Baylor Annette C. and Harold C. Simmons Transplant Institute 2015 Annual Report by Baylor Health Care System

for life We share this journey together. Weâ&#x20AC;&#x2122;re linked in purpose always. From people to treatments to transplants, we are all connected for life.

Contents // Dr. Klintmalm Letter 2 // Introduction 4 // Research 6 // Donors 8 // By the Numbers 12 // Liver 14 // Kidney & Pancreas 16 // Heart 18 // Lung 20 // Islet Cell 22 // Outreach 24 // Publications 26 // Medical Staff 34

“Organ donors are the center of our world. Everything we GÖRAN KLINTMALM, MD, PhD, FACS

do in organ transplantation begins with them.”

Chairman, Baylor Annette C. and Harold C. Simmons Transplant Institute: Chief & Medical Director, Transplant Services Department

a great year in review

A LETTER FROM DR. KLINTMALM TO FRIENDS & COLLEAGUES

Having lived and breathed organ transplantation since 1978, I have experienced the suffering of families who lost loved ones and yet chose to donate organs during tragic events. For them, it was a glimmer of hope—a source of solace—in an otherwise very dark time.

with international researchers at the University of Pennsylvania; Emory University; University of California, Los Angeles; University of Pittsburgh; Northwestern University; The University of Chicago and Charité Hospital in Berlin.

As we reflect on 2015 and look ahead, we never lose sight of the donors. That’s why this report features more of their stories and showcases how we honor them for their ultimate lifesaving gifts.

On September 1, 2015, we became the first hospital in Texas—and the second in the country—to perform 12 transplants in just 24 hours (page 5). This momentous (and unplanned) day marked the commitment, compassion and capacity of our team. No one ever asked, “Can we slow down?” Everyone extended themselves, because when you have a donor, you respond.

RESEARCH FOCUSED A pioneering leader in transplantation for more than 30 years

Founded the Baylor Annette C. and Harold C. Simmons Transplant Institute in 1984

Co-author of Transplantation of the Liver, the essential textbook that was called a “magnum opus” by the New England Journal of Medicine and was released as a third edition in 2015

Since our inception in 1984, the Baylor Annette C. and Harold C. Simmons Transplant Institute has been in earnest pursuit of questions and answers— stretching the bounds of possibility every single day. In three decades, we’ve undergone research that has saved lives, influenced the industry and world around us, and has reminded us daily that the work we do is rich with purpose. Our research efforts in 2015 revolved around creating a research database for heart, lung and kidney transplantation that will launch in 2016 that is similar to the liver transplant database we started in 1985. Additionally, our biorepository represents one of the most diverse tissue collection labs of its kind. These features have given us access to highquality data and samples so that we can launch new study trials and further advance the science and medicine of organ transplantation. WORLD-RENOWNED

Our prominence stems not only from the caliber and volume of our medical staff, but also from the global contributions we’ve made in publications and conferences. In 2015, our faculty published 98 peerreviewed papers and gave numerous presentations around the world. In doing so, we collaborated

12 IN 24 ACCOMPLISHMENT

NEW TALENT AND STAFF

Our transplant program was built as an integrated service model before multidisciplinary teams were even part of medical nomenclature. The collaboration between our administration and transplant professionals is extremely close. We office on the same floor. We share the same goals, plan together and discuss new ideas. The level of trust we share is outstanding. Our medical staff is simply remarkable. And when they are hired, they tend to stay. We have people working not just on the transplant team for 20 to 25 years, but also in the operating room, ICU and on the transplant floor. In 2015, new faces joined our ranks, including new directors, nurses and specialists (page 34). I joined the institute in 1984. With an interview and a handshake, I uprooted my family from Sweden and moved to Dallas. Baylor’s administration, the board of trustees, and the medical board and staff put their trust and faith in me. I was amazed then and will be amazed for the rest of my life.

“ This year, we salute the lifeblood of the Baylor Annette C. and Harold C. Simmons Transplant Institute: organ donors and their families, whose lasting legacies have brought all of this—and all of us—together.” Kirk Starr, MBA, RPh

Vice President, Baylor Annette C. and Harold C. Simmons Transplant Institute

In the past, we’ve recognized our achievements in science and research. Our advances in transplant medicine. Our excellent outcomes. Our continued growth in both size and caliber. Our renowned talent and remarkable staff.

SYNTHESIS OF SIZE, TALENT AND TECHNOLOGY

Among our proudest moments: On September 1, 2015, we became the first hospital in Texas— and the second in the country—to perform 12 transplants in just 24 hours. The transplants took

A RECORD–BREAKING DAY

CLINICAL RESEARCH THAT MAKES A DIFFERENCE

We’ve also grown our clinical research program with new innovations that affect our patients’ lives on a daily basis. In 2015, discoveries improved living donor transplants of the liver (page 14), while a new generation of left ventricular assist devices could provide heart patients with long-term options (page 18). Plus, exciting new advances in kidney (page 16), pancreas (page 17), lung (page 20) and islet cell (page 22) transplantation could impact more patients than ever before. And by 2017, we could see Baylor’s first baby born from a transplanted uterus. A REACH AS BIG AS THE LONE STAR STATE

introduction

As we’ve charted new paths in transplant medicine and achieved unbelievable things, organ donors are the ones who have connected us all and whose donations have sustained this program. And in 2015—thanks to them—those achievements were ample.

12 in 24

place at Baylor University Medical Center in Dallas (Baylor Dallas) and involved a synthesis of sheer size, manpower, resources and technology. In the past three decades, our program has evolved into one that could make that historical day possible. One that has the capacity to perform 12 complex surgeries—of the lungs, kidneys, heart and liver—within twice as many hours. One that has the infrastructure, personnel, ability and dedication to save lives when organs become available.

We bring these advancements directly into communities through an expansive geographic reach—starting with our home bases in Dallas and Fort Worth, which house Baylor Dallas and Baylor Scott & White - Fort Worth, respectively. Both sites share an exceptional team of nephrologists, hepatologists and cardiologists who have treated thousands of patients with organ failure. Liver, kidney and heart outreach clinics help expand Baylor throughout Texas, with locations in Amarillo, Lubbock, Odessa, Longview, Austin, Abilene and across the Dallas/ Fort Worth Metroplex. MOTIVATION FOR AN EVEN BETTER 2016

New frontiers of transplant research have steered our program to a unique moment—one where advanced surgical techniques and anti-rejection approaches have led to better outcomes, longer life expectancy, lower costs and an improved quality of life. But as the demand for transplants increases, so does the need for donors— and sadly, so does the waitlist of those hoping for their perfect match. That’s why the need for living donors is so important, as you’ll read more about within the next pages. And that’s also why we honor those whose contributions will never be forgotten. They are the reason we do what we do, and they are our motivation to keep going in 2016.

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kidney transplants

liver / kidney multiorgan transplants

heart transplant

double-lung transplant

single-lung transplant

One grandfather from Louisiana. One Texas State Trooper. One North Texas veterinarian. One Atlanta resident. Two living kidney donations (both cases were a wife giving to her husband) and others were among those saved.

PATIENTS SAVED

TRANSPLANT ALL ORGAN RESEARCH SYSTEM

research Investigators conduct research in every area—and every organ that we transplant—at the Baylor Annette C. and Harold C. Simmons Transplant Institute. And while clinical trials support the success of our program, we’re most concerned with supporting the success of our patients and connecting them with the lifesaving treatments they need most. From our hepatitis C research—a new study that treats patients with Hepatitis C with one pill a day for 28 days starting on the day of liver transplant with an impressive 94 percent cure rate—to clinical trials that evaluate advances in cardiovascular devices like the HeartMate 3® Left Ventricular Assist System, our research has helped improve the field of transplant medicine worldwide.

BAYLOR’S PRESENCE AT INTERNATIONAL EVENTS

RESEARCH FOR EVERY ORGAN

November 2015, Seoul, Korea: International Congress of Living Donor Liver Transplantation (ILDLT) Study Group

In collaboration with Baylor Dallas and Baylor Scott & White - Fort Worth, the institute oversees transplant research and programs for every organ. We’re globally recognized for our contributions to transplantation research and our effectiveness at translating complex studies to patients in need—having conducted and published more research than any other transplant center.

We are humbled to have been asked to present at and host several international conferences: March 2015, Dallas: mTOR in Liver Transplantation held by the American Society of Transplant Surgeons, co-chaired by James Trotter, MD

In 2015, we saw an opportunity to inject innovation into our data management—we built the Transplant All Organ Research System, a database that houses patient information from pre- and post-transplant. Physicians and scientists can conduct major research in all organ systems and transplants using this comprehensive information. Formerly known as the Liver Transplant Research Database System (LTRDS)—which Baylor established in 1985 and was the most detailed and longest existing research database for liver transplant worldwide—the new system has expanded beyond the liver to include heart/VAD, lung, kidney and pancreas. 2015 PUBLICATIONS AND SCIENTIFIC PRESENTATIONS

In 2015, a total of 22 researchers at the institute had 98 manuscripts (including book chapters) published in medical and science journals, such as the Journal of Surgical Oncology, the American Journal of Transplantation and the New England Journal of Medicine—and many others. Additionally, investigators secured numerous national and international speaking engagements and abstract presentations at scientific conferences and events. By sharing their findings with the medical community and significantly contributing to the field of transplant medicine, these investigators, authors and speakers have shown how the institute—and Baylor overall—has impacted transplant medicine for the better. See full list of publication citations on pages 26-33.

