UPMC Physician Resources

Pitt Researchers Receive $1.25 Million from Defense Department to Make Whole-Eye Transplantation a Reality

PITTSBURGH, Oct. 7, 2014 University of Pittsburgh School of Medicine researchers have been awarded $1.25 million from the U.S. Department of Defense (DOD) to fund two projects that aim to establish the groundwork for the nation’s first whole-eye transplantation program. 

Offered through the DOD’s Vision Research Program, the grants support conceptually innovative research that ultimately could lead to critical discoveries or major advancements. The Pitt researchers will lead a multidisciplinary consortium that includes clinicians and scientists from Harvard University and the University of California, San Diego.

Although corneal transplants are routinely performed today,  whole-eye transplantation has remained an unrealized goal in vision restoration because of challenges related to immune rejection and reestablishing the connectivity of the optic nerve to the visual centers in the brain.

The Audacious Restorative Goals in Ocular Sciences (ARGOS) Consortium established at Pitt will be the first cross-disciplinary, systematic attempt to explore strategies to enable corneal regeneration, retinal cell survival, long-distance optic nerve regeneration with cortical integration and whole-eyeball transplantation.

“Recent advances in our understanding of retinal ganglion cell survival and successes with optic nerve regeneration in experimental studies strengthen our hope that whole-eye transplantation is an audacious yet achievable goal,” said principal investigator Vijay Gorantla, M.D., Ph.D., associate professor of surgery in the Department of Plastic Surgery at the University of Pittsburgh, and the administrative medical director of the Pittsburgh Reconstructive Transplant Program at UPMC. “Our experience with transplanting complex immunogenic tissues, such as the hand, will help us optimize treatments for rejection in eye transplants.”

According to the DOD, blast injuries are the most common for soldiers wounded in action, with up to 40 percent of blast injuries affecting the eyes. Approaches to minimize worsening of injury to the eye after trauma, preserve and protect residual retinal and optic nerve function, and restore vision are all goals that will be investigated.

“This is an aggressive program with very high-risk and high-reward scenarios. We’re excited to be leading the project and honored to be collaborating with global leaders in optic nerve regeneration,” said co-principal investigator Joel Schuman, M.D., chair of the Department of Ophthalmology, Pitt School of Medicine, and director of the UPMC Eye Center. “By solving one facet of the problem at a time, the long dreamed-of goal of whole-eye transplantation may be possible with the promise of a better life for millions of patients worldwide.”

Sub-awardees of the current award include Jeffrey Goldberg, M.D., of the University of California, San Diego; and Larry Benowitz, Ph.D., of Harvard University.

In a related project  led by principal investigator Kia Washington, M.D., assistant professor of plastic surgery, University of Pittsburgh School of Medicine, the research team will focus on establishing baseline viability and structural integrity in an  animal model of whole-eye transplantation. The researchers will examine immune rejection and evaluate the usage of extracellular matrix therapy for improvement of optic nerve function after whole-eye transplantation.

“We have successfully performed an eye transplant in a small animal model,” said Dr. Washington. “This ongoing project may eventually lead to restoration of vision after trauma or degenerative disease.”

The Louis J. Fox Center for Vision Restoration will provide additional key funding for the whole-eye transplantation effort.

UPMC Partners with GK Klinika to Develop and Co-Manage Cancer Hospital in Lithuania

 PITTSBURGH, Oct. 7, 2014 GK Klinika Group, a private health care company in the Baltic region, is partnering with UPMC for its help in developing and co-managing a new, 100-bed cancer hospital in Vilnius, Lithuania.

Scheduled to open in 2017 and funded by GK Klinika, the hospital is expected to care for patients covered by both private and public insurance to enhance the quality of oncology care throughout the Baltic region. Under the 15-year agreement, UPMC will assist with project planning, construction and training, and will co-manage all clinical and administrative activities after the facility opens.

The prime minister of Lithuania, Algirdas Butkevicius, will participate in a signing ceremony at UPMC’s headquarters today. The Lithuanian government is actively working to encourage foreign business expansion in that country, particularly in its highly advanced life sciences sector, and expects that this partnership with UPMC will foster U.S.-Lithuania relations and geopolitical stability in the region. 

