100Th Living Donor Liver Transplant Takes Place At

henryford.com Trans 1-855-85-TRANSPLANT all for you

PUBLISHED BY HENRY FORDnotes TRANSPLANT INSTITUTE SPRING 2018 100TH LIVING DONOR LIVER TRANSPLANT TAKES PLACE AT HENRY FORD HOSPITAL Susan Cowles, of the Saginaw area, received a section of liver from her cousin and goddaughter, Joyce Gendron, of Bryan, Ohio. Joyce became the Henry Ford Transplant Institute’s 100th living liver donor in a 9.5-hour transplant at Henry Ford Hospital. “She’s saved my life, is what she did,” a grateful Susan said from her hospital bed two days after surgery. “It does feel good, yes,” said Joyce, from her hospital bed across the hall from Susan’s, two days after donating part of her liver. Marwan Abouljoud, M.D., director of the Henry Ford Transplant Institute and a world-renowned liver surgeon, removed a portion of Joyce’s liver in a six-hour surgery that began at 8 a.m. “The delicate procedure of dividing the liver in half is very safe for Joyce Gendron and Susan Cowles both the donor and the recipient,” he said. Atsushi Yoshida, M.D., surgical director of Liver Transplant at Henry Ford Hospital added, “Both patients were carefully evaluated to make sure their health and anatomy are perfectly matched for a successful transplant.” continued on page 6 CELEBRATING 50 YEARS OF TRANSPLANTS This year marks the 50th anniversary of the Henry Ford 1,250 bone marrow stem cell transplants. Transplant Institute. Along the way, there have been many “firsts” “Fifty years ago, Henry Ford Hospital brought the in Michigan, including the first split-liver transplant from a lifesaving option of organ transplants to the Detroit and deceased donor, first adult-to-adult living-donor liver trans- southeast Michigan community,” says Marwan Abouljoud, M.D., plant, first modified multivisceral transplant, first lung-liver director of the Henry Ford Transplant Institute. “Today, I’m transplant, first heart-liver transplant, first robotic kidney proud of the pioneering efforts of our teams, as we collab- transplant and the first machine liver perfusion pump. orate with physicians across Michigan to offer adult and The Henry Ford Transplant Institute is recognized locally pediatric transplants, that improve and extend life through and nationally for making advancements in transplantation. innovative, compassionate, and personalized care.” Our transplant physicians have been on the forefront of The first organ transplant at Henry Ford Hospital took specialized end-stage organ failure care, offering new place on January 4, 1968 when a kidney transplant was therapies to extend life and position patients for transplant performed by pioneering surgeons Drs. Emerick Szilagyi, candidacy. Our surgeons have pioneered lifesaving devices Roger Smith, and Joseph Elliot. as bridges to transplant, as well as minimally invasive Since then, Henry Ford transplant teams have and robotic transplant surgeries that minimize side performed more than 6,150 solid organ transplants and effects and improve recovery. continued on page 2

PAGE 5 PAGE 7 PAGE 10 Pioneers in Robotic- Safety of Statin IPF: A Disease With Assisted Kidney Therapy After Liver No Cure, But A New Transplant Surgery Transplantation Treatment Option