2015 RESEARCHER AWARDS

Because of their contributions, physicians and scientists on the medical staff at Baylor have been awarded for their innovative research, clinical acumen and dedication to transplant medicine. For her significant contribution to the field of transplantation health care, Jacqueline O’Leary, MD, MPH, received the Clinical Science Investigator Award from the American Society of Transplantation, an organization of transplant physicians dedicated to advancing the field through research, education and advocacy. Dr. Klintmalm received a lectureship named in his honor by the Texas Transplantation Society.

years of tissue samples in the biorepository

The most detailed and longest-existing research database for liver transplant worldwide.

November 2015, Melbourne, Australia: International Pancreas and Islet Transplant Association. Ten abstracts were accepted for presentation. April 2015, Nice, France: Annual Meeting of the International Society of Heart and Lung Transplant. Four abstracts and a poster were accepted for presentation.

donors: honoring their gifts of life Few things in life are more powerful than giving a part of yourself to save another. It’s not just an act of kindness or heroism. It goes beyond courage and compassion. At its deepest core, organ donation is about a love for life and doing the right thing. THE IMPACT OF LIVING DONORS

That’s what drove Andy Rose in January 2015, when he gave a piece of his liver to a coworker whose life depended on it. After reading a newspaper article about his colleague, Christer Hiort, who had been diagnosed with a chronic liver condition, Andy sent a note to his future “blood brother” with a simple offer: I will be your donor. Now, Christer is healthy and active, while Andy lives knowing that he helped save someone’s life. “There is a piece of me living within another human being with the promise of a long and healthy life. And, if it were possible, I know for certain I would do it again—in a minute,” he said. Andy and Christer have spent the last year advocating for living donors and spoke at the Donor Advocate Symposium in October 2015. Thanks to

stories like theirs, the living donor program at the institute has grown exponentially, which means that we can provide patients the organs they need right here in DFW, without months or years spent waiting on a list. SPECIAL BONDS THAT CONNECT NEW FAMILIES

We also salute the families of donors whose loved ones profoundly left a piece of themselves behind. Because of their departing gifts, lives have been saved and renewed. In 2014, Dawn Sterling lost her two daughters and her unborn grandson in a car accident. Dawn was unconscious and seriously injured, so her husband made the decision to donate organs from one of their daughters, 15-year-old Courtney.

Just 10 hours earlier, 25-year-old Lisa Barker had been diagnosed with a rare blood disease that was killing her liver. By the time she went in for surgery, she had less than two days to live. The only treatment that could save her was a liver transplant, and Courtney’s liver turned out to be a match.

above: Andy Rose & Christer Hiort left: Lisa Barker and Dawn Sterling reunited and revealing a flora-graph of Courtney that was part of the National Donate Life float at the Parade of Roses on New Year’s Day 2015.

Six months after the tragic accident, Lisa wrote a letter to Dawn thanking the Sterlings for a second chance at life. Little did she know the immense impact it would have on Dawn. “Lisa actually saved my life,” Dawn explains. “I was in a very dark place after losing both of my girls and my grandson.” While Dawn will always carry the pain of losing her two daughters, she takes comfort in the fact that Lisa is now a part of her family. The women are extremely close and have formed a strong, beautiful connection. The Sterlings have now met four of the five organ recipients Courtney saved. Dawn calls them their godchildren thanks to Southwest Transplant Alliance.

“ D ur ing the d a rkest hour of the ir l ives , the y chos e to s a y ‘ yes .’ An d b ec a u s e of tha t d ec ision , I a m stil l a l ive.” LISA BARKER, ORGAN RECIPIENT

LIVING DONOR WALL

WALL OF HEROES

One of the many ways we honor those who have given the gift of life is the Living Donor Wall, which signifies the tree of life and celebrates four years of donors who gave their kidney or part of their liver to those in need. The wall is displayed proudly in the lobby of Baylor Dallas, where transplant patients can see it daily. Each year, we add green blocks— representing leaves on the tree of life—as a tribute to those donors and as a token of gratitude for giving while living.

As a tribute to departed donors, the Wall of Heroes represents those individuals whose legacy lives on through gifts of life to others. It is in their memory that we dedicate this space, which features photos of deceased donors alongside a poignant poem, “My Final Gift.” Against an inspiring backdrop of greens and blues silhouetted by a stately oak, the plaque memorializes the deceased and their families: “They leave a legacy that brings hope, even in the midst of loss.”

DONOR ADVOCATE SYMPOSIUM

DONATE LIFE FLAG

With a program as extensive as Baylor’s, it’s integral to keep everyone informed about the many facets of living donation—both clinical and nonclinical. That’s just what the Donor Advocate Symposium has done since 2012. In October 2015, the fourth annual symposium involved nurses, clinicians, social workers and clergy from over seven states who gathered together under the guidance and direction of Giuliano Testa, MD. The event, which has been growing every year, focuses on sharing the living donor option with patients, family, friends and potential donors. Topics included spirituality in living donation, donor awareness, insurance coverage and a series of real-life stories of living donors to showcase the experience of giving while living.

For those who have given or whose family members made a lasting gift, Baylor’s annual “Donate Life” flag-raising event celebrates donation while encouraging others to follow suit. On April 1, 2015, donor families gathered around the flagpole at Baylor Dallas and raised the “Donate Life” flag in celebration of National Donate Life Month. The flag represents the lives of those who gave and who received—an inspiring reminder for everyone to register as an official organ donor. These efforts are in collaboration with Southwest Transplant Alliance (Dallas). In April of 2016, Baylor Scott & White Fort Worth will have a ceremony in collaboration with LifeGift. HEART TRANSPLANT LIVE-TWEET

DONOR DEDICATION CEREMONY

Held at Baylor Dallas and led by transplant staff and clergy, this peaceful service honors the individuals who donated organs while celebrating those who received the gift of life. Living donors, recipients and the families of departed donors gather during these events to recognize and rejoice in the legacy of organ donation.

We’re also involved in digital awareness activities to encourage donor registrations, such as the live tweeting of a heart transplant in February 2015. As Baylor’s social media team documented the transplant in real time, they provided information about organ donation. People were inspired, resulting in a 30 percent increase in registrations through the Donate Life Texas program.

“ The donors aren’t just heroes. The y are ex cellent , beautiful hum an b eing s with a resp ect for life and lo ve for p eople.” G I U L I A N O T E S TA , M D S u r g i c a l C h i e f, A b d o m i n a l Tr a n s p l a n t

by the numbers

LIVER TRANSPLANT VOLUMES

HEART TRANSPLANT AND LVAD VOLUMES

Liver volumes are combined and reflect programs at both Baylor University Medical Center at Dallas and Baylor Scott & White All Saints Medical Center at Fort Worth.

Volumes reflect the heart program, which is only available at Baylor University Medical Center at Dallas.

140

Transplant surgeons on the medical staff at Baylor Dallas and Baylor Scott & White - Fort Worth have performed 9,411 solid organ transplants since 1984. In addition, we provide many comprehensive, multi-disciplinary advanced disease clinics and offer patients with organ disease more treatment options than ever before. We are committed to using our skills, experience and expertise to further develop these options and continually promote quality improvement.

140

120

100

0 2011

100.00

One (1) Year Kidney Transplant Survival Rates

One (1) Year Liver Transplant Survival Rates

for transplants performed from Jul. 2012 to Dec. 2014

96.47

97.97 94.48

97.42

94.11 94.36 93.35

94.96

LIVING DONOR

100

100.00

90.04 88.42

90.89

87.90 86.13

96.97

2012

88.61

2013

2014

2015

2011

CAD

LVAD

60.00

40.00

20.00

10 0.00%

0.00%

0 2011

100

One (1) Year Lung Transplant Survival Rates

One (1) Year Heart Transplant Survival Rates

for transplants performed from Jul. 2012 to Dec. 2014

89.94

100 87.51

88.71

88.36

86.52

90.64

88.49

TRANSPLANT

Volumes reflect the lung program, which is only available at Baylor University Medical Center at Dallas.

1 Year Graph Survival

2015

LUNG TRANSPLANT VOLUMES

60.00

1 Year Patient Survival

2014

ISLET TRANSPLANT VOLUMES

80.00

1 Year Graph Survival

2013

Auto and allo islet cell combined.

80.00

1 Year Patient Survival

2012

2013

2014

2015

2011

2012

2013

2014

2015

Source: Baylor Annette C. and Harold C. Simmons Transplant Institute Internal Research Database

KIDNEY TRANSPLANT VOLUMES Kidney volumes are combined and reflect programs at both Baylor University Medical Center at Dallas and Baylor Scott & White All Saints Medical Center at Fort Worth.

90.27

250 200 150 100 50

0 1 Year Patient Survival

1 Year Graph Survival

1 Year Patient Survival

1 Year Graph Survival 0 2011

BAYLOR ANNETTE C. AND HAROLD C. SIMMONS TRANSPLANT INSTITUTE (CENTERS COMBINED)

BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH

BAYLOR UNIVERSITY MEDICAL CENTER

ALL UNITED STATES TRANSPLANT CENTERS

Source: Scientific Registry of Transplant Recipients as of 12/18/2015

LIVING DONOR

2012

2013

2014

2015

CAD

126

liver transplantation

“ Going for ward , to meet the g ro wing dem and of patients who require a t ranspl ant , healthy living liv er donors are the only real alter n ative.”

liver transplants performed in 2015

living donor liver transplants in 2015, surpassing 2014’s 12

G I U L I A N O T E S TA , M D S u r g i c a l C h i e f, A b d o m i n a l Tr a n s p l a n t

Treatment advances have brightened the outlook for people with liver disease, as has the subspecialty of hepatology. Undoubtedly, the specialty’s growth has led to new approaches to screen, diagnose and treat patients at risk—improving outcomes for diseases that were once bleak. “Developments in hepatitis C medicines, for example, have been some of the most important of my career,” said James F. Trotter, MD, director of the Division of Hepatology and medical director of liver transplantation at Baylor Dallas. “With the growth of hepatology, it’s hard to imagine a better scenario for getting our patients the care they need—sometimes before their health declines.” Despite those improvements, a problem remains: an enormous gap in available organs and a twoyear waitlist for those who simply don’t have much time. Some call it the “liver purgatory,” but hope lies in the living. Because as liver disease becomes more prevalent and widespread—in many ways because of the obesity epidemic—living donors become integral to the fight. They are the ones who connect recipients with second chances at a healthy, vibrant life.

