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Department of Surgery News - 2020

Couple Has Open Heart Surgery, Performed by Dr. Victor Pretorius, Months Apart

November 30, 2020 –In early 2020, Steven and Linette Williamson experienced the true meaning of the wedding vow in sickness and in health when they both underwent open heart surgery within just four months of each other.

After seven years of treatment for a genetic heart abnormality, Steven was told he needed a heart transplant to save his life. Soon after Steven began his recovery process, Linette was diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH), and found herself in the care of the same surgeon who performed her husband’s surgery, Dr. Victor Pretorius, Cardiothoracic Surgeon and Surgical Director of the Heart Transplant Program at at UC San Diego Health.

Now, both husband and wife are on the road to recovery together.

Surgeons Can Use a Person’s Own Tissue as Alternative to Implants after Breast Cancer

October 28, 2020 –In October 2019, while watching a television interview about breast cancer awareness, Annette Whalen made a mental note to schedule a mammogram. That moment may have saved her life.

The mammogram revealed ductal carcinoma in situ or DCIS, an early form of breast cancer that affects the milk ducts.

“I was fortunate that it had not spread into the breast tissue,” said Whalen.

While breast cancer may be found after symptoms appear, many women experience no symptoms, which makes screening a lifesaving tool.

“Mammography can find some cancers that may otherwise elude detection for years,” said Anne Wallace, MD, director of the Comprehensive Breast Health Centerat UC San Diego Health. “If left alone, tumors confined in the duct can eventually break through and become invasive. Early treatment prevents the spread of the tumor and makes treatment more successful.”

Study: COVID-19 Infection Combined with Blood Clots Worsen Patient Outcomes

November 23, 2020 –While respiratory issues continue to be the most common symptom of a COVID-19 infection, new research indicates the disease could also be associated with hypercoagulability, or increased tendency of the blood to clot. In a new study published November 20, 2020 in the journal EClinical Medicine by The Lancet, researchers from UC San Diego Health found that blood clots led to an increased risk of death by 74 percent.

Led by Mahmoud Malas, MD, division chief of Vascular and Endovascular Surgery at UC San Diego Health, researchers reviewed 42 different studies involving more than 8,000 patients diagnosed with COVID-19. Using random models, the team produced summary rates and odds ratios of mortality in COVID-19 patients with thromboembolism, blood clots — and compared them to patients without these conditions to determine what effect blood clots may have on risk of death.

Genetic Testing Cost Effective for Newly Diagnosed GIST

September 28, 2020 –Because gastrointestinal stromal tumors (GIST) are sensitive to the targeted small molecule therapy imatinib, oncologists tend to treat all patients with metastatic GIST with this drug. However, because this rare type of cancer is caused by different genetic mutations, imatinib does not help all patients equally.

To determine whose cancer may be most responsive, the National Comprehensive Cancer Network suggests that patients undergo genetic testing to identify each individuals’ tumor mutations. And yet, only 30 percent of patients have genetic testing at the time of diagnosis, likely due to concerns over cost and utility of testing, said Jason Sicklick, MD , professor of surgery in the Division of Surgical Oncology at University of California San Diego School of Medicine.

UC San Diego Health Revives Non-Beating Donor Heart for Successful Transplantation

Investigational procedure is first-ever on West Coast and could significantly decrease transplant waiting list times and improve patient outcomes

September 15, 2020 –UC San Diego Health is the first hospital on the West Coast to perform heart transplant surgery from a donor after circulatory death, or DCD, using a new portable organ care system. The successful surgery is part of a national interventional clinical trial that could increase organ donation by an estimated 20-30 percent, resulting in less waiting time for patients in need of a new heart.

DCD involves retrieving organs from hospitalized donors who have died because their heart has stopped, either naturally or because life support has been discontinued. In such cases, with prior consent, surgeons remove the organ — within 30 minutes — and connect it to a machine that perfuses the heart with warm blood, reviving and keeping the organ beating and functional for assessment and possible transplantation. The warm perfusion system can potentially keep the organ viable for longer periods than traditional cold storage, allowing for transporting organs over much longer distances.

Surgical Team Performs San Diego's First HIV Donor to HIV Recipient Liver Transplant

Procedure part of a national clinical trial examining outcomes of HIV organ transplantation

September 3, 2020 –UC San Diego Health is the first hospital in San Diego and only health care system in Southern California to transplant a liver from a donor with Human Immunodeficiency Virus (HIV) into an HIV-positive recipient. The successful surgery is part of a national clinical trial that could result in more life-saving options and less time on the transplant wait list for HIV-positive patients.

UC San Diego Health is participating in two national clinical trials supported by the HIV Organ Policy Equity (HOPE) Act, which was passed by Congress in 2013. The HOPE Act permits transplant teams in the United States with an approved research protocol to transplant organs from donors with HIV to qualified recipients with HIV and end-stage organ failure.