HENRY FORD HOSPITAL From The Editor CELEBRATING 50 YEARS OF TRANSPLANTS Welcome to the continued from cover Spring 2018 issue of Following transplant, our infectious TransNotes, a newsletter ORGAN PROCUREMENT AND DONATION disease specialists and pharmacists produced by the All transplant professionals will are improving transplant outcomes Henry Ford Transplant tell you that the shortage of available Institute. Our purpose through advancements in immu- organs is their biggest challenge. for producing this nosuppression and anti-rejection One of Henry Ford Hospital’s most publication is to share therapies. significant contributions has been our research and Our transplant patients also are cultivating collaboration among advances in the field pioneers. Henry Ford’s Transplant institutions for transplant and organ of transplantation Living Community (TLC) is the first Marwan S. Abouljoud, procurement. with our colleagues. M.D., FACS program of its kind in the country to Early on, Henry Ford Hospital It was 50 years offer peer-to-peer patient advocacy established relationships with Harper ago that organ transplantation began at with a defined educational curriculum Hospital in Detroit and the University Henry Ford Hospital. In celebration, several before and after transplantation. Pub- of Michigan in Ann Arbor to formalize educational opportunities and events will be lished research has demonstrated that the Transplant Society of Michigan, held this year. I hope you mark your calendars the TLC program leads to improved later named Gift of Life – Michigan’s as the events are announced and join us. compliance and patient satisfaction. only federally designated organ and In this edition, you’ll find articles about tissue recovery program. two amazing patients. First, Joyce Gendron TRANSPLANT THROUGH COLLABORATION To expand the pool of available was the 100th living liver donor for her “Our first kidney transplant organs, Henry Ford has been an early godmother and cousin Susan Cowles. Since the in 1968 was made possible when adopter of organ donation after cardiac first living donor liver transplant in December surgeons from different specialties – death and among the first institutions 2000, we’ve witnessed hundreds of patients vascular, urology and general surgery to utilize the latest perfusion systems returning to their lives. – came together as a team,” remarks that increase the viability of organs Judith Popard, the second patient featured Dr. Abouljoud. “Collaboration by for transplant, such as ex-vivo lung in this edition, was diagnosed with idiopathic surgeons, physicians, and the larger pulmonary fibrosis (IPF) that eventually perfusion (EVLP) and TransMedic medical and caregiver team is what’s required a lung transplant. By sharing her normothermic liver perfusion. always made transplant successful.” story, Judy’s hope is that all physicians will Additionally, Henry Ford always Even though Henry Ford Hospital become re-educated about IPF and understand has been a leader in expanding was among the early adopters of although it’s not curable, it is treatable. living donation. We are the largest organ transplants, transplantation as Treating IPF patients early, using ECMO, center in Michigan for adult-to-adult a field of medicine is still considered provides a better quality of life while waiting living donor liver transplants. For one of the younger specialties. The for a lung transplant than a ventilated patient. kidney donation, we’ve pioneered Next in this edition is a study on the safety Henry Ford Transplant Institute was minimally invasive and robotic of statin therapy after liver transplantation, officially established as a Center of kidney procurement, and participate which concluded that statin therapy did not Excellence in 2004 and today is one in creative paired kidney exchanges. cause significant elevations in liver enzymes of the most integrated, comprehensive Looking to the future, the Henry Ford and no difference in patient or graft survival, transplant programs in the country. Transplant Institute has established and there were less statin episodes of rejection. Under Dr. Abouljoud’s leadership, the Center for Living Organ Donation. For patients who are unable to tolerate the typical hospital silos have been Too often our living donors are the open procedures or are heavier, robotic surgery eliminated so that every specialty that forgotten heroes in the transplant for kidney transplant opens new opportunities touches transplant – from anesthesia at Henry Ford Hospital, as Dr. Yoshida explains. process. Our goal is to prepare them and infectious disease, to pharmacy, I hope you find these and the other for the experience of donating a kidney nursing, psychology, dietary and others, articles informative and thought-provoking or part of their liver, and support works together to create a unique, and perhaps valuable in your own research them throughout their physical and patient-focused care experience or practice. As always, referring physicians emotional recovery. throughout the transplant journey. should feel free to contact us at our toll-free We also cannot talk about transplant As a transplant institute, we’ve number, 1-855-85-TRANSPLANT, or to without recognizing our deceased expanded our resources and partnered contact me directly at (313) 916-2941, donor families, who deserve our for your patient or practice needs. with physicians throughout Michigan gratitude. Without their decision to Marwan S. Abouljoud, M.D., FACS to bring transplant outreach clinics give the gift of life, 50 years of Director, Henry Ford Transplant Institute to the communities of Kalamazoo, transplantation at Henry Ford Hospital Benson Ford Chair Grand Rapids, Lansing, Flint and would not have been possible. E-mail: [email protected] Ypsilanti.

2 www.henryford.com/transplant 1-855-85-TRANSPLANT MEET OUR NEW PHYSICIANS...

Jennifer Cowger, M.D., M.S. Medical Director of Mechanical The University of Michigan Master of Science in Clinical Circulatory Support Medical Center (Ann Arbor, MI) – Research Design and Statistical Fellowship in Cardiovascular Analysis Medical School Education: Medicine, Chief Fellow The Ohio State University College Board Certiﬁcation: of Medicine and Public Health The University of Michigan American Board of Internal (Columbus, OH) Medical Center (Ann Arbor, MI) – Medicine – Internal Medicine Advanced Fellowship Denison University American Board of Internal Training in Heart Failure and (Granville, OH) Medicine – Cardiovascular Transplant Cardiology with Medicine Post-Graduate Training: Supplemental Training in Adult Jennifer Cowger, American Board of M.D., M.S. Duke University Medical Center Echocardiography (Durham, NC) – Internship and Internal Medicine – The University of Michigan Residency in Internal Medicine Advanced Heart Failure School of Public Health Graduate and Cardiac Transplant Training Program in Clinical Research (Ann Arbor, MI) –