QUALITY OUTCOMES FOR DONOR AND RECIPIENT

It takes an extraordinary facility, team and resources to perform living donor liver transplantation. The process involves surgical precision and clinical acumen to split a healthy liver from one, transplant half of it to another, and monitor both as the donor’s and recipient’s livers regenerate and recover. “Living donor liver transplantation is a very complex surgery that requires a great deal of experience and expertise,” said Dr. Testa, surgical chief of abdominal transplant and medical director of the living donor liver transplant program on the medical staff at Baylor Dallas. “As more patients and donors explore this possibility, they are learning that we have been able to achieve safe, quality outcomes for both donor and recipient.” RESEARCH IN REGENERATION

As Baylor’s living donor liver program expands, it has invested research and resources toward improving the process for both donors and recipients. Results from a two-year Liver Regeneration Study, internally funded by the institute, will be reported in 2016.

LIVER AND PANCREAS DISEASE CENTER

For patients with cancerous and nonmalignant tumors in the liver or pancreas, as well as those with chronic pancreatitis, the Liver and Pancreas Disease Center provides access to hepatology, oncology and surgical treatment options. Since 1998, the center has cared for more than 7,000 patients—being one of the few in the nation dedicated to treating liver and pancreas cancer. LIVER DONATION EVENTS & CONFERENCES

In 2015, 418 researchers from 31 countries participated in the 2nd International Congress of Living Donor Liver Transplantation (ILDLT) Study Group in Seoul, Korea. In 2017, the ILDLT Study Group will gather at the Simmons Transplant Institute in Dallas. To host this event here is an immense achievement and recognition of Baylor’s work. We’re also proud that our own Göran Klintmalm, MD, PhD, and Jacqueline O’Leary, MD, MPH, will co-direct the Antibody Mediated Rejection in Liver Transplantation: An Update conference in April 2016. The two-day program features speakers and panelists from around the world to discuss advances in liver transplantation as an update to the gathering’s 2013 inaugural event.

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Living donor transplants make up 14 percent of liver transplantations, compared to other transplant programs’ 1 or 2 percent—putting Baylor's program ahead as one of the top five in the country. Baylor Dallas is one of only two centers in Texas performing living donor liver transplants.

liver transplants took place during Baylor’s record-setting 12 organs in 24 hours

“We’re pioneering this and other concepts here at Baylor Dallas, and I would not be surprised that in two or three years, we might see a 30 percent increase in living donor liver donations,” Dr. Testa said.

kidney & pancreas transplantation “ Compared to patients on dialysis, those who receive living donor t ra nspl ants liv e three times longer. Costs are also three times less. L iv i ng donor kidne ys l a st on average t wice a s long a s decea sed- donor ki dn e ys . L iv ing donors als o have healthier kidne ys than the average popul ation, b ecau se o ur screening is so st r ict .” S T E V E N H AY S , M D M e d i c a l D i r e c t o r, L i v i n g D o n o r K i d n e y P r o g r a m Kidney failure is a long-term challenge. On average, a patient spends three years enduring dialysis while awaiting a potential transplant. But when a living donor is involved, those wait times decrease dramatically—giving patients a new, healthy organ in as few as six weeks. That’s why Baylor’s Living Donor Kidney Transplant Program helps patients skip dialysis altogether in favor of a longer-lasting, less costly and healthier transplant option. “Patients on dialysis have a higher mortality because dialysis is just not as effective as a living kidney,” said Bernard Fischbach, MD, medical director of renal and pancreas transplantation in the Baylor Annette C. and Harold C. Simmons Transplant Institute. “Patients receiving effective dialysis have the equivalent of a glomerular filtration rate (GFR) of 20 to 25 milliliters per minute, while the GFR of patients who receive a working kidney can be 60 or above.” It’s because of these benefits to the patient that we implemented changes in the way we approach kidney transplant. In 2015, we focused on early education of patients and their potential donors about the benefits and process of living donor kidney transplant. As a result, our volumes increased from 42 living donor kidney transplants performed in 2014 to 62 in 2015. It’s a trend we hope to continue in 2016, as we expand engagement with primary care physicians and community nephrologists—including offering educational opportunities about immunosuppression and use of corticosteroids.

KIDNEY-PANCREAS TRANSPLANT Approximately 90 percent of the pancreas transplants performed at Baylor are combined kidney-pancreas transplants; pancreas alone transplants are rare at only 5 to 10 percent. The wait times for this program averages no more than four months—eclipsing many Texas centers, which can be up to 44 months at some centers. SUPPORTING LOCAL DOCTORS We’re proud to report that we continue to support community nephrologists in the post-transplant care of patients. Once patients are clinically stable, it is more convenient for them to receive care from their local physicians in the comfortable surroundings of their hometown. This, paired with our kidney transplant outreach program in West Texas (page 24), helps patients better navigate the process before, during and after transplantation. AT HOME DESENSITIZATION Up to 30 percent of patients on the kidney waitlist are “sensitized”—meaning their bodies are more likely to reject potential organs, leaving them with long wait times. But unlike many centers in the country, Baylor offers a desensitization program—with monthly visits to the patient’s home for intravenous immunoglobulin (IVIG) treatment. Some patients respond in six to eight months; others have received the treatment up to 18 months. Desensitization can be used for patients on the waiting list for a deceased donor, as well as those with a potential living donor.

PATIENT STORY

ALICIA SLIMAK Alicia Slimak lived with type 1 diabetes for nearly 30 years before a kidney-pancreas transplant became crucial. At just 42 years old and chronically exhausted, Alicia—a schoolteacher—joined the waitlist for a simultaneous kidney and pancreas transplant. In just six days, her physicians at the institute found a match. Two new organs and nearly a year of recovery time later, Alicia feels better than before. Since then, she’s had the chance to meet her donor’s family, who have taken her in as one of their own. “It’s like I’m part of the family now,” Alicia said. “I hope to always have a relationship with them.” Now, Alicia has the energy to teach her first-grade students, determination to follow an active lifestyle, and the utmost gratitude for her donor and his family for giving her a second chance at life. “I’m back,” she said. “I’m the old Alicia.”

214 62

6 4.3

total number of kidney transplants performed in 2015

living donor kidney transplants in 2015, surpassing 2014’s 42

kidney transplants took place during Baylor’s record-setting 12 organs in 24 hours

4.3 months average wait time for a kidney-pancreas transplant, which compares to wait times that can be up to 44 months at other centers 17

heart transplantation “ O ftentimes in transpl ant w e foc us the at tention on the recip ient b ec a u se he is the liv ing proof of the success of o ur pro g ram ; ho we ver, w e all acknowledg e that we co uld not p er for m that miracle of medicine without the tr ust , faith and hop e of the lo ved ones who took upon thems elv es the decision of shar ing a g ift of life.” G O N Z A L O G O N Z A L E Z - S TAW I N S K I , M D C h i e f, H e a r t Tr a n s p l a n t a t i o n a n d M e c h a n i c a l C i r c u l a t o r y S u p p o r t

Year after year, the sheer volume of heart transplants done by the Simmons Transplant Institute places it among the largest programs in the country. It’s the combination of research and talent that drives that extraordinary volume, but an aggressive approach is what makes it possible. “Our volumes are continuing to increase because we find opportunities where others do not,” said Gonzalo Gonzalez-Stawinski, MD, chief of heart transplantation and mechanical circulatory support and chief of cardiovascular services on the medical staff of Baylor Dallas. He, along with Shelley Hall, MD, chief of transplant cardiology and mechanical circulatory support on the medical staff at Baylor Dallas, lead the heart transplant team. “We are willing to travel to examine grafts that are declined by other centers. We also accept high-risk recipients who other centers may have declined, yet we’re able to maintain survival rates that are comparable to the national average," Dr. Gonzalez-Stawinksi adds. A central location in North Texas makes it easier to accommodate the four-hour window of heart transport—meaning that organs from the north, south, east or west can all make it on time to save a life. That, coupled with outreach clinics across the state (page 24), have helped feed the program’s growth. MORE SURGERIES WITH DUAL LISTING PROGRAM

Our dual listing program gives patients outside of Texas access to Baylor’s waitlist as well as the waitlist at a transplant center close to their home.

“Our transplant reputation continues to grow,” Dr. Gonzalez-Stawinski said. “The number of patients coming to us from outside of Texas has dramatically increased. During calendar year 2015, we implanted 50 ventricular assist devices and performed 60 heart transplants. This volume is a testimony to the trust and confidence our community cardiologists have placed in our program.” MOMENTUM WITH HEARTMATE 3®

In 2015, Baylor researchers joined a nationwide study for the HeartMate 3® Left Ventricular Assist System, a newer generation of a device that became the first LVAD approved for long-term use in heart failure patients. “The science behind the new HeartMate 3® design is sound, so we hope this will decrease the risk of complications. Technology is continuing to move forward at a much faster rate than our ability to treat failure with pills or by modifying the immune system after transplant,” said Dr. Hall. “If the results of this trial are positive, it will speed up the process of approval of these life-saving devices by literally years,” Dr. Hall adds. STAY DIGITALLY CONNECTED WITH BAYLOR’S APP

The new Baylor Heart Center App offers access to associated specialists from cardiac disease, cardiac surgery and cardiovascular treatments, such as advanced heart disease, atrial fibrillation and heart transplant. To download the free app to your iPhone or iPad, search for “Baylor Heart Center” in the Apple Store.