“As an international leader in health care and medical research — and one that has proven that its model of care can be adapted to other countries and cultures — UPMC was the logical choice to be our partner in creating a world-class cancer facility,” said Karapet Babaian, M.D., chief executive officer of GK Klinika and of Baltijos Medicinos Tyrimu Institutas (BMTI), the unit that is working with UPMC. “The scope and length of this agreement is a testament to our faith in this new partnership.”

GK Klinika is one of the leading private clinics in the Baltic region, with more than 15 years of experience and a reputation for promoting innovative medical technology to achieve better patient outcomes. 

“GK Klinika and UPMC share the same vision: to give patients access to the best cancer care in the world close to home. We look forward to working with our partner to make that dream a reality in Lithuania,” said Charles Bogosta, president of UPMC’s International and Commercial Services Division.

UPMC’s wide-ranging assistance to GK Klinika will include hiring and training of staff in Pittsburgh and Vilnius, information technology planning, developing early cancer detection programs, conducting a genomics-testing pilot project and providing disease-specific treatment algorithms. UPMC physicians also will periodically provide consults related to advanced surgeries performed at the new hospital and second opinions via telemedicine.

The chief executive officer of the new hospital will be appointed by mutual agreement of both partners. 

Starting with its partnership to create a transplant center in Italy 18 years ago, UPMC has expanded its international footprint to include operations or services in countries that now include Ireland, India, China, Singapore, Japan and Kazakhstan. Through its international growth and commercialization efforts with industry partners, UPMC is diversifying its sources of revenue, fueling economic development in its local communities, and strengthening its ability to recruit and retain the best clinicians to improve health care outcomes globally.

Pitt Researchers Awarded $4.2 Million to Continue Cancer Studies in Chinese Populations

PITTSBURGH, Oct. 6, 2014 – Cancer epidemiologist Jian-Min Yuan, M.D., Ph.D., has been awarded a five-year grant of more than $4.2 million from the National Cancer Institute (NCI) to support the continued work of two studies examining how environmental and lifestyle exposures and genetics have affected the incidence, mortality and age-related outcomes of cancer in more than 81,000 Chinese men and women.

Dr. Yuan, associate director for Cancer Control and Population Sciences at the University of Pittsburgh Cancer Institute (UPCI), partner with the UPMC CancerCenter, and co-leader of UPCI’s Cancer Epidemiology and Prevention Program, is the principal investigator of the Shanghai Cohort Study and the Singapore Chinese Health Study. For the two population-based prospective studies, researchers examine cancer and other major health outcomes by evaluating blood, urine and other samples collected from participants for more than 25 years. These studies already have yielded important findings about the causes and prevention of cancer and have led to chemoprevention trials underway in the U.S.

“We anticipate that the two Asian study groups will become even more scientifically valuable over the next five years as the younger members of these groups get older and have a greater risk of developing cancer, thereby increasing the number of pre-disease, biomarker-based research opportunities,” said Dr. Yuan, who also is Pitt’s Arnold Palmer Endowed Chair in Cancer Prevention.

With the new award, Dr. Yuan and his collaborators hope to accrue 2,700 new cancer cases over the next five years. They also hope to:

  • Gather data to maintain and enhance the two Asian study databases, including follow-up for cancer, non-cancer and death outcomes; maintenance of the biorepositories; and management of the databases.
  • Conduct in-person and telephone interviews among participants to update exposure and medical information.
  • Collect blood and urine samples from participants with cancer diagnoses.
  • Engage in collaborative research projects of the NCI and the Asia Cohort Consortium. 

“Having the ability to examine diseases in large populations is reshaping the way we approach diagnosis and treatment. We’re excited about the possibilities this research holds and what we’ll learn next,” said Nancy E. Davidson, M.D., director of UPCI and UPMC CancerCenter.

This research is supported by the NCI under award number UM1CA182876.