Gillian Grafton, D.O. Advanced Heart Failure and University of Michigan Research Interests: Transplantation (Ann Arbor, MI) – Cardiology Heart Failure Fellowship Cardiac Transplantation Medical School Education: Left Ventricular Assist Devices Kansas City University of University of Minnesota Pulmonary Hypertension Medicine and Biosciences – (Minneapolis, MN) – Internal Critical Care Cardiology (Kansas City, MO) Medicine Residency Post-Graduate Training: Board Certiﬁcation: Henry Ford Hospital (Detroit, MI) – American Board of Internal Critical Care Fellowship Medicine – Internal Medicine Gillian Grafton, D.O. University of Michigan (Ann American Board of Internal Arbor, MI) – Advanced Heart Medicine – Cardiovascular Disease Failure and Transplantation

Themistokles Chamogeorgakis, M.D. Surgical Director of Mechanical University Hospitals Case Clinical Areas of Interest: Circulatory Support Medical Center (OH) – Thoracic Clinical interests of Surgery Dr. Chamogeorgakis include Medical School Education: thoracic transplantation, Patras University School of Board Certiﬁcation: mechanical circulatory Medicine, Greece American Board of Surgery support and aortic surgery. National and Kapodistrian American Board of Surgery: Dr. Chamogeorgakis also speaks University of Athens Thoracic Surgery Greek and French. Post-Graduate Training: Lankenau Medical Themistokles Center (PA) – General Surgery Chamogeorgakis, M.D.

www.henryford.com/transplant 1-855-85-TRANSPLANT 3 MEET OUR NEW PHYSICIANS... continued

Julio C. Pinto Corrales, M.D. Senior Staff Pulmonary, American Board of Internal Medicine Poster Presentations: Critical Care American Board of Critical Care Amiodarone-Induced Pulmonary Toxicity Medical School Education: Research: Presenting as Pulmonary Universidad Cayetano Heredia, Association of the Use of HMG-CoA Alveolar Proteinosis. (Lima, Peru) Reductase Inhibitors during Sepsis with Sepsis Outcomes. Poster presentation Internship and Residency at: American Thoracic Pneumatosis Intestinalis in Lung Henry Ford Hospital (Detroit, MI) Society, ATS 2015; Transplant Patients at Henry Ford Internal Medicine Residency Denver, CO. Hospital. Fellowship: Association of the Use Julio C. Pinto Publications: Corrales, M.D. Henry Ford Hospital (Detroit, MI) of HMG-CoA Reductase Sepsis outcomes in patients receiving Critical Care and Pulmonary Inhibitors during Sepsis statins prior to hospitalization for Medicine Fellowship with Sepsis Outcomes. sepsis: comparison of in-hospital Oral presentation at: The American Board Certiﬁcation: mortality rates between patients College of Chest Physicians, American Board of Pulmonary who received atorvastatin and those CHEST 2012; Atlanta, GA. Medicine who received simvastatin. Annals of Intensive Care 2015, 5:9 Dr. Pinto Corrales is ﬂuent in Spanish.

Dimitrios Apostolou M.D., FACS Senior Staff, Cardiothoracic Surgery, University of Athens, Greece, (Athens, Aortic valve Transplant Surgery Greece) – Residency, Surgery pathology in combination with Medical School Education: Board Certiﬁcation: ascending aortic Medical School of Athens, Greece American Board of Surgery – Surgery aneurysms. Post-Graduate Training: American Board of Thoracic Aneurysms and Wayne State University, (Detroit, MI) – Surgery – Cardiothoracic Surgery Dissections of the Fellow, Cardiothoracic Surgery Research Interests: Thoracic Aorta. Henry Ford Hospital, (Detroit, MI) – Multiple Injuries in Blunt Residency, General Surgery Abdominal Trauma Dimitrios Apostolou M.D.