PATIENT STORY

ORLANDUS NOEL At just 24, Orlandus Noel began experiencing chest pain, shortness of breath, and problems sleeping at night that eventually became unbearable. After a visit to the ER and testing, he was diagnosed with congestive heart failure due to an enlarged heart and leaking mitral valve. He and his family traveled three hours from Lawton, Oklahoma, to Baylor Dallas for treatment, where he initially received a temporary Impella pump while awaiting a transplant. The heart transplant team came up with a better, long-term solution. Because of his young age, doctors inserted an LVAD—a bridge to an eventual transplant that would extend Orlandus’ life. “Being that he is young, the LVAD is probably a better solution,” his father said. “Transplant average lifespan is 12-15 years; you may get 20 years.” After his operation, Orlandus completed three months of rehabilitation and returned back home to Lawton, where he has adjusted to a new life with the LVAD. He will keep the LVAD as along as possible before eventually undergoing a heart transplant.

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One of the top five transplant programs in the nation

heart transplants performed in 2015

Baylor Heart Center app is one easy access point to the advanced heart failure physicians and programs at Baylor Dallas heart transplants performed in one week with four occurring in one day, tying the national record and establishing a new Texas record

lung transplantation “ We take care of our patients thro ugho ut the co urse of their liv es. It’s not just their t ranspl ant , and then the y’re g one. The y b ecome part of the family at Baylor. We look for ward to long lives.”

“I take my grandkids hunting and fishing, boating and waterskiing. I’m doing the things a grandpa likes to do with youngsters.”

D AV I D M A S O N , M D C h i e f, T h o r a c i c S u r g e r y a n d L u n g Tr a n s p l a n t a t i o n

From cystic fibrosis to chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis, Baylor’s lung transplant team treats patients with complex and life-threatening pulmonary diseases. Every year, the team builds on its reputation for accepting—and saving the lives of—many patients considered too high risk for other transplant centers. We pride ourselves in creating strong connections with patients and their families, which requires a highly coordinated and caring transplant team. “Patients put their lives in our hands,” Dr. Mason said. “It is a privilege and an honor to take care of them. Each of us has tremendous pride in what we have accomplished as an organization.” Baylor’s lung transplant program continues to grow as we increase the number of transplant patients each year. This has been accomplished through focused efforts to expand the donor pool—such as using lungs from donation after cardiac death (DCD). Our transplant program is one of the few centers in the country with expertise in this technique. Results have been excellent and have helped reduce waitlist times. Outcomes continue to improve with excellent survival while on the waitlist and following transplant. COORDINATED CARE, MULTISPECIALTY TEAM

As lung transplant has grown at Baylor, so has its team. In 2015, we welcomed three new nurse

31 31 lung transplants performed, placing it as the 25th largest program for volumes in the nation in 2015

coordinators, one thoracic surgeon and one transplant pulmonologist. We also grew geographically, relocating our clinics to the second floor of the Sammons building and consolidating patient care into one large, new space. Now, diagnostic testing, physician evaluations and pulmonary rehabilitation are all concentrated in one central location, which provides an enhanced patient experience. “Patients no longer have to visit different locations in the hospital to obtain their diagnostic testing and to see the physicians,” said Randall Rosenblatt, MD, chief of pulmonary medicine and medical director of lung transplant on the medical staff at Baylor Dallas. “We bring the services to them.” As part of treating and transplanting the sickest patients with advanced lung disease, Baylor Dallas has an extremely busy Extracorporeal Membrane Oxygenation (ECMO) Program that deploys immediate ECMO support to patients at other hospitals both in and out of state. This program is unique in North Texas and allows patients to be bridged to lung transplant or recovery, depending on their illness. “ECMO may be used in addition to mechanical ventilation or as a bridge to transplantation,” Dr. Rosenblatt said. “We have the potential to get the patients in a chair or even walking, which makes them stronger and may expedite their recovery from their devastating illness.”

7 One-year survival rates: 90.1 percent at Baylor and are comparable with the nationally published statistics

Our goal is to see all patients referred for evaluation within seven days of referral

Baylor Dallas is the topranked hospital in North Texas in pulmonology and continues to be ranked as one of America’s top hospitals by U.S. News & World Report.

PATIENT STORY

CARROLL PREWITT When Carroll Prewitt was diagnosed with pulmonary fibrosis, he couldn’t walk across a room without losing his breath. He needed oxygen 24 hours a day. At 64, he was told he was too old for the only solution, a lung transplant. His disease was considered terminal and his life expectancy brief. He decided he wanted a second opinion. After doing some research on his own, he found a pulmonologist at Baylor Dallas where he was evaluated and listed and eventually, transplanted.

After his double lung transplant, Carroll regained his strength and energy, and he can do almost everything he used to do before he became sick. “I take my grandkids hunting and fishing, boating and waterskiing. I’m doing the things a grandpa likes to do with youngsters,” he said. Carroll now volunteers at Baylor Dallas helping other patients who are facing or recovering from transplantation.

INNOVATIVE RESEARCH IN ISLET CELL TRANSPLANTATION

islet cell transplantation “ The g oal is to offer more opp ortunities to patients who don’t hav e a lot of options . The y’re the or phans of the medical w orld—no one knows what to do with them, so we’ve taken on the challeng e of taking care of them .” PETER KIM, MD I n t e r i m D i r e c t o r, A u t o I s l e t C e l l P r o g r a m

Whether it’s to treat chronic pain caused by pancreatitis or to better control type 1 diabetes, Baylor’s islet cell transplant team provides innovative approaches for patients who need them most. As the first hospital in the Southwest and one of only 33 centers in North America to offer islet cell transplantation, we’ve helped patients feel—and live—better through our comprehensive program, which offers autologous (for pancreatitis) and allogeneic (for diabetes) methods for treatments that change lives. AUTOLOGOUS ISLET CELL TRANSPLANTATION

In cases of chronic pancreatitis—a non-cancerous disease that can often cause severe and difficult-tomanage pain—surgically removing the pancreas is typically the only solution. But because this organ produces insulin, it leads to the onset of diabetes once it’s removed. Enter autologous islet cell transplantation. This procedure performed at Baylor’s laboratory extracts islet cells from the pancreas after removal. The cells are then purified and infused back into the

patient’s liver, where they produce insulin shortly after transplantation. In 2015, we performed 22 of these procedures, outpacing 2014’s 20. With positive outcomes and reduced pain—a reported 90 percent of patients with good to excellent relief—it has become an effective approach for treating chronic pancreatitis. ALLOGENEIC ISLET CELL TRANSPLANTATION

Studies are currently testing whether type 1 diabetics could benefit from allogeneic islet cell transplantation by helping the body produce enough insulin from transplanted islets to eliminate the need for insulin injections. As a result, it could help diabetics better control their blood sugar permanently.

By looking at islet cell transplantation over the past decade, our researchers have made significant contributions to the field. Since 2011, Baylor’s islet team has published 50 articles in peer-reviewed journals and has made discoveries that improved patients' quality of life—from pain relief to better treatment and disease management.

1st

In a study presented at the International Pancreas and Islet Transplant Association, International Xenotransplantation Association and Cell Transplantation Society (IPITA-IXACTS) 2015 Joint Congress in Melbourne, the islet team led by Bashoo Naziruddin, PhD, found that pancreatic mesenchymal stem cells—which can differentiate into a variety of cell types—are capable of forming islet-like structures that produce insulin. Dr. Naziruddin, who directs the islet cell laboratory, linked these findings to potential new therapies that could regenerate islet cells through stem cell therapy as a new source for insulin-producing cells. The result? With more ways to generate islet cells, more patients would have the opportunity to undergo islet transplantation to help control, prevent or even reverse their diabetes.

First hospital in the Southwest to perform islet cell transplantation from our own lab for type 1 diabetes and chronic pancreatitis patients

1 of 33 Baylor is one of 33 medical centers in North America to offer islet cell transplantation procedures

PROTECTING ISLET CELLS

Over the past few years, we have discovered that Withaferin, a plant-derived compound with anti-inflammatory and antioxidant properties, can inhibit the inflammatory response and protect transplanted islet cells from damage. The use of Withaferin may increase the mass of functional islets and improve the clinical outcome significantly.

Top 3

in the nation in auto islet transplant volume

The process is similar to auto cell transplantation, but the difference is that islet cells are extracted from a deceased donor’s pancreas. Typical candidates have had type 1 diabetes for more than five years, experience diabetes-related complications and show early signs of kidney problems.

outreach A reach as extraordinary as ours doesn’t just extend across North Texas—it touches the entire Lone Star State and beyond. And for those unable to bring themselves to the Simmons Transplant Institute, we bring the Simmons Transplant Institute to them. With dedicated outreach clinics in Abilene, Amarillo, Austin, Longview, Lubbock and Odessa, our heart, liver and kidney transplant teams have a presence that serve both urban and rural communities across the state. Importantly, these clinics give patients who are miles away from Baylor the same pre- and post-transplant care they’d otherwise have in Dallas or Fort Worth—from talented and compassionate physicians, nurses and staff to advanced treatments, innovative approaches and clinical trial opportunities.

4 6

But our reach expands beyond serving Texans alone. Patients have come from as far away as New York, New Jersey, North Carolina, Tennessee, Missouri and Michigan—as well as neighboring states such as Arkansas, Louisiana, New Mexico and Oklahoma—to take part in Baylor’s expansive network of transplant medicine.

