Category Archives: TF Original

This Surgeon is Redefining the Possibilities of Organ Transplant Surgery – UVA Today (press release) (registration)

This was originally published on this site

Robots have assisted in transplant surgeries for more than a decade in the United States, but Dr. Jose Oberholzer sees untapped possibilities for the technology. Having performed more than 1,000 transplant-related surgeries himself, Oberholzer is bringing his experience and his plans for innovation to the University of Virginia Health System.

In March, he will become the new director of UVA’s Charles O. Strickler Transplant Center. He comes to the University from the University of Illinois, Chicago, where he led the Division of Transplantation and directed the Islet and Pancreas Transplant Program. Oberholzer is a pioneer in robotic surgery and an expert in liver, kidney, pancreas and small bowel transplants, as well as transplants in patients with diabetes. He is also co-founder and coordinator for the Chicago Diabetes Project, which is researching a cure for diabetes.

Before he begins his new position, UVA Today spoke with Oberholzer about his plans for UVA’s transplant center and how he plans to use the University’s cross-disciplinary research structure to advance the treatment of diabetes and other chronic conditions.

Q. What attracted you about UVA?

A. UVA is quite a unique American academic institution in that you have the School of Medicine and the entire Health System sharing a vision on their priorities – and of course, that includes transplantation. That was a huge point for me. In many academic institutions, you have a bit of a silo between the health system and the school, and that leads to some inefficiencies. At UVA, I felt that gap just did not exist. It’s all one body.

That’s really important for transplantation because, more than any other discipline, it needs to have all the different players on the same train. You need so many disciplines; you can’t do anything alone in transplantation. It’s all team-based.

Q. How have robotics changed the landscape of transplant surgery?

A. The robot reduces the learning curve for [new transplant surgeons] and allows you to do movement inside the human body in a way that you just cannot do with normal laparoscopic instruments. To give you an idea, normal laparoscopic instruments are like chopsticks. You have very few degrees of movement and you can only move in a cone, whereas the robot has sort of mini-hands inside the body and you can move it in all directions. You can actually make more movements that you could with your own hands.

My role [in Chicago] was to develop this for more complex procedures. You could argue that to remove a kidney you really wouldn’t need a robot, and that’s fair, but this allows us to take on cases that we may not consider for normal laparoscopic surgery. For example, if there are anatomical variations or if the patient is obese, laparoscopy is difficult. With the robot, these cases are possible.

Q. What robotic surgery advances did you work on in Chicago?

A. There is a very large proportion of kidney transplant recipients who are being denied access to transplantation because they’re overweight. The reason for that is because they have a very high rate of surgical complications and wound complications. We thought that if we could do a kidney transplant through a very small incision using robotic surgery, we may be able to prevent complications and wound infections and achieve a much better outcome. We did that and the results proved our hypothesis to be correct.

Q. What are some new areas of innovation you’re looking forward to here?

A. In general, the structure of a transplant institute or the vertical integration allows us to have discussions between different disciplines and to open doors that we didn’t even know were there.

As an example, UVA has a fantastic heart transplant program. So when I met with the directors of the different organ transplant programs, I asked them, “Do you have any patients that you feel could benefit from a transplant, but right now don’t have access to it for whatever reason – medical, logistical, technical or otherwise?”

Dr. James Bergin, the medical director of the heart transplant program, said that they can offer patients with heart failure left ventricular assist devices, but in patients who already have kidney failure, they are reluctant to consider it because many dialysis units don’t know how to handle a patient with a ventricular assist device.

Right now, UVA owns 11 dialysis units, so it could be the place to explore new treatment options for those kinds of patients. That would be a wonderful example of how vertical integration could bring disciplines together to attack a very complex problem.

Q. How will your work be a part of UVA’s fight to end juvenile diabetes?

A. I am very interested in the treatment of diabetes using cell therapy and technology in general. One of the things that attracted me to UVA is that the University has tremendous brainpower in diabetes technologies, such as the artificial pancreas, and in addition is building a very large cell therapy unit. That’s something that I have been doing now for over 20 years.

I did that at the University of Illinois, Chicago and I’m in the process of applying for a biologic license – getting FDA approval for a cell therapy for juvenile diabetes. That will be the first approved cell product for diabetes in the U.S.

Q. Is there anything you wish more people knew about the transplant process?

A. Even in the year 2017, some people think transplantation is bizarre and done very rarely, but the truth is that it has become standard of care for many diseases – for heart failure, for a number of lung, liver and kidney diseases, for diabetes, and the list keeps on growing on diseases that can benefit.