Deepak Venkat, M.D. Senior Staff Hepatologist Fellowship: Research Interests: University Hospitals Case Chronic hepatitis C Medical School Education: Medical Center in kidney transplant Northwestern University, Feinberg recipients, predictors School of Medicine (Chicago, IL) Case Western Reserve University School of Medicine (Cleveland, OH) of PBC recurrence Internship and Residency: in liver transplant Ohio State University Fellow, Transplant Hepatology and Gastroenterology recipients, predictors Medical Center (Columbus, OH) of morbidity/ Board Certiﬁcation: Chief Resident, Department mortality after TIPS, American Board of Internal Medicine - Deepak Venkat, M.D. of Internal Medicine, and novel cardiac Transplant Hepatology Intern and Resident, risk factors in relation Department of Internal Medicine American Board of Internal Medicine - to liver transplant. Gastroenterology Dr. Venkat also speaks American Board of Internal Medicine - French and Tamil. Internal Medicine

4 www.henryford.com/transplant 1-855-85-TRANSPLANT PIONEERS IN ROBOTIC-ASSISTED KIDNEY TRANSPLANT SURGERY Henry Ford Hospital is Michigan’s Transplant first and only transplant center, and Institute. To qualify among a few throughout the country, for robotic-assisted where robotic-assisted kidney transplant kidney transplant, surgical techniques are performed and a living donor is are dramatically improving patient required. outcomes. The da Vinci® Atsushi Yoshida, M.D., director of robotic surgery Transplant Robotic Surgery, Henry Ford system used by Transplant Institute, explains, “We have the surgeons in not changed the way we do kidney the Henry Ford Henry Ford surgeons also helped transplants in about 50 years, so this Transplant Institute was first brought pioneer a breakthrough cooling is a significant change.” This procedure to Henry Ford by the Vattikuti Urology technique that gives surgeons more provides smaller incisions, less scarring, Institute. Ten of the 15 robot-assisted time to robotically transplant kidneys reduces pain and the risk of infection kidney transplants performed in a given from living donors. Using a special and patients recover faster with smaller year in the United States are done at device to inject a sterile ice mixture into incisions of 5 cm versus 15-30 cm. Henry Ford. the area of the recipient’s body where “This approach also provides Use of the robot, as directed by the the donated kidney will will be placed, patients who may not be able to tolerate surgeon, allows placement and clear increases the chances of a successful an open procedure or heavier patients view of the surgical field with up to transplant by preserving the kidney. the opportunity for kidney transplant eight times the magnification. It also To learn more about robotic-assisted who might otherwise have been allows the surgeon to more easily make kidney transplant or refer a patient to deprived a kidney transplant,” explains instrument adjustments during the the Henry Ford Transplant Institute, Dean Kim, M.D., surgical director, procedure. call (313) 916-1269. Kidney Transplant, Henry Ford

Source: Scientiﬁc Registry of Transplant Recipients, Center and OPO-speciﬁc Reports, based on data available 04/30/2017, released 07/06/2017.

MEET OUR NEW PHYSICIANS... continued Ashina D. Singh, M.D. Senior Staff Hepatologist University of Cincinnati Hospital. Board Certiﬁcation: Fellow in Gastroenterology and American Board of Medical School Education: Hepatology Fellowship Training Internal Medicine – University of Maryland School of Program. Internal Medicine Medicine, Gold Humanism Honor Society University of Cincinnati Hospital. American Board of Internal Categorical Resident in Internal Medicine - Gastroenterology Post-Graduate Training: Medicine Residency Training University of Maryland Medical Research Interests: Program. Center. Fellow in Transplant Pregnancy and liver disease Hepatology. Dr. Singh also speaks Hindi. Ashina Singh, M.D.