CLOSE-TO-HOME CARDIAC CONSULTS

The year 2015 marked continuous growth in the outreach clinics, driven largely by closerto-home consultation options for patients with end-stage heart failure. Through monthly clinics, a transplant cardiologist on the medical staff at Baylor evaluates patients in Abilene, Amarillo, Longview, Lubbock and Odessa for cardiac transplantation, left ventricular assist devices (LVADs) and chronic inotropic

1 | Abilene

2 | Amarillo

3 | Austin

4 | Longview

5 | Lubbock

6 | Odessa

Heart Transplant Clinic

Heart Transplant Clinic Kidney Transplant Clinic Liver Transplant Clinic

Liver Transplant Clinic

Liver Transplant Clinic Heart Transplant Clinic

Liver Transplant Clinic Heart Transplant Clinic Kidney Transplant Clinic

Liver Transplant Clinic Heart Transplant Clinic

therapy—techniques that are usually more limited in rural communities. Plus, LVAD Visitation Days allow referring cardiologists to come to Baylor Dallas to learn about the device’s short- and long-term solutions. KIDNEY SUPPORT IN THE TEXAS PLAINS

Patients in West Texas and the Panhandle have access to the same Baylor experience they’d have in North Texas through satellite clinics at the Baylor Health Center at Amarillo and the Baylor Health Center at Lubbock. There, kidney transplant physicians offer evaluations and posttransplant monitoring and care without the need to take multiple trips away from home. When patients receive a kidney transplant, our goal is to get them back home within two to three weeks, where they can be closely followed by the transplant team in the outreach clinic nearest them, while we can stay in close communication with their referring nephrologist. LIVER HEALTH CLINICS

Every month, Baylor’s team of experienced hepatologists travels to clinics in Odessa, Lubbock, Longview and Austin to give patients there access to the same techniques, treatments and research opportunities that others have at the institute's home bases in Dallas and Fort Worth. At those clinics, patients with viral hepatitis, cirrhosis, liver masses and other liver conditions receive advanced pre- and posttransplant counseling and care right at home. In addition, patients may also be seen in Frisco, McKinney, Grand Prairie, Waxahachie and Midlothian. All clinics are an outreach service of Baylor’s HealthTexas Provider Network.

ABDOMINAL AND ISLET CELL TRANSPLANT

publications

A cut-off serum creatinine value of 1.5 mg/dl for AKI--to be or not to be. Wong F, O’Leary JG, Reddy KR, Kamath PS, Garcia-Tsao G, Maliakkal B, Subramanian R, Thacker L, Bajaj J; North American Consortium for the Study of End-Stage Liver Disease. J Hepatol. 2015 Mar;62(3):741-3.

133

A mass in the porta hepatis: A Rare Presentation of Ectopic Thyroid. Fernandez H, Kim P, Goldstein R. International Journal of Hepatobiliary and Pancreatic Diseases. 2016. ABO-compatible liver allograft antibodymediated rejection: an update. Demetris AJ, Zeevi A, O’Leary JG. Curr Opin Organ Transplant. 2015 Jun;20(3):314-24. Acute-on-Chronic Liver Failure. Asrani SK, Simonetto DA, Kamath PS. Clin Gastroenterol Hepatol. 2015 Nov;13(12):2128-39. American Gastroenterological Association Institute technical review on prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Perrillo RP, Gish R, Falck-Ytter YT. Gastroenterology. 2015 Jan;148(1):221-244.e3.

Antibody-mediated rejection: Immunology phenomenon looking for a clinical phenotype. Klintmalm GB. Liver Transpl. 2015 Nov;21 Suppl 1:S24.

Can one pill a day keep rejection away? Asrani SK, O’Leary JG. Am J Transplant. 2015 May;15(5):1135-6. Circulating TGF-ß1 and VEGF and risk of cancer among liver transplant recipients. Engels EA, Jennings L, Kemp TJ, Chaturvedi AK, Pinto LA, Pfeiffer RM, Trotter JF, Acker M, Onaca N, Klintmalm GB. Cancer Med. 2015 Aug;4(8):1252-7.

Number of publications in peerreviewed journals and book chapters

133

Active clinical research projects

Countries where physicians on the medical staff and scientists presented in 2015

Comparison of surface modification chemistries in mouse, porcine, and human islets. SoRelle JA, Kanak MA, Itoh T, Horton JM, Naziruddin B, Kane RR. J Biomed Mater Res A. 2015 Mar;103(3):869-77.

Design and Implementation of the International Genetics and Translational Research in Transplantation Network. Transplantation. International Genetics & Translational Research in Transplantation Network (iGeneTRAiN). 2015 Nov;99(11):2401-12. Development of a biliary-hepatic vein fistula after liver biopsy in a living donor liver candidate. Fernandez, H, Kim P, Goldstein R, Testa G. Applied Radiology. 2016. Diabetes and prediabetes in patients with hepatitis B residing in North America. Khalili M, Lombardero M, Chung RT, Terrault NA, Ghany MG, Kim WR, Lau D, Lisker-Melman M, Sanyal A, Lok AS; HBRN. Hepatology. 2015 Nov;62(5):1364-74. Diagnostic Accuracy of Magnetic Resonance Elastography in Liver Transplant Recipients: A Pooled Analysis. Siddharth Singh, Sudhakar K. Venkatesh, Andrew Keaveny, Sharon Adam Frank H. Miller, Patrick Asbach, Edmund M. Godfrey, Alvin C. Silva, Zhen Wang, Mohammad Hassan Murad, Sumeet K. Asrani, David J. Lomas, Richard L. Ehman. Annals of Hepatology, in press. Donor-specific alloantibodies in liver transplantation: how should we define and improve long-term success? O’Leary JG. Transpl Int. 2015 Dec;28(12):1359-61. Effect of the Duration of Chronic Pancreatitis on Pancreas Islet Yield and Metabolic Outcome Following Islet Autotransplantation. Takita M, Lara LF, Naziruddin B, Shahbazov R, Lawrence MC, Kim PT, Onaca N, Burdick JS, Levy MF. J Gastrointest Surg. 2015 Jul;19(7):1236-46. Effectiveness of Simeprevir Plus Sofosbuvir, With or Without Ribavirin, in Real-World Patients With HCV Genotype 1 Infection. Sulkowski MS, Vargas HE, Di Bisceglie AM, Kuo A, Reddy KR, Lim JK, Morelli G, Darling JM, Feld JJ, Brown RS, Frazier LM, Stewart TG, Fried MW, Nelson DR, Jacobson IM; HCV-TARGET Study Group. Gastroenterology. 2016 Feb;150(2):419-29. Elastography in Overweight and Obese Patients With Chronic Liver Disease. Flores A, Asrani SK. Clin Gastroenterol Hepatol. 2015 Aug;13(8):1510-2.

Enteral Nutrition in Chronic Liver Disease: Translating Evidence Into Practice. Hasse JM, DiCecco SR. Nutr Clin Pract. 2015 Aug;30(4):474-87. Equalizing MELD Scores Over Broad Geographies Is Not the Most Efficacious Way to Allocate a Scarce Resource in a Value-based Environment. Reed A, Chapman WC, Knechtle S, Chavin K, Gilroy R, Klintmalm GB. Ann Surg. 2015 Aug;262(2):220-3. Essential phospholipids prevent islet damage induced by proinflammatory cytokines and hypoxic conditions.Shahbazov R, Kanak MA, Takita M, Kunnathodi F, Khan O, Borenstein N, Lawrence MC, Levy MF, Naziruddin B. Diabetes Metab Res Rev. 2015 Sep 17. Evaluation of MicroRNA375 as a Novel Biomarker for Graft Damage in Clinical Islet. Transplantation. Kanak MA, Takita M, Shahbazov R, Lawrence MC, Chung WY, Dennison AR, Levy MF, Naziruddin B. 2015 Aug;99(8):1568-73. Hepatitis B reactivation during cancer chemotherapy: an international survey of the membership of the American Association for the Study of Liver Diseases. Hwang JP, Barbo AG, Perrillo RP. J Viral Hepat. 2015 Mar;22(3):346-52. Hepatitis B Virus. Gonzalez SA. In: Yu VL, ed. Antimicrobial Therapy and Vaccines. Vol 1. 4th ed. Pittsburgh, PA: ESun Technologies. 2015. Hepatitis B Virus Reactivation in the Setting of Cancer Chemotherapy and Other Immunosuppressive Drug Therapy. Gonzalez SA, Perrillo RP. Clinical Infectious Diseases. 2016; in press. Hepatitis C genotype influences post-liver transplant outcomes. Campos-Varela I, Lai JC, Verna EC, O’Leary JG, Todd Stravitz R, Forman LM, Trotter JF, Brown RS,‑ Terrault NA; Consortium to Study Health Outcomes in HCV Liver Transplant Recipients (CRUSH-C). Transplantation. 2015 Apr;99(4):835-40. Hepatitis C Therapeutic Registry Research Network Study Group. Interferon-free therapy for genotype 1 hepatitis C in liver transplant recipients: Real-world experience from the hepatitis C therapeutic registry and research

network. Brown RS Jr, O’Leary JG, Reddy KR, Kuo A, Morelli GJ, Burton JR Jr, Stravitz, RT, Durand C, Di Bisceglie AM, Kwo P, Frenette CT, Stewart TG, Nelson DR, Fried MW, Terrault NA; Liver Transpl. 2016 Jan;22(1):24-33.

Invited Commentary: Screening for hepatitis B in the immigrant population and individuals who are in need of immunosuppressive drug therapy. Perrillo R. Proc (Bayl Univ Med Cent). 2015 Oct;28(4):443-4. PMID: 26424936.

Hepatitis C treatment in patients on the liver transplant waiting list. Verna EC, O’Leary JG. Curr Opin Organ Transplant. 2015 Jun;20(3):242-50.