Children’s Hospital of Pittsburgh of UPMC Partners with Tampa Hospital to Provide Cardiothoracic Services

PITTSBURGH, Oct. 2, 2014 Children’s Hospital of Pittsburgh of UPMC today announced a partnership with St. Joseph’s Children’s Hospital in Tampa, Fla., to assist their team with pediatric cardiothoracic services. Surgeons from the Heart Institute at Children’s Hospital of Pittsburgh will provide highly specialized cardiovascular care for patients.

The partnership will be led by Victor Morell, M.D., co-director of the Heart Institute at Children’s Hospital of Pittsburgh of UPMC and chief of the Division of Pediatric Cardiothoracic Surgery.

Children’s Hospital of Pittsburgh’s pediatric cardiovascular surgery program has the lowest overall four-year surgical mortality rate among all medium- and high-volume programs with a rate of 1.1 percent, according to the latest data compiled by the Society of Thoracic Surgeons (2008-2012).

“We are grateful for the opportunity to bring our unique expertise in pediatric heart surgery to families in Florida,” said Dr. Morell. “We share a commitment with St. Joseph’s Children’s Hospital to provide the absolute best possible pediatric care to patients and families from the Tampa area and beyond.”

In addition to collaborating with St. Joseph’s Children’s Hospital’s cardiac team on surgical and non-invasive cardiology services, Children’s Hospital of Pittsburgh’s experts will provide support to patients, families and caregivers in St. Joseph’s Children’s Hospital’s cardiac intensive care unit via telemedicine.

Children’s Hospital of Pittsburgh is leading the way in the development of telemedicine services to meet the needs of young patients regionally and around the world with video conferencing technologies that provide complex pediatric cardiac care through remote and virtual examinations — whenever and wherever expertise is needed.

For nearly two decades, St. Joseph’s Children’s Hospital has provided a full spectrum of pediatric cardiac services, from less-invasive diagnostic catheterization, nonsurgical valve replacement and electrophysiology studies, to cardiovascular surgery for the rarest and most complex congenital heart defects. St. Joseph’s Children’s Hospital has been home to one of the largest pediatric cardiovascular programs in the southeast and is a regional referral center for the diagnosis and treatment of congenital heart defects.

Prior to joining Children’s Hospital of Pittsburgh of UPMC in 2004, Dr. Morell led the pediatric cardiac surgical team at St. Joseph’s Children’s Hospital.

“This partnership brings the expertise of some of the country’s top-ranking pediatric heart physicians to our community, providing families across Florida with unprecedented access to the highest level of pediatric heart care available,” said Kimberly Guy, president, St. Joseph’s Children’s Hospital.

Pitt Shares in $17 Million Federal Grant to Improve Traumatic Brain Injury Clinical Trials

PITTSBURGH, Sept. 30, 2014 – University of Pittsburgh researchers are key players in a national “dream team” that seeks to identify the best biological and imaging markers of traumatic brain injury (TBI) to improve the ability of clinical trials to find effective treatments for the condition, which annually affects 2.5 million people in the U.S., including athletes and soldiers.

The $17 million initiative, called the TBI Endpoints Development (TED) Award, is funded by the U.S. Department of Defense (DOD) and includes many universities, the U.S. Food and Drug Administration (FDA), companies and philanthropies. It is overseen by the University of California, San Francisco.

“This project is going to redefine how we measure the outcomes for traumatic brain injury studies,” said TED investigator Stephen Wisniewski, Ph.D., senior associate dean and co-director of the Epidemiology Data Center at the University of Pittsburgh Graduate School of Public Health. “We need a more robust, detailed way to determine what challenges a person faces when he suffers a traumatic brain injury, and that is what we’re setting out to accomplish with this ambitious study.”

Under Dr. Wisniewski’s leadership, Pitt Public Health will run the data analysis for the project, meaning the school will compile data from previous studies and analyze it to see what existing methods for measuring traumatic brain injuries prove most promising. That information will be used as a launch point for clinical evaluation in real-life situations.

David Okonkwo, M.D., Ph.D., associate professor of neurological surgery and clinical director of the Brain Trauma Research Center at Pitt’s School of Medicine, is co-leading the second branch of the project to test those findings through the previously announced $18.8 million National Institutes of Health (NIH) project called Transforming Research and Clinical Knowledge in TBI, or TRACK-TBI.