www.henryford.com/transplant 1-855-85-TRANSPLANT 5 100TH LIVING DONOR Dr. Abouljoud explained, LIVER TRANSPLANT “Living donor continued from cover liver transplant truly offers the By 11:30 a.m., after removing Susan’s diseased liver, gift of life in a Dr. Yoshida began transplanting the donated half-liver and regenerative, by 5:30 p.m. the vital vessels were re-attached to assure life-affirming proper blood flow to the remaining liver, which will technique. In regenerate to its original size in six to eight weeks. addition to Marwan S. Abouljoud, Atsushi Yoshida, M.D. A long-time registered nurse, Susan found out her liver saving the life M.D., FACS was not functioning after she walked onto the porch of her of the recipient, home in northern Michigan in January 1999. The sunshine, a living donor liver transplant also allows a liver from a sparkling on the snow in Onaway, lit up her face. “My son deceased donor to be used to save someone else’s life. said, ‘Mom, you’re all yellow!’” she remembers. “He called Living donors truly are angels on earth.” out to my husband, ‘Come see Mom!’” Her family insisted Joyce says, “Susan has her life back now. She was going she go to the ER instead of her job at the local hospital. to die without it. She can now go ahead and plan her life.” After rounds of testing, doctors explained her liver was Doctors expect Susan will take anti-rejection medication for failing from an auto-immune disorder and she would the rest of her life. Joyce went home four days later; Susan eventually need a transplant. went home 11 days later, and both are doing exceptionally Joyce immediately called Henry Ford Hospital and well, say their doctors. asked if she could donate right away. As with most who “Since our first living donor liver transplant, in December need a transplant, Susan’s doctors recommended she keep 2000, we have seen this over and over — patients returning her original liver as long as possible, as all surgeries include to their lives after transplant,” says Dr. Abouljoud. “They are some risk. When Susan’s health and liver deteriorated, able to continue their lives, go back to work, take their trip the transplant took place on Monday, June 12, 2017. of a lifetime, see their kids grow up, enjoy grandchildren. “Our expertise as one of the leading liver transplant It truly is a gift of life.” centers in the United States allows us to draw on our doctors’ To see a hologram of how a liver is split for donation, vast knowledge regarding transplant, particularly liver visit http://www.henryfordweb.com/SplitLiver/index.html. transplant,” says Dr. Yoshida. “We are honored to offer such For more information about living donor liver transplant a high level of medical treatment to patients who come to or donation, call 1-855-85-TRANSPLANT or visit https:// Detroit from all over Michigan and the country.” www.henryford.com/services/transplant/liver/living-donor.

MEET OUR NEW PHYSICIANS... continued Nadeen Khoury, M.D. Senior Staff Transplant Nephrologist Board Certiﬁcation: Cutting Edge of American Board of Internal Transplant Medical School Education: Medicine/ Nephrology Lebanese University, Lebanon Kidney American Board of Internal Medicine Transplantation Faculty of Medical Sciences – in Octogenarians: Doctor of Medicine Educational Commission for Foreign Medical Graduates (ECFMG) Certiﬁcation The Mayo Clinic Internship and Residency: experience Roger Williams Medical Center Research Interests: Women’s health, pregnancy after kidney ASN Kidney Week Boston University School of Medicine transplant, kidney transplant in the Warfarin-Related Nadeen Khoury, M.D. Residency-Internal Medicine elderly. Nephropathy in a (Categorical Track) Poster Presentations: Kidney Transplant Patient Fellowship: 15th Annual Mayo Clinic Update in A case of Post-Transplant Yale-New Haven Hospital Nephrology and Transplantation Kaposi sarcoma treated Yale School of Medicine Failed Allograft? Not so fast. A Case with combination chemotherapy Clinical Nephrology Fellowship of Post-Transplant de novo Thrombotic and mTOR inhibitor. Mayo Clinic- Rochester Campus Microangiopathy Dr. Khoury also speaks Arabic Renal Transplant Fellowship and French.

6 www.henryford.com/transplant 1-855-85-TRANSPLANT SAFETY OF STATIN THERAPY AFTER LIVER TRANSPLANTATION The question of statin therapy among liver transplant (LT) Adverse reactions were reported in patients due to drug interactions with immunosuppression and 5.4 percent of patients on a statin. One elevation of liver enzymes was the focus of a study conducted patient on atorvastatin 40 mg complained by Nimisha Sulejmani, PharmD, BCPS, transplant pharmacy of myalgias, but subsequently tolerated specialist, at Henry Ford Hospital. The objective of this study pravastatin 20 mg. The other patient on was to assess the incidence of transaminase elevation and simvastatin 40 mg experienced elevations Nimisha Sulejmani, safety of statin use after LT. in transaminases and was discontinued, PharmD, BCPS Cardiovascular disease (CVD) remains a leading cause of but was restarted five months later long-term mortality in transplant patients. A risk factor for without effect on liver enzymes. Another 31 patients received CVD is hyperlipidemia, where the treatment is statin therapy. calcineurin inhibitors were on a statin compared to six There is insufficient data assessing the safety of statin therapy patients on mammalian target of rapamycin inhibitors. in LT. Majority of patients on statin therapy received a moderate Methods: A retrospective chart review of LT recipients at intensity statin (59.5 percent) per the American College of an academic medical center from January 2013 to December Cardiology / American Hospital Association. Only 8.1 percent 2014 was performed. All LT recipients with ICD-9/10 codes (n=3) patients in the statin arm had an episode of rejection of hyperlipidemia were eligible. Primary endpoint was an compared to 29.9 percent (n=20) in the non-statin (p=0.01). increase of greater than two times the baseline liver enzymes There was no difference in graft or patient survival. in patients on statin therapy compared to no statin therapy. Dr. Sulejmani shared the study’s conclusion, “The use of Secondary endpoints included adverse effects, rejection, and statin therapy after LT did not cause significant elevations in patient or graft survival. Bivariate analysis was performed. liver enzymes. Although there was no difference in patient or Results: Out of the 170 liver transplants completed, 123 graft survival, the statin arm had significantly less episodes patients had a diagnosis of hyperlipidemia. There were 104 of rejection.” who met inclusion criteria with 37 patients receiving statin Further investigation is needed to determine if statin use therapy. Median time to statin initiation was six months decreases the incidence of rejection. With monitoring, statins post-transplant. There was no difference in the incidence appear safe to use in LT recipients. of transaminase elevations in the statin arm compared to non-statin arm (51.4 percent vs. 35.8 percent; p=0.14).