Keeping high model for end-stage liver disease score liver transplantation candidates alive. O’Leary JG, Orloff SL, Levitsky J, Martin P, Foley DP. Liver Transpl. 2015 Nov;21(11):142837.

Hepatic Encephalopathy: Pharmacological Therapies Targeting Ammonia. Rahimi RS, Rockey DC. Semin Liver Dis. 2016 Feb;36(1):4855. High risk of delisting or death in liver transplant candidates following infections: Results from the North American Consortium for the Study of End-Stage Liver Disease. Reddy KR, O’Leary JG, Kamath PS, Fallon MB, Biggins SW, Wong F, Patton HM, Garcia-Tsao G, Subramanian RM, Thacker LR, Bajaj JS; North American Consortium for the Study of End-Stage Liver Disease. Liver Transpl. 2015 Jul;21(7):881-8. Impact of IgG3 subclass and C1q-fixing donorspecific HLA alloantibodies on rejection and survival in liver transplantation. O’Leary JG, Kaneku H, Banuelos N, Jennings LW, Klintmalm GB, Terasaki PI. Am J Transplant. 2015 Apr;15(4):1003-13. Improved long-term outcomes after resection of pancreatic adenocarcinoma: a comparison between two time periods. Serrano PE, Cleary SP, Dhani N, Kim PT, Greig PD, Leung K, Moulton CA, Gallinger S, Wei AC. Ann Surg Oncol. 2015 Apr;22(4):1160-7. Incorporation of Noninvasive Measures of Liver Fibrosis Into Clinical Practice: Diagnosis and Prognosis. Asrani SK. Clin Gastroenterol Hepatol. 2015 Nov;13(12):2190-204. Inferior vena cava reconstruction for leiomyosarcoma of Zone I-III requiring complete hepatectomy and bilateral nephrectomy with autotransplantation. Fernandez HT, Kim PT, Anthony TL, Hamman BL, Goldstein RM, Testa G. J Surg Oncol. 2015 Oct;112(5):481-5.

Ledipasvir and Sofosbuvir Plus Ribavirin for Treatment of HCV Infection in Patients With Advanced Liver Disease. Charlton M, Everson GT, Flamm SL, Kumar P, Landis C, Brown RS Jr, Fried MW, Terrault NA, O’Leary JG, Vargas HE, Kuo A, Schiff E, Sulkowski MS, Gilroy R, Watt KD, Brown K, Kwo P, Pungpapong S, Korenblat KM, Muir AJ, Teperman L, Fontana RJ, Denning J, Arterburn S, Dvory-Sobol H, Brandt-Sarif T, Pang PS, McHutchison JG, Reddy KR, Afdhal N; SOLAR-1 Investigators. Gastroenterology. 2015 Sep;149(3):649-59. Lactulose vs Polyethylene Glycol for Treatment of Hepatic Encephalopathy-Reply. Rahimi RS, Cuthbert JA, Rockey DC. JAMA Intern Med. 2015 May;175(5):868-9. Liver Transplantation. Gonzalez SA, Trotter JF. In: McNally PR, ed. GI Liver Secrets 5th ed. Philadelphia: Elsevier; 2015 Liver transplantation for hepatocellular carcinoma: outcomes and treatment options for recurrence. Rahimi RS, Trotter JF. Ann Gastroenterol. 2015 Jul-Sep;28(3):323-330. Review. PubMed PMID: 26130250; PubMed Central PMCID: PMC4480168. Long-term follow-up of biliary complications after adult right-lobe living donor liver transplantation. Kim PT, Marquez M, Jung J, Cavallucci D, Renner EL, Cattral M, Greig PD, McGilvray ID, Selzner M, Ghanekar A, Grant DR. Clin Transplant. 2015 May;29(5):465-74. Long-term use of antibiotics and proton pump inhibitors predict development of infections in patients with cirrhosis. O’Leary JG, Reddy KR, Wong F, Kamath PS, Patton HM, Biggins SW, Fallon MB, Garcia-Tsao G, Subramanian RM,

Malik R, Thacker LR, Bajaj JS; North American Consortium for the Study of End-Stage Liver Disease. Clin Gastroenterol Hepatol. 2015 Apr;13(4):753-9.e1-2. Making the extraordinary, ordinary: renoportal bypass for complete portal vein thrombosis. McKenna GJ. Liver Transpl. 2015 Mar;21(3):275-6. Management of the critically ill patients with cirrhosis: A multidisciplinary perspective. Nadim MK, Durand F, Kellum JA, Levitsky J, O’Leary JG, Karvellas CJ, Bajaj JS, Davenport A, Jalan R, Angeli P, Caldwell SH, Fernández J, Francoz C, GarciaTsao G, Ginès P, Ison MG, Kramer DJ, Mehta RL, Moreau R, Mulligan D, Olson JC, Pomfret EA, Senzolo M, Steadman RH, Subramanian RM, Vincent JL, Genyk YS. J Hepatol. 2015 Oct 28. pii: S0168-8278(15)00718-7. Medical Management of Bleeding Varices: Primary and Secondary Prophylaxis. Gonzalez SA, Trotter JF. In: Jarnagin WR, ed. Blumgart’s Surgery of the Liver, Biliary Tract, and Pancreas. 6th ed. Philadelphia: Elsevier; 2016: in press. Model for end-stage liver disease score and MELD exceptions: 15 years later. Asrani SK, Kamath PS. Hepatol Int. 2015 Jul;9(3):346-54. Modeling the allocation system: principles for robust design before restructuring. Mehrotra S, Kilambi V, Gilroy R, Ladner DP, Klintmalm GB, Kaplan B. Transplantation. 2015 Feb;99(2):278-81. Monitoring of beta cell replacement outcomes. Chang CA, Haque WZ, Yoshimatsu G, Balaji PS, Lawrence MC, Naziruddin B. Panminerva Med. 2016 Jan 13. [Epub ahead of print] PubMed PMID: 26763742. National financial impact of broader liver sharing: organ procurement organizations experience with share 35. Fernandez H, Weber J, Barnes K, Wright L, Levy M. American Journal of Transplantation. 2016, 16: 287-291. Natural History of Hepatitis C. Gonzalez SA, Davis GL. In: Busuttil RW and Klintmalm GB, eds. Transplantation of the Liver. 3rd ed. Philadelphia, PA: Saunders; 2015

NFAT targets signaling molecules to gene promoters in pancreatic ß-cells. Lawrence MC, BorensteinAuerbach N, McGlynn K, Kunnathodi F, Shahbazov R, Syed I, Kanak M, Takita M, Levy MF, Naziruddin B. Mol Endocrinol. 2015 Feb;29(2):274-88. Non-cirrhotic Hyperammonemia—When High Ammonia Is not Always from Cirrhosis. Kumar S. Asrani SK. Curr Hepatology Rep. 2015;14:25–31 Non-invasive assessment of liver fibrosis and prognosis. Hagan M, Asrani SK, Talwalkar. J. Expert Rev Gastroenterol Hepatol. 2015;9(10):1251-60. Novel Ammonia-Lowering Agents for Hepatic Encephalopathy. Rahimi RS, Rockey DC. Clin Liver Dis. 2015 Aug;19(3):539-49. Organ Allocation: The Only Way to Predict Your Future Is to Know Your Past. Klintmalm GB. Am J Transplant. 2016 Feb;16(2):383-4. Post-liver transplant hepatitis C therapy. Rahimi RS, O’Leary JG. Curr Treat Options Gastroenterol. 2015 Jun;13(2):249-58. Preventing hepatitis B reactivation due to immunosuppressive drug treatments. Perrillo RP, Martin P, Lok AS. JAMA. 2015 Apr 28;313(16):1617-8. Proposed Diagnostic Criteria for Chronic AntibodyMediated Rejection in Liver Allografts. O’Leary JG, Cai J, Freeman R, Banuelos N, Hart B, Johnson M, Jennings LW, Kaneku H, Terasaki PI, Klintmalm GB, Demetris AJ. Am J Transplant. 2016 Feb;16(2):603-14. Reactivation of Hepatitis B Virus Due to Chemotherapy or Immunosuppressive Drug Therapy. Gonzalez SA, Perrillo RP. In: Liaw YF and Zoulim F, eds. Hepatitis B Virus in Human Diseases. 1st ed. New York: Springer; 2015. Recent US Food and Drug Administration warnings on hepatitis B reactivation with immune-suppressing and anticancer drugs: just the tip of the iceberg? Di Bisceglie AM, Lok AS, Martin P, Terrault N, Perrillo RP, Hoofnagle JH. Hepatology. 2015 Feb;61(2):703-11. Renal Autotransplantation in Lynch Syndrome: A Viable Option in a Patient With Contralateral Metachronous Ureteral Cancer. Woods T, Jennings

NB, Fernandez HT, Onaca N, Carlile BK, Levy MF, Gould DL, Ruiz R. Am J Transplant. 2015 Sep;15(9):2507-10.

The changing liver transplant waitlist: an emerging liver purgatory? Asrani SK, O’Leary JG. Gastroenterology. 2015 Mar;148(3):493-6.

Requirements for nutrition support pharmacists. Hasse JM. Nutr Clin Pract. 2015 Feb;30(1):11-3.

The Influence of Immunosuppressive Agents on the Risk of De Novo Donor-Specific HLA Antibody Production in Solid Organ Transplant Recipients. O'Leary JG, Samaniego M, Barrio MC, Potena L, Zeevi A, Djamali A, Cozzi E. Transplantation. 2016 Jan;100(1):39-53.