“In the clinical component of the TED project, we will take the insights Dr. Wisniewski and his team gather from their systematic review of previous research and apply that to real-world TBI cases,” said Dr. Okonkwo. “If we can more accurately identify and quantify these injuries, we will be better able to select appropriate patients for clinical trials and to evaluate the success or failure of our therapies.”

TED will examine data from thousands of patients to identify effective measures of brain injury and recovery, using biomarkers from blood, new imaging equipment and software, and other tools. The research collaborators will be collecting a broad range of long-term data from existing studies and databases, and integrating these into a dataset that can be interrogated for TBI associations and causes in a way that has never before been possible.

The project is specifically designed to overcome the difficulty in demonstrating the effectiveness of TBI drugs and medical devices by actively involving the FDA in clinical-trial design from the outset. It also fosters collaboration between the DOD, the NIH, foundation-funded research networks, industry co-sponsors such as General Electric, and patient advocacy groups to try to develop procedures, outcomes measures and standards for interpreting clinical data.

Each year, more than 2.5 million people in the U.S. seek medical care for traumatic brain injuries that arise when blows to the body or nearby explosions cause the brain to collide with the inside of the skull. According to the U.S. Centers for Disease Control and Prevention, an estimated 2 percent of the U.S. population now lives with TBI-caused disabilities, at an annual cost of about $77 billion. No TBI treatment has proved to be effective.

“TBI is really a multifaceted condition, not a single event,” said UCSF neurosurgeon Geoffrey T. Manley, M.D., Ph.D., principal investigator for the new award and chief of neurosurgery at San Francisco General Hospital and Trauma Center, a UCSF partner hospital. “TBI lags 40 to 50 years behind heart disease and cancer in terms of progress and understanding of the actual disease process and its potential aftermath. More than 30 clinical trials of potential TBI treatments have failed, and not a single drug has been approved.”

Pitt Public Health to Strengthen Public Health Workforce with $3.4 Million Training Center

PITTSBURGH, Sept. 29, 2014 – The University of Pittsburgh Graduate School of Public Health will receive nearly $3.4 million from the federal government over the next four years to establish and operate a training center intended to improve the nation’s public health system.

The U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA) selected Pitt Public Health to create the Region 3 Public Health Training Center to serve Pennsylvania, Delaware, Maryland, Virginia, West Virginia and the District of Columbia. It also will serve as the health informatics training center for the entire country.

The center will provide free training sessions to public health professionals on a variety of topics, ranging from behavioral health programming for smoking cessation to computer programs that track an infectious disease spread and simulate interventions to stop it.

“This is a critical investment in our nation’s public health infrastructure and represents a wonderful opportunity for Pitt Public Health to further share our innovations in data collection and analysis,” said Margaret Potter, J.D., M.S., principal investigator of the grant and professor of health policy and management at Pitt Public Health.

Pitt Public Health has served as the Public Health Training Center for Pennsylvania for the past 14 years. In the new regionalization of the HRSA training centers, Pitt Public Health will oversee local training sites run by Drexel University School of Public Health, which will serve eastern Pennsylvania; Johns Hopkins Bloomberg School of Public Health, which will serve Delaware, Maryland and the District of Columbia; the Virginia Department of Health, which will serve Virginia; and West Virginia University School of Public Health, which will serve West Virginia.

“Monitoring for air and water pollution, inspecting restaurants for food safety, containing infectious disease outbreaks — these are all examples of the crucial work done by people who serve in our public health sector,” said Ms. Potter. “In order for public health professionals to keep up with the latest technical developments in their fields, they need formal continuing education programs. That’s what the training center provides.”

Due to Pitt Public Health’s prowess in collecting, analyzing and disseminating health-related data, the Region 3 Public Health Training Center will run sessions in health informatics nationwide. The school’s Public Health Dynamics Laboratory has developed programs including Project TychoTM, the Framework for Reconstructing Epidemiological Dynamics (FRED) and the LEgal Network Analyzer (LENA), which can assist public health professionals in making decisions based on real-world data.