Milagros D. Samaniego-Picota, M.D. Senior Staff Transplant Nephrologist Residency, Chief Medical Resident, Research Interests: The Methodist Hospital, Department of Dr. Samaniego’s Medical School Education: Medicine, Baylor College of Medicine clinical and Facultad de Medicina, Universidad (Houston, Texas) research interests de Panama (Panama City, Panama) Fellowship: focus on Internship and Residency: The Johns Hopkins School of Medicine, experimental and Residency, Internal Medicine, Baltimore, Maryland clinical antibody- Hospital General de la Caja Division of Nephrology mediated rejection, de Seguro Social (Panama City, desensitization Senior Clinical Fellow Republic of Panama) protocols, ABO- Milagros D. Internship, Internal Medicine, Postdoctoral Research Fellow, incompatible Samaniego-Picota, M.D. Baylor College of Medicine Immunopathology kidney transplantation and other (Houston, Texas) Board Certiﬁcation: treatment options for highly sensitized Residency, Internal Medicine, American Board of Nephrology kidney transplant candidates including Baylor College of Medicine American Board of Internal Medicine pair-kidney exchange programs. (Houston, Texas) Educational Commission for Foreign Medical Graduates (ECFMG) Certiﬁcation

www.henryford.com/transplant 1-855-85-TRANSPLANT 7 MEET THE HENRY FORD TRANSPLANT TEAM… Yakir Muszkat, M.D. ABDOMINAL ORGAN TEAM Specialties: Gastroenterology & Hepatology Services: Digestive Disorders, Intestinal Diseases, TRANSPLANT SURGEONS Intestine Transplant Syed-Mohammed R. Jafri, M.D. Marwan S. Abouljoud, M.D. Specialties: Gastroenterology & Hepatology Specialties: Surgery Services: Digestive Disorders, Intestinal Diseases, Intestine Services: Cancer Surgery, Intestine Transplant, Transplant, Liver Cancer, Liver Disease, Liver Transplant Kidney Transplant, Liver Cancer, Liver Transplant Reena J. Salgia, M.D., MPH Atsushi Yoshida, M.D. Specialties: Gastroenterology & Hepatology Specialties: Surgery Services: Digestive Disorders, Intestine Transplant, Services: Cancer Surgery, Intestine Transplant, Liver Cancer, Liver Disease, Liver Transplant Kidney Transplant, Liver Cancer, Liver Transplant, Pancreas Transplant Deepak Venkat, M.D. Dean Y. Kim, M.D. Specialties: Gastroenterology & Hematology Specialties: Surgery Ashina D. Singh, M.D. Services: Cancer Surgery, Intestine Transplant, Specialities: Transplant Hepatology, Gastroenterology Kidney Transplant, Liver Transplant, TRANSPLANT NEPHROLOGY Pancreas Transplant Anita K. Patel, M.D. Shunji Nagai, M.D. Specialties: Nephrology Specialties: Surgery Services: Kidney Transplant, Pancreas Transplant Services: Cancer Surgery, Intestine Transplant, Kidney Transplant, Liver Transplant, Nadeen Khoury, M.D. Pancreas Transplant Specialties: Nephrology Services: Kidney Transplant Kelly M. Collins, M.D. Specialties: Surgery Milagros D. Samaniego-Picota, M.D. Services: Cancer Surgery, Intestine Transplant, Specialties: Nephrology Kidney Transplant, Liver Cancer, Liver Transplant, Services: Kidney Transplant Pancreas Transplant Vanji Karthikeyan, M.D. Jason E. Denny, M.D. Specialties: Nephrology Specialties: Surgery Services: Kidney Transplant, Pancreas Transplant Services: Kidney Transplant, Pancreas Transplant Rohini Prashar, M.D. Lauren E. Malinzak, M.D. Specialties: Nephrology Specialties: Surgery Services: Kidney Transplant, Pancreas Transplant Services: Kidney Transplant, Pancreas Transplant K. K. Venkat, M.D. Michael D. Rizzari, M.D. Specialties: Nephrology Specialties: Surgery Services: Kidney Transplant, Pancreas Transplant Services: Cancer Surgery, Intestine Transplant, Kidney Transplant, Liver Cancer, Liver Transplant, Pancreas Transplant For a referral, call: TRANSPLANT HEPATOLOGY Liver: (313) 916-8865 Kimberly A. Brown, M.D. Kidney and Pancreas: (313) 916-1269 Specialties: Gastroenterology & Hepatology Services: Digestive Disorders, Intestine Transplant, Liver Cancer, Liver Disease, Liver Transplant Dilip K. Moonka, M.D. Specialties: Gastroenterology & Hepatology Services: Digestive Disorders, Intestine Transplant, Liver Cancer, Liver Disease, Liver Transplant Stuart C. Gordon, M.D. Specialties: Gastroenterology & Hepatology Services: Intestine Transplant, Liver Cancer, Liver Disease, Liver Transplant