Safety and efficacy of Simeprevirplus Sofosbuvir with or without Ribavirin in patients with decompensated genotype 1 hepatitis C cirrhosis. Modi AA, Nazario H, Trotter JF, Gautam M, Weinstein J, Mantry P, Barnes M, Habib A, McAfee J, Teachenor O, Tujague L, Gonzalez S. Liver Transpl. 2015 Sep 3. Significance of measured intraoperative portal vein flows after thrombendvenectomy in deceased donor liver transplant recipients with portal vein thrombosis. Draoua M, Testa G, Kim P, Ramsay M, Saracino G, Gupta A, Fernandez H, Klintmalm G, Titze N. Journal of the American College of Surgeons. 2015; 221: S158-159. Sofosbuvir and Simeprevir in Hepatitis C genotype 1- patients with End-Stage Renal Disease on hemodialysis or GFR <30mL/min. Nazario HE, Ndungu M, Modi AA. Liver Int. 2015 Nov 19. Sofosbuvir and Velpatasvir for HCV in Patients with Decompensated Cirrhosis. Curry MP, O’Leary JG, Bzowej N, Muir AJ, Korenblat KM, Fenkel JM, Reddy KR, Lawitz E, Flamm SL, Schiano T, Teperman L, Fontana R, Schiff E, Fried M, Doehle B, An D, McNally J, Osinusi A, Brainard DM, McHutchison JG, Brown RS Jr, Charlton M; ASTRAL-4 Investigators. N Engl J Med. 2015 Dec 31;373(27):2618-28. Sotrastaurin in liver transplantation: has it had a fair trial? Trotter JF, Levy G. Am J Transplant. 2015 May;15(5):1137-8. Telaprevir- and Boceprevir-based Triple Therapy for Hepatitis C in Liver Transplant Recipients With Advanced Recurrent Disease: A Multicenter Study. Verna EC, Saxena V, Burton JR Jr, O’Leary JG, Dodge JL, Stravitz RT, Levitsky, J, Trotter JF, Everson GT, Brown RS Jr, Terrault NA; CRUSH-C Consortium. Transplantation. 2015 Aug;99(8):1644-51.

The Three-Month Readmission Rate Remains Unacceptably High in a Large North American Cohort of Cirrhotic Patients. Bajaj JS, Reddy KR, Tandon P, Wong F, Kamath PS, Garcia-Tsao G, Maliakkal B,Biggins SW, Thuluvath PJ, Fallon MB, Subramanian RM, Vargas H, Thacker LR, O’Leary JG; NACSELD. Hepatology. 2015 Dec 21. Total pancreatectomy with islet autotransplantation: summary of an NIDDK workshop. Bellin MD, Gelrud A, Arreaza-Rubin G, Dunn TB, Humar A, Morgan KA, Naziruddin B, Rastellini C, Rickels MR, Schwarzenberg SJ, Andersen DK. Ann Surg. 2015 Jan;261(1):21-9. Transfusing common sense instead of blood products into coagulation testing in patients with cirrhosis: Overtreatment ≠ safety. Rahimi RS, O’Leary JG. Hepatology. 2016 Feb;63(2):368-70. Tumor necrosis factor inhibitor therapy for hepatitis B virus-infected individuals: How loud is the alarm bell? Perrillo RP. Hepatology. 2015 Jul;62(1):16-8. Variations in albumin use in patients with cirrhosis: An AASLD members survey. Bajaj JS, O’Leary JG, Wong F, Kamath PS. Hepatology. 2015 Dec;62(6):1923-4.

HEART AND LUNG TRANSPLANTATION An Orally Bioavailable, Indole-3-glyoxylamide Based Series of Tubulin Polymerization Inhibitors Showing Tumor Growth Inhibition in a Mouse Xenograft Model of Head and Neck Cancer. Colley, H. E., M. Muthana, S. J. Danson, L. V. Jackson, M. L. Brett, J. Harrison, S. F. Coole, D. P. Mason, L. R. Jennings, M. Wong, V. Tulasi, D. Norman, P. M. Lockey, L. Williams, A. G. Dossetter, E. J. Griffen

and M. J. Thompson (2015). J Med Chem. 58(23): 9309-9333. Antitumor activity of paclitaxel is significantly enhanced by a novel proapoptotic agent in nonsmall cell lung cancer. Razi, S. S., S. Rehmani, X. Li, K. Park, G. S. Schwartz, M. J. Latif, F. Y. Bhora (2015). J Surg Res. 194(2): 622-630. Assessment of the Accuracy of the Diagnosis for Heart Failure in a Large Metropolitan Health Care System and the Impact on Readmission Rates. Carey, Sandra et al. Journal of Cardiac Failure, Volume 21, Issue 8, S6. Atrophy of the Heart After Insertion of a Left Ventricular Assist Device and Closure of the Aortic Valve. Roberts WC, Hall SA, Ko JM, McCullough PA, Lima B. Am J Cardiol. 2016 Mar 1;117(5):8789. Cerebral protection during deep hypothermic circulatory arrest: Can a molecular approach via microRNA inhibition improve on a millennia-old strategy. Squiers, J. J., M. Arsalan, B. Lima and J. M. DiMaio (2015). J Thorac Cardiovasc Surg. 150(3): 684-686. Clinical and morphologic features of acute, subacute and chronic cor pulmonale (pulmonary heart disease). Roberts, W. C., A. E. Shafii, P. A. Grayburn, J. M. Ko, M. R. Weissenborn, R. L. Rosenblatt and J. M. Guileyardo (2015). Am J Cardiol. 115(5): 697-703. Distal aortic interventions after repair of ascending dissection: the argument for a more aggressive approach. Roselli, E. E., G. Loor, J. He, A. E. Rafael, J. Rajeswaran, P. L. Houghtaling, L. G. Svensson, E. H. Blackstone and B. W. Lytle (2015). J Thorac Cardiovasc Surg. 149(2 Suppl): S117-124.e113. Early graft dysfunction after lung transplantation. Brown, C. R., M. M. Budev and D. P. Mason (2015) Am J Transplant. 15(2): 569-571. Expanding the donor pool: donation after cardiac death. Elgharably, H., A. E. Shafii and D. P. Mason (2015). Thorac Surg Clin. 25(1): 35-46.

Gefitinib in definitive management of esophageal or gastroesophageal junction cancer: a retrospective analysis of two clinical trials. Sohal, D. P., T. W. Rice, L. A. Rybicki, C. P. Rodriguez, G. M. Videtic, J. P. Saxton, S. C. Murthy, D. P. Mason, B. E. Phillips, R. R. Tubbs, T. Plesec, M. J. McNamara, D. I. Ives, J. W. Bodmann and D. J. Adelstein (2015). Dis Esophagus. 28(6): 547-551. Heart transplantation in the Ehlers-Danlos syndrome. Reinhold SM, Lima B, Khalid A, Gonzalez-Stawinski GV, Stoler RC, Hall SA, Chamogeorgakis T. Proc (Bayl Univ Med Cent). 2015 Oct;28(4):492-3. PubMed PMID: 26424951; PubMed Central PMCID: PMC4569234. Human recombinant apyrase therapy protects against canine pulmonary ischemia-reperfusion injury. Ibrahim, M., X. Wang, C. A. Puyo, A. Montecalvo, H. J. Huang, R. R. Hachem, C. Andreetti, C. Menna, R. Chen, A. S. Krupnick, D. Kreisel, E. A. Rendina and A. E. Gelman (2015). J Heart Lung Transplant. 34(2): 247-253. Hypothermic Circulatory Arrest in Cardiac Transplantation. Lima B, Chamogeorgakis T, MacHannaford JC, Gonzalez-Stawinski GV. Transplant Proc. 2015 Nov;47(9):2719-21. Imaging mouse lung allograft rejection with (1)H MRI. Guo, J., H. J. Huang, X. Wang, W. Wang, H. Ellison, R. P. Thomen, A. E. Gelman and J. C. Woods (2015). Magn Reson Med. 73(5): 1970-1978. Imaging pulmonary inducible nitric oxide synthase expression with PET. Huang, H. J., W. Isakow, D. E. Byers, J. T. Engle, E. A. Griffin, D. Kemp, S. L. Brody, R. J. Gropler, J. P. Miller, W. Chu, D. Zhou, R. A. Pierce, M. Castro, R. H. Mach and D. L. Chen (2015). J Nucl Med. 56(1): 76-81. Implications from neurologic assessment of brain protection for total arch replacement from a randomized trial. Svensson, L. G., E. H. Blackstone, C. Apperson-Hansen, P. M. Ruggieri, P. Ainkaran, R. I. Naugle, B. Lima, E. E. Roselli, M. Cooper, D. Somogyi, E. M. Tuzcu, S. Kapadia, D. G. Clair, J. F. Sabik, 3rd and B. W. Lytle (2015). J Thorac Cardiovasc Surg. 150(5): 1140-1147.e1111. Intralobar Pulmonary Sequestration Presenting as Chronic Non-productive Cough. Gudavalli, R., C. C. Farver, D. P. Mason and U. Hatipoglu (2015). Gudavalli, R., C. C. Farver, D. P. Mason and U. Hatipoglu (2015).

Invited Commentary: Using â&#x20AC;&#x153;broken heartsâ&#x20AC;? for cardiac transplantation: a risky venture or fruitful endeavor? Lima B. Proc (Bayl Univ Med Cent). 2016 Jan;29(1):74-5. PubMed PMID: 26722179; PubMed Central PMCID: PMC4677864. Replacement of the aortic valve with a bioprosthesis at the time of continuous flow ventricular assist device implantation for preexisting aortic valve dysfunction. Lima B, Chamogeorgakis T, Mountis M, Gonzalez-Stawinski GV. Proc (Bayl Univ Med Cent). 2015 Oct;28(4):454-6. PubMed PMID: 26424939; PubMed Central PMCID: PMC4569222.