“Local public health departments collect a treasure trove of data. However, they often don’t have the time, personnel or resources to turn that data into useful information that will inform their work,” said Ms. Potter. “What we’ll be able to do is give them the tools and the training to do their own analyses quickly and efficiently.”

For example, knowing how to use certain data analysis programs, such as the ones developed by Pitt Public Health, during a disease outbreak could help a public health department make decisions on how to allocate its budget, what expertise it might need to bring in to manage the outbreak, and what laws or policies might support or constrain the response.

Renowned Robotic Thoracic and Esophageal Surgeon Joins UPMC

PITTSBURGH, Sept. 25, 2014 – A thoracic surgeon who specializes in the minimally invasive treatment of malignant and benign diseases of the chest has joined the Department of Cardiothoracic Surgery under the direction of James D. Luketich, MD.

Inderpal S. Sarkaria, MD, FACS, joined the Department of Cardiothoracic Surgery at UPMC as Director of Thoracic Robotic Surgery, Vice Chairman for Clinical Affairs, and Co-Director of the Esophageal Surgery Institute.

Dr. Sarkaria has extensive expertise and experience in minimally invasive and Video Assisted Thoracic Surgical (VATS) approaches including esophagectomy for esophageal cancer, VATS lobectomy for lung cancer, VATS thymectomy, laparoscopic anti-refux surgery for GERD, laparoscopic surgery for achalasia, laparoscopic repair of giant paraesophageal hernias (GPEH), and robotic-assisted approaches to these conditions.

Dr. Sarkaria is also a member of and has lectured extensively at several major national and international thoracic surgical societies, and has been involved with committees for resident and fellow education, health care policy, and neuroendocrine lung tumors.

Pitt Rheumatology Division Named Part of NIH Network for Lupus and Rheumatoid Arthritis Study

PITTSBURGH, Sept. 24, 2014 – The National Institutes of Health (NIH) announced today that it has awarded five-year grants to 11 research centers across the United States in a private-public partnership designed to better identify and develop new diagnostics and drugs for rheumatoid arthritis (RA) and lupus. The Division of Rheumatology and Clinical Immunology of the University of Pittsburgh School of Medicine, led by chief Larry W. Moreland, M.D., has been chosen as one of the research sites – the only one between the states of New York and Colorado.

“From our perspective, this is a tremendous collaborative effort involving physicians and researchers across disciplines, including basic scientists, clinical researchers, orthopaedic surgeons, radiologists and numerous clinical rheumatologists,” said Dr. Moreland. The lab of Mandy McGeachy, Ph.D., assistant professor of medicine, will direct the basic science effort for the Pitt team.

Under this NIH Accelerated Medicines Partnership:

  • Pitt’s research team will collect data from a large group of patients already participating in NIH-funded research. The project aims to unravel biological pathways involved in RA by examining surgical tissue samples, performing ultrasound-guided biopsies of inflamed joints, and utilizing specialized tissue processing for immune-cell analytics, as well as conducting other tests. The team also has proposed a clinical study in which patients who haven’t responded to first-line therapy with methotrexate will be randomized to receive a biologic therapy.
  • Members of the 11 network centers – totaling 18 principal investigators – will collaborate as a consortium, starting with a meeting scheduled for the end of October.
  • The incentivized research plan consists of a seed grant from the NIH, which then may award larger sums moving forward dependent upon the progress of the research and further studies to follow.

The NIH news release can be found on its site.

Pitt Drug Discovery Researchers Receive $5.8 Million Federal Grant to Build 3D Liver Model

PITTSBURGH, Sept. 23, 2014 – With a new $5.8 million, three-year award from the National Institutes of Health (NIH), researchers at the University of Pittsburgh School of Medicine will further develop a state-of-the-art, microfluidic 3D model system that mimics structure and function of the liver to better predict organ physiology, assess drug toxicity and build disease models.

The funding supports the next phase of the NIH’s Tissue Chip for Drug Screening program, which aims to improve ways of predicting drug safety and effectiveness. Researchers from 11 institutions will collaborate over three years to refine existing 3-D human tissue chips and combine them into an integrated system that can mimic the complex functions of the human body.