8 www.henryford.com/transplant 1-855-85-TRANSPLANT TRANSPLANT PULMONOLOGY CARDIOTHORACIC TEAM Lisa L. Allenspach, M.D. Specialties: Pulmonary Disease, Critical Care Medicine TRANSPLANT SURGEONS Lisa D. Stagner, D.O. Hassan W. Nemeh, M.D. Specialties: Pulmonary Disease, Critical Care Medicine Services: Lung Transplant Specialties: Cardiothoracic Surgery Services: Heart Surgery, Heart Transplant, Lung Transplant Julio C. Pinto Corrales, M.D. Specialties: Pulmonary Disease, Critical Care Medicine Gaetano Paone, M.D. Services: Lung Transplant Specialties: Cardiothoracic Surgery Services: Heart Surgery, Heart Transplant Zane T. Hammoud, M.D. Specialties: Thoracic Surgery BONE MARROW STEM CELL TEAM Services: Cancer Surgery, Esophageal Cancer, Lung and Thoracic Cancer, Lung Transplant Nalini Janakiraman, M.D. Themistokles Chamogeorgakis, M.D. Specialties: Hematology, Medical Oncology Specialties: Cardiothoracic Surgery Services: Leukemia and Lymphoma, Medical Oncology, Services: Heart Surgery, Heart Transplant, Lung Transplant Stem Cell Transplant Dimitrios Apostolou M.D., FACS Bernd G. Barthel, M.D. Specialties: Cardiothoracic Surgery Specialties: Hematology, Medical Oncology Services: Heart Surgery, Heart Transplant, Lung Transplant Services: Leukemia and Lymphoma, Medical Oncology, ADVANCED HEART FAILURE/ Stem Cell Transplant CARDIAC TRANSPLANTATION Shatha Y. Farhan, M.D. Specialties: Hematology, Medical Oncology Celeste T. Williams, M.D. Services: Medical Oncology, Stem Cell Transplant Specialties: Cardiology Services: Advanced Heart Failure, Cardiology, Edward M. Peres, M.D. Heart Transplant Specialties: Hematology, Medical Oncology Services: Leukemia and Lymphoma, Medical Oncology, David E. Lanfear, M.D. Stem Cell Transplant Specialties: Cardiology Services: Advanced Heart Failure, Cardiology, Heart Transplant For a referral, call: Yelena Selektor, M.D. Lung: (313) 916-1471 Specialties: Cardiology Services: Advanced Heart Failure, Heart Transplant Heart: (313) 916-2895 Cristina Tita, M.D. Bone Marrow Stem Cell: (313) 916-5002 Specialties: Cardiology Services: Advanced Heart Failure, Cardiology, Heart Transplant FOR MORE INFORMATION, PLEASE CONTACT Gillian Grafton, D.O. AN OUTREACH COORDINATOR Specialities: Cardiology Michelle “Cookie” Crossley, R.N., B.S.N. Services: Advanced Heart Failure, Cardiology, (248) 219-2326 Heart Transplant Christina Somers, R.N., B.S.N. Jennifer Cowger, M.D., M.S. (313) 622-4352 Specialities: Cardiology Services: Advanced Heart Failure, Cardiology, Heart Transplant Each transplant team also includes: • Transplant nurses • Registered dietitians • Transplant pharmacists • Pathologists • Rehabilitation therapists • Psychologists • Exercise therapists • Social workers