The outcomes from an organ transplant are amazingly good. Most people would not recognize a transplant patient. A few years ago there was a snowboarder named Chris Klug who had liver disease and received a liver transplant in Colorado. He went on to win an Olympic bronze medal after receiving a transplant.

What organ transplant allows us to do is for the donor to make one last altruistic act to donate their organs and by that, allow another person to have a second lease on life. That’s the beauty of transplantation. There is giving involved where there is not much coming back. It’s a pure, altruistic act.

Early diagnosis campaign might help pulmonary hypertension patients avoid transplant

**Thank you to the Pulmonary Hypertension Association for educating us and working with us to make this article possible.

April 17th 2015 2:20 pm

With so many people on the transplant list and a shortage of viable organs, transplant is as much about preventing transplant as it is about being listed and ultimately receiving that precious gift of life.  Patients and caregivers want to make sure they have exhausted every option before being listed.  Transplant is an amazing gift, but it is NOT a cure.  Transplant comes with its own list of side effects, medications and long-term issues.

We are starting a series of articles in partnership with other organizations that will educate and inform our families.  The series will provide information that will help you ask your medical staff the right questions as you consider transplant as a treatment option.  If transplant is the option for you, we hope to provide useful information that helps you throughout your transplant journey.

Education empowers patients and families, making you a vital part of your medical team as a patient/parent advocate.  Your medical team will appreciate the fact that you want to learn everything you can about your child’s condition.  It is a part of the family-centered care model that many hospitals are adopting and by which many are rated nationally.

Our first article is written in partnership with the Pulmonary Hypertension Association (PHA).  Pulmonary Hypertension can eventually lead to lung or heart/lung transplant.  The Pulmonary Hypertension Association defines pulmonary hypertension (PH) as “a rare, debilitating disease in which high blood pressure in the arteries of the lungs can lead to right heart failure.”

PHA was established in 1991 by four women, and has evolved into a membership association of more than 16,000.  The organization’s website offers a multitude of educational materials for patients, caregivers and healthcare providers.  PHA offers many ways to engage with your clinicians, whether by finding a doctor or giving feedback to your specialty pharmacy.  PHA’s devotion to research and finding cutting-edge technology in the field of PH is consistent with its mission of “find[ing] ways to prevent and cure pulmonary hypertension (PH), and to provide hope for the pulmonary hypertension community through support, education, research, advocacy and awareness.”

Early Diagnosis

Early diagnosis is critical to getting the right treatment for you child.  With early diagnosis your family will be able to connect with the right experts and explore many different therapies that can be used before transplantation is considered.  PHA has started an Early Diagnosis Campaign which is an organization-wide effort to eliminate diagnostic delays & reduce the average time to accurate PH diagnosis and appropriate treatment.

Once a patient has been diagnosed, PHA has an “Empowered Patient Online Toolkit”  that offers educational materials, questions to ask, documents to keep, travel resources and a place to document medical information.  In addition PHA’s website – PHAssociation.org – lists all available treatments, how to contact doctors who specialize in PH, providing feedback to your specialty pharmacy and insurance resources to help you cover the costs involved.

Once diagnosed, PHA has an “Empowered Patient Online Toolkit”  that offers educational materials, questions to ask, documents to keep, travel resources and a place to document medical information.  In addition, PHA’s website – PHAssociation.org – lists all available treatment options, resources on how to contact doctors who specialize in PH, or to provide feedback to your specialty pharmacy, as well as insurance resources to help you cover the costs involved.

Transplant

If all other options have been exhausted and transplant is your current option, PHA has many wonderful resources to help your family through the transplant journey.  One of the best parts about PHA’s support is that it is truly family-centered, including support for the caregiver, the patient and the siblings.

Wonderful resources, including the document “Transplant and your child: Front Listing to New Lungs,” will take you through the entire transplant process, while you’ll find answers to many of questions you might have during the transplantation process in “Answers about Lung Transplantation for Pulmonary Hypertension.”  Finally some great tips and hints for parents from PHA’s Scientific Leadership Council are available in “Transplant and Pulmonary Hypertension: Information for Parents.”

PHA’s website is a tremendous resource for any family dealing with Pulmonary Hypertension and especially for those considering transplant.  We encourage you to explore PHAssociation.org, to request their printed materials, and to connect with PHA’s community.