and have the opportunity to register for hands-on simulation courses.

This year’s Co-Chairs for the meeting are Dr. Uma Duvvuri-Assistant Professor, Director of Robotic Surgery, Department of Otolaryngology University of Pittsburgh School of Medicine and Dr. Jason Newman-Associate Professor Otorhinolaryngology- Head and Neck Surgery Center for Cranial Base Surgery University of Pennsylvania.

Uma Duvvuri, MD, PhD

Uma Duvvuri, MD, PhD


2017 Conference Highlights:
•    Tips & tricks in robotic urology
•    Up-to-date scientific data on oncological and functional outcomes
•    Hands-on training
•    What is new in robotics?
•    What is the advantage of the da Vinci Xi in urological practice?
•    Weekend of the Miami Food Festival

For Further registration information and to submit an abstract, go to www.srobotics.org.

Grant Awarded for National Biorepository for GUDMAP Biobank

Sunder Sims-Lucas, PhD, and Jacqueline Ho, MD, are co-investigators on a $600,000 per year grant for 5 years from the National Institutes of Health to be the national biorepository for the GenitoUrinary Development Molecular Anatomy Project (GUDMAP).











GUDMAP is an international consortium working to generate gene expression data and transgenic mice as tools to study genitourinary development. This curated, high-resolution dataset serves as a powerful resource for biologists, clinicians and bioinformaticians interested in the developing urogenital system.

GUDMAP data is accessible at www.gudmap.org.

Hospitalized Patients at Risk if Sodium Levels are Low

Michael Moritz, MD, explains how hospitalized patients could be at risk of weak bones, and increased infections if physicians ignore low-sodium in the body, known as hyponatremia.

Dr. Moritz is clinical director, Division of Pediatric Nephrology at Children’s Hospital of UPMC and as Professor of Pediatrics at the University of Pittsburgh School of Medicine. Dr. Moritz is an authority on sodium and water metabolism in children.

Hospitalized patients at risk if sodium levels are low – Frontiers Science Hero from Frontiers on Vimeo.

Growing Kidneys in Lymph Nodes

Carl Bates, MD, and Sunder Sims-Lucas, PhD, of the Division of Pediatric Nephrology at Children’s Hospital of Pittsburgh of UPMC, in collaboration with Eric Lagasse, PhD, of the University of Pittsburgh McGowan Institute for Regenerative Medicine, are developing a novel approach to regenerate kidney tissues.

The group has discovered that embryonic kidney fragments and isolated nephron progenitors have the potential to form perfused kidney structures when injected into mouse lymph nodes. The Bates, Sims-Lucas, and Lagasse laboratories have received a Pediatric Device Initiative Award sponsored by the Commonwealth of Pennsylvania in support of their work.


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