UC San Diego Health Flexes New Robotic Surgical Capabilities

System mimics surgeons’ hand movements, enhances performance

August 13, 2020 –Surgeons at UC San Diego Health were the first in California to use a new flexible robotic system for operations in two highly intricate areas of the body: the neck and throat. Using an articulated telescope, combined with a flexible instrumentation and a high-definition 3D vision system, the robotic system provides safe access to delicate anatomical regions, such as the tonsils, base of the tongue, lower portions of the throat and around and inside the larynx or voice box.

“This flexible robotic system is used across a range of applications, including tumor resection, sleep surgery and micro-laryngeal surgery,” said Charles Coffey, MD , board-certified otolaryngologist and head and neck surgeon at UC San Diego Health. “With this new technology, we’ll continue UC San Diego Health’s advances in minimally invasive surgical approaches.”

A Kidney Named Lefty

Through remote donation, a woman’s life is saved and a “sisterhood” is formed

August 20, 2020 – Barbara Gallas, age 70, knew she was getting significantly more ill.

“I had no energy. I could do like two errands and then I needed to go home and go back to sleep,” she said.

In 2005, the San Diego resident was diagnosed with polycystic kidney disease, a genetic disorder that causes many fluid-filled cysts to grow in the kidneys. Unlike the harmless kidney cysts that can form later in life, PKD cysts can distort the shape of your kidneys, including making them much larger.

Out of Thin Air

Two childhood friends who suffer from lung disease reunite while seeking treatment at UC San Diego Health

August 27, 2020 –Jillian Queri knew something was terribly wrong. A student living abroad in Australia and lifelong athlete, she began struggling to breathe and almost drowned one morning while surfing. Later in a hospital emergency department, Queri learned she had multiple pulmonary embolisms, or blood clots, in her lungs and deep vein thrombosis (DVT) in her arm.

“I finished the rest of the year in Australia regularly taking blood thinners, but I still wasn’t feeling well and when I returned to the United States, my condition deteriorated significantly.”

Expanding Treatment Options for Severe Brain Trauma

Every 15 seconds someone in the United States suffers a traumatic brain injury; a new research study at UC San Diego Health seeks to improve treatment options

July 23, 2020 –Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room or tube, and is commonly used to treat decompression sickness resulting from scuba diving or wounds that resist healing, such as those resulting from some types of cancer radiation treatment or from complications of diabetes. Researchers at UC San Diego Health have joined a national research study called Hyperbaric Oxygen Brain Injury Treatment (HOBIT) to assess whether the approach might also benefit patients with severe brain injuries.

"Trauma can be a devastating injury that will greatly effect a person’s quality of life, and we are looking to improve treatment options in order to significantly increase positive outcomes for our patients,” said Todd Costantini, MD, trauma medical director at UC San Diego Health and the site principal investigator for the HOBIT study. “This is the first randomized, controlled trial analyzing the effects that hyperbaric oxygen treatment has on outcomes following brain injury and preliminary studies have demonstrated that it may improve neurological recovery.”

UC San Diego Health Ranked #1 by U.S. News & World Report

Region’s only academic health system has 10 medical and surgical specialties rated among nation’s best

July 27, 2020 –UC San Diego Health is ranked first in San Diego and sixth in California, placing it among the nation’s best hospitals, according to the 2020-2021U.S. News & World Report . The annual rankings are designed to assist patients and their doctors in making informed decisions about where to receive care for a variety of health conditions, common elective procedures and complex surgeries.

Treating COVID-19 South of the Border

In some ways, San Diego has been lucky: The rise in COVID-19 cases in the county was initially delayed compared to many other places around the U.S., which bought some time for health care providers to aggressively prepare to be as ready as possible when the spike came.

However, just south of the border in Tijuana, Mexico, a combined shortage of resources, along with less strict social distancing and governmental outreach, caused the virus to spread more quickly. As more people with COVID-19 arrived in Tijuana's hospitals, many physicians providing care to them in the intensive care units also got sick with the disease. Although other physicians and care providers stepped in to volunteer, many lacked training in ICU care.

Dr. Jason Sicklick Appointed Executive Vice Chair for Research

Our Department is thrilled to announce the appointment of Jason Sicklick, MD, to the role of Executive Vice-Chair for Research in the Department of Surgery effective June 1. Dr. Sicklick is a highly accomplished clinician-scientist whose portfolio of research activities spans practice-changing clinical trials, sophisticated translational science, and provocative health services research. His extraordinary record of success in these domains will be fundamental to driving needed change in our research infrastructure, organizational structure, and processes.