“We are very enthusiastic about the potential of these microphysiology systems to serve as powerful platforms for studying human diseases and identifying human toxic liabilities,” said the Pitt project’s principal investigator D. Lansing Taylor, Ph.D., Allegheny Foundation Professor of Computational and Systems Biology, Pitt School of Medicine, and director, University of Pittsburgh Drug Discovery Institute.

“The development of tissue chips is a remarkable marriage of biology and engineering, and has the potential to transform preclinical testing of candidate treatments, providing valuable tools for biomedical research,” said NIH Director Francis S. Collins, M.D., Ph.D.

The Pitt research team, along with additional collaborators, is creating models of the functional unit of the liver, called the acinus, using human liver cells and eventually liver cells derived from precursor cells known as induced pluripotent stem cells, as well as three additional cell types. The liver platform includes microfluidic devices, human cells, engineered matrix materials, fluorescence-based biosensors for real-time physiological read-outs, and biochemical and mass spectrometry measurements to determine acute and chronic toxicity effects. They also will build a “microphysiology database” to manage, analyze and model the data collected from the liver constructs.

With such a platform, biomedical scientists will be able to test treatment efficacy in conditions such as non-alcoholic fatty liver disease, liver cancer and breast cancer that has spread to the liver, as well as liver damage including immune-mediated toxicology and fibrosis.  Also, a team of institutions and investigators has been assembled to integrate the liver, kidney and gut models to recapitulate the organ system that is central to drug absorption and metabolism.

The integrated platform will involve the creation of a universal medium, the development of the proper “scaling” of the interacting organ constructs, physiologically relevant flow, incorporation of a micro-formulator to add factors from missing organs and micro-analyzers for monitoring parameters such as pH and oxygen.

Fifteen NIH Institutes and Centers are involved in the coordination of the tissue chip program. Current funding is being provided by the National Center for Advancing Translational Sciences, the National Institute for Biomedical Imaging and Bioengineering, the National Cancer Institute, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Environmental Health Sciences, NIH Common Fund and NIH Office of Research on Women’s Health.

Collaborators include Martin Yarmush, M.D., Ph.D., of Massachusetts General Hospital; John Wikswo, Ph.D., of Vanderbilt University; Jonathan Himmelfarb, M.D., of the University of Washington; Mark Donowitz, M.D., of Johns Hopkins University; and Mary Estes, Ph.D., of Baylor University.

Adding Chemotherapy to Radiation Treatment Not Effective in Treating Vulvar Cancer, UPMC Study Shows

SAN FRANCISCO, Sept. 18 - The addition of chemotherapy to post-surgical radiation treatment is not effective in treating vulvar cancer, according to Magee-Womens Hospital of UPMC research presented this week in San Francisco at the 56th annual meeting of the American Society for Radiation Oncology (ASTRO).

Vulvar cancer is extremely rare, accounting for just 4 percent of gynecologic cancers and 0.6 percent of cancers women face in the U.S. each year. Led by Sushil Beriwal, M.D., associate professor with the department of radiation oncology at the University of Pittsburgh School of Medicine and radiation oncologist at Magee, this study identified patients diagnosed with vulvar cancer between 1998 and 2011 who had undergone surgery to remove the cancer and required adjuvant radiation therapy because the disease had spread to their lymph nodes.

The study utilized the National Cancer Database, a nationwide oncology outcomes database, to identify 1,087 patients who underwent chemotherapy treatment in addition to radiation therapy after their initial surgery to remove the cancer. The study took into account factors including age, race, insurance coverage, tumor size and spread of the disease.

“Our study found that overall, the addition of chemotherapy to adjuvant radiation therapy did not improve patient survival,” said Dr. Beriwal. “While retrospective studies do impose some limits on our conclusion, we found that at the very least, use of concurrent chemotherapy should be carefully evaluated on an individual basis.”

While the study didn’t confirm a benefit of the addition of adjuvant chemotherapy to treatment, Dr. Beriwal said it is important to share the findings because they move researchers one step closer to understanding how to most effectively treat vulvar cancer.

 

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