Utility of cardiac computed tomography for inflow cannula patency assessment and prediction of clinical outcome in patients with the HeartMate II Left Ventricular Assist Device. Chamogeorgakis, Themis, Hall, Shelley, and MacHannaford, Juan. Eur J Cardiothorac Surg. 29 July 2015;pii:ivv205. Ventricular assist devices: The future is now. Lima, B., M. Mack and G. V. Gonzalez-Stawinski (2015). Trends Cardiovasc Med. 25(4): 360-369. Women with Rheumatoid Arthritis: The Unspoken Risk Factor. Carey, S.A. The Journal for Nurse Practitioners, 11 no. 8 (2015).

Surgical management of inflow cannula misalignment in an LVAD patient. Hall, Shelley A, Trungale, Kellis R., Dockery, Dee, and GonzalezStawinski, Gonzalo V. Clinical Case Report. Baylor University Medical Center, Annette C. and Harold C. Simmons Transplant Institute. 2015;1(2). Thalidomide for treatment of gastrointestinal angiodysplasia in patients with left ventricular assist devices: case series and treatment protocol. Draper, K., P. Kale, B. Martin, K. Cordero, R. Ha and D. Banerjee. (2015). J Heart Lung Transplant. 34(1): 132-1343. The Impact of Sleep Apnea Syndrome Post Cardiac Transplantation. Carey, Sandra et al. Journal of Cardiac Failure, Volume 21, Issue 8, S128. The two extremes of cardiac sarcoidosis and the effect of Prednisone therapy. Armstrong D, Gonzalez-Stawinski GV, Ko JM, Hall SA, Roberts WC. Am J Cardiol. 2015 Jan 1;115(1):150-3. Usefulness of percutaneous closure of patent foramen ovale for hypoxia. Munkres AG, Ball TN, Chamogeorgakis T, Ausloos KA, Hall SA, Choi JW. Proc (Bayl Univ Med Cent). 2015 Apr;28(2):2046. PubMed PMID: 25829655; PubMed Central PMCID: PMC4365121. Utility of cardiac computed tomography for inflow cannula patency assessment and prediction of clinical outcome in patients with the HeartMate II left ventricular assist device. Sacks, J., G. V. Gonzalez-Stawinski, S. Hall, B. Lima, J. MacHannaford, W. Dockery, M. Cura and T. Chamogeorgakis (2015). Interact Cardiovasc Thorac Surg. 21(5): 590-593.

medical staff

LEADERSHIP TEAM Göran Klintmalm, MD, PhD, FACS

In 2015, our team grew by extraordinary measures. We welcomed new transplant cardiologists, new pulmonologists and a new lung transplant surgeon—in addition to many new compassionate and skilled clinical, operational and support staff members. As we attract and retain this exceptional talent, we’re proud to have a team that combines years of experience and dedication to advancing medicine. Those attributes—paired with our team’s tremendous compassion and genuine interest to grow, learn and teach through research and educational events— contribute to our success as a center of excellence.

Chief and Medical Director of the Transplant Services Department; Chairman of the Baylor Annette C. and Harold C. Simmons Transplant Institute

ABDOMINAL TRANSPLANT SURGEONS Giuliano Testa, MD, FACS, MBA Surgical Chief, Abdominal Transplant; Medical Director, Living Donor Liver Transplant Program of the Baylor Annette C. and Harold C. Simmons Transplant Institute

Tiffany Anthony, MD

Peter Tae Wan Kim, MD, MSc, FRCS(C)

Nicholas Onaca, MD

Surgical Director, Laparoscopic Kidney Donation

Interim Director of the Islet Cell Program for Baylor Scott & White Health; Assistant Surgical Director, Living Donor Liver Transplantation; Associate Program Director/ Surgical Instructor

Surgical Director, Kidney Transplantation; Interim Director, Allo Islet Cell Transplantation

Robert M. Goldstein, MD, FACS WHEN PERSONAL AND PROFESSIONAL PATHS CROSS

When Mike Delozier passed away in May 2012 at the age of 51, his wife Paula did what many grieving partners do to share their loved one’s legacy and what her husband wanted–she donated his organs so that lives somewhere, somehow could be saved. And saved they were. Mike’s heart, corneas, bone tissue, kidneys—almost every organ he had, actually—gave second chances to many people. “Mike was the type of guy who would give you the shirt off his back,” said Paula, who was a nurse at the time of her husband’s death. “To me, it was fitting that he still could give, that he helped so many people. I felt like it was easier to grieve and accept that crazy loss that was just completely unexpected.” But there was something so special about Paula’s interactions with Baylor that she wanted to do more. “Baylor was great to me and our family,” she said, adding that the compassionate staff helped her start the grieving process. She even met the surgical team involved in Mike’s donation. Paula began volunteering with Donate Life Texas, then applied for a job at Baylor in the surgical department, and in November 2015, transferred to the transplant department, where she works as a lung transplant coordinator—counseling transplant candidates by sharing her perspective. “I wanted to be here to share my story, to help and encourage patients,” said Paula, who

participated in a flag-raising Donate Life Texas event in honor of her husband. While at that ceremony, she said: “I wasn’t a Baylor nurse when this happened, but I got here as fast as I could.” Moments like these are what matter at Baylor. Every interaction is an opportunity to make a difference in someone’s life. And for Paula— whose husband’s name lives on across the Wall of Heroes at Baylor Dallas as a token of his own departing gift to others—working at Baylor is her way of saving lives, too.

Surgical Director, Liver Pancreas Disease Center at Baylor Dallas; Division Chief, Hepatobiliary; Assistant Medical Director, Transplantation Services at Baylor Dallas

Gregory J. McKenna, MD, FRCS(C), FACS Director, Liver Transplant Surgical Research; System Physician Informatics Leader

Richard M. Ruiz, MD, FACS Surgical Director, Pancreas Transplant; Assistant Director, Fellowship Program; Interim Surgical Director, Baylor Scott & White - Fort Worth Transplant Program

HEART TRANSPLANT SURGEONS Gonzalo Gonzalez-Stawinski, MD Chief, Heart Transplantation and Mechanical Circulatory Support at Baylor Dallas; Chief, Cardiovascular Surgery Services at Baylor Dallas

Themistokles Chamogeorgakis, MD

Brian Lima, MD

Juan MacHannaford, MD

Associate Director, Heart Transplantation & Mechanical Circulatory Support; Medical Director, Quality for Cardiovascular Surgical Services

Director, Clinical Research, Heart Transplantation and Mechanical Circulatory Support

Vice Chairman, Cardiovascular Surgical Services

Aldo Rafael, MD

LUNG TRANSPLANT SURGEONS David P. Mason, MD Chief, Thoracic Surgery and Lung Transplantation at Baylor Scott & White Health; Chief, Department of Thoracic Surgery and Lung Transplantation at Baylor Dallas

Themistokles Chamogeorgakis, MD

Gary Schwartz, MD

Associate Director, Heart Transplantation & Mechanical Circulatory Support; Cardiovascular Surgery Medical Director for Quality Committee

Surgical Director, Major Airway Disorders Department of Thoracic Surgery and Lung Transplantation, Baylor University Medical Center

Aldo Rafael, MD

TRANSPLANT CARDIOLOGISTS Shelley A. Hall, MD, FACC Chief, Transplant Cardiology and Mechanical Circulatory Support Services

Susan Joseph, MD

Jose Mendez, MD

Parag Kale, MD

Medical Director, Ventricular Assist Device Program

Medical Director, Advanced Heart Failure Fellowship Program

Medical Director, Amyloid Center

Johannes J. Kuiper, MD Medical Director, Outreach Center for Heart Disease and Transplant

Amarinda Bindra, MD Assistant Medical Director, Outreach for Advanced Heart Disease and Transplant

TRANSPLANT HEPATOLOGISTS James Trotter, MD Medical Director of Liver Transplant, Baylor Annette C. and Harold C. Simmons Transplant Institute; Jim and Angela Thompson Chair Hepatology; Research and Scholarly Activities

Mohammad Ashfaq, MD

Linsheng Guo, MD

Sumeet Asrani, MD, MSC

Maria Lepe, MD

Manjushree Gautam, MD, MAS Stevan A. Gonzalez, MD, MS Medical Director, Liver Transplant, BASMC

Director, Hepatology Fellowship Program

Apurva A. Modi, MD Natalie G. B. Murray, MD

Jacqueline O’Leary, MD, MPH Director of Research, Baylor Annette C. and Harold C. Simmons Transplant Institute; Medical Director, Hepatology/Liver Unit at Baylor Dallas

Robert Perrilo, MD Robert S. Rahimi, MD, MSCR

TRANSPLANT NEPHROLOGISTS Bernard V. Fischbach, MD Medical Director, Renal and Pancreas Transplantation

Steven Hays, MD

Arun Chandrakantan, MD

Arthi Rajagopal, MD

Medical Director, Hemodialysis and Renal Replacement Therapy; Medical Director, Living Donor Kidney Program

Larry Melton, MD

Kim Rice, MD

Imran Memon, MD

Angelito Yango, MD

Kenneth Ausloos, MD

Puneet Garcha, MD

Howard J. Huang, MD

Medical Director, Lung Transplant and Pulmonary Hypertension; Medical Advisor, Pulmonology

Assistant Director, Lung Transplantation and Advanced Lung Disease

Assistant Director, Lung Transplantation; Director, Lung Transplantation Research at Baylor Dallas

Yousri Barri, MD

TRANSPLANT PULMONOLOGISTS Randall L. Rosenblatt, MD, MACP, FACCP Chief of Pulmonary Medicine

Physicians provide clinical services as members of the medical staff at one of Baylor Scott & White Health’s subsidiary, community or affiliated medical centers and do not provide clinical services as employees or agents of those medical centers, Baylor Health Care System, Scott & White Healthcare or Baylor Scott & White Health. ACHC 553 © 2016 Baylor Scott & White Health

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