In Memoriam: Dr. Arnost Fronek, MD, PhD

We are deeply saddened to announce the loss of Arnost Fronek, MD, PhD, professor emeritus of the UC San Diego Department of Surgery and founding member of the American College of Phlebology. Dr. Fronek passed away on June 8 at the age of 97.

Arnost Fronek was born in Slovakia in 1923, and as a young teenager developed an aptitude for electronics and radio repairs. Following the rise of the Nazi regime in the 1930s, his parents sent him to Israel, where he worked in a metal shop before matriculating at the Israel Institute of Technology to study the theory of wireless systems.

UC San Diego Health Nationally Recognized with ‘A’ Grades for Safety

Leapfrog Hospital Safety Grades released for Spring 2020

April 30, 2020 –UC San Diego Health has been awarded double ‘A’ grades for the spring 2020 Leapfrog Hospital Safety Grade. This national distinction recognizes UC San Diego Health’s hospitals in Hillcrest and La Jolla for providing demonstrably safer health care for its patients. Leapfrog assigns letter grades based on a hospital’s record of patient safety, and effective, systemic efforts to prevent errors, injuries, accidents and infections.

Mobile Life Support Delivered to Area Hospitals During COVID-19 Pandemic

Transportable heart-and-lung machine provides lifesaving care to critically ill patients

May 26, 2020 –News coverage of the coronavirus pandemic has been fraught with stories and images of patients hospitalized with COVID-19 struggling for breath, often involving mechanical lung support. However, a small number of patients become so ill that a ventilator alone cannot sustain life and help doctors get the patient on the road to recovery. When all else fails, these patients require extracorporeal membrane oxygenation, or ECMO.

Telehealth Visits Allow Patients to Connect to Care During COVID-19

May 21, 2020 –A seizure sent Danielle Lovette to the hospital where a brain scan revealed an oligodendroglioma, a cancer of the central nervous system. Subsequent mobility and communications challenges caused by the malignancy, compounded by recovery from necessary surgery and radiation treatments, made the 24-mile round-trips from her home to Moores Cancer Center at UC San Diego Health daunting and exhausting.

With the help of her husband, Corey Nigrelli, Lovette endured the lifesaving treks, but then the novel coronavirus changed everything, including how Lovette attends speech therapy.

Tested and Testing: UC San Diego Health Expands COVID-19 Diagnostics

April 6, 2020 –From the beginning, the ability of front line clinicians to test patients for COVID-19 — to determine whether a person is infected with the disease-causing novel coronavirus, SARS-CoV-2 — has been part and parcel of the pandemic.

Testing shortages have hindered health care systems around the world, spurring extraordinary efforts to find and implement testing strategies.

New Injection Technique May Boost Spinal Cord Injury Repair Efforts

In rodent studies, method reduced likelihood of further spinal cord trauma while delivering large doses of potentially reparative stem cells; the approach may have utility for multiple neurodegenerative conditions

January 29, 2020 –Writing in the journal Stem Cells Translational Medicine , an international research team, led by physician-scientists at University of California San Diego School of Medicine, describe a new method for delivering neural precursor cells (NSCs) to spinal cord injuries in rats, reducing the risk of further injury and boosting the propagation of potentially reparative cells.

The findings are published in the Jan. 29, 2020 print issue.

Liver Fibrosis 'Off Switch' Discovered in Mice

UC San Diego School of Medicine researchers identify several genetic switches, or transcription factors, that determine whether or not liver cells produce collagen — providing a new therapeutic target for liver fibrosis

January 23, 2020 – Chronic alcohol abuse and hepatitis can injure the liver, often leading to a buildup of collagen and scar tissue. Understanding this process, known as liver fibrosis, could help researchers develop new ways to prevent or treat conditions such as alcoholic liver disease, non-alcoholic steatohepatitis (NASH) and nonalcoholic flatty liver disease (NAFLD).

In a study published January 23, 2020 by Gastroenterology, researchers at University of California San Diego School of Medicine demonstrated for the first time that liver fibrosis progression could potentially be addressed by manipulating a special population of liver cells called hepatic stellate cells (HSCs).

How Marijuana Accelerates Growth of HPV-related Head and Neck Cancer Identified

January 13, 2020 –University of California San Diego School of Medicine researchers have identified the molecular mechanism activated by the presence of tetrahydrocannabinol (THC) — the ingredient that causes people to feel the euphoria or “high” associated with cannabis — in the bloodstream that accelerates cancer growth in patients with human papillomavirus (HPV)-positive head and neck squamous cell carcinoma.

“HPV-related head and neck cancer is one of the fastest growing cancers in the United States. While at the same time, exposure to marijuana is accelerating. This is a huge public health problem,” said Joseph A. Califano III, MD , senior author and professor and vice chief of the Division of Otolaryngology in the Department of Surgery at UC San Diego School of Medicine.