www.henryford.com/transplant 1-855-85-TRANSPLANT 9 IPF: A DISEASE WITH NO CURE, BUT A NEW TREATMENT OPTION

Idiopathic pulmonary fibrosis When Judy’s pulmonologist passed, a body mass index less than 35. (IPF) causes tissue deep in the lungs she was referred to other doctors. They have untreatable lung disease to become thick and stiff, or scar over “They basically told me to go home with a life expectancy of less than time. As the disease progresses, the and die. That was the day I decided to three years. lungs become fibrotic and struggle help myself,” she said. On her own she “The nurses would put my ECMO to move oxygen into the bloodstream continued pulmonary rehabilitation, machine in a wheelchair, so I could damaging the heart. There is no cure but one day she used three tanks take a walk. It reduced my anxieties and existing medications are not of oxygen; her therapist called the and physically I felt better and curative. Henry Ford Transplant Institute. stronger,” explains Judy. But at the IPF may have genetic factors and Judy spent two weeks in the end of the road, Judy knew she was affects middle-aged and older adults, ICU needing oxygen each day. waiting for a lung transplant. Several many only live 3 to 5 years after She remembers fondly the friends lungs came before the right lungs were diagnosis. Its prognosis is worse than she made with an “amazing transplanted by Hassan Nemeh, M.D., lung cancer. The most common cause staff.” Around week three she was cardiothoracic transplant surgeon. of death is respiratory failure; other transferred to Cardiac ICU where she “I wouldn’t be here today if not for causes are pulmonary hypertension, was introduced to extracorporeal ECMO,” Judy explains. heart failure, pulmonary embolism, membrane oxygenation (ECMO). Patients with IPF who come and pneumonia. “I was so weak lifting my cell phone to Henry Ford have an additional Judy Popard of Okemos, remembers was impossible, ECMO took over and advantage because it is a the day she was diagnosed with IPF replaced my lung’s job by supplying comprehensive Transplant Center. as if it were yesterday. “For many oxygen to my body. I was scared, but There are experts in each specialty of years I had been diagnosed with trusting,” she explains. organ transplantation. For example, asthma, sinusitis and allergies, but While not the standard of care at Dr. Allenspach says, “Our patients the results of extensive tests resulted most facilities, ECMO is used when benefit from transplant surgeons like in a diagnosis of IPF. I had the lungs are no longer able to supply Dr. Nemeh, a leading expert in lung to go online to find out what IPF enough oxygen, by taking the blood transplant.” even was – I was shocked to learn into a machine outside the body Judy implores, “Doctors read there is no cure.” and clearing carbon dioxide and the research, become educated about Despite trying experimental replenishing oxygen. At Henry Ford IPF and look at new protocols for drugs, her condition worsened. Hospital, rather than sedating and educating and treating their patients ventilating the patient and get their patients into pulmonary while waiting for a lung rehab right away.” transplant, ECMO has been Typically, patients come to a successful bridge to lung Henry Ford very sick. “We’d like to transplant. change that as we work with our Lisa Allenspach, M.D., colleagues to refer their patients medical director, Lung to our program when they are first Transplant, explains, “For diagnosed. In the early stages, there’s most, the use of ECMO so much more we can do for the allows patients the ability patient to educate and monitor the to move, eat, speak and progression of the disease,” says optimizes the patient’s time Dr. Allenspach. while waiting for a lung After more than 12 years on transplant. And, in many oxygen, Judy is healthy and enjoying cases extends the waiting long lunches with her friends — time.” minus the oxygen tank. Candidates for ECMO are To learn more about IPF or to refer 70 years-old or younger, a an IPF patient, call Soula Barrett at non-smoker for six months, (313) 916-1269. are cancer-free for five years and have

10 www.henryford.com/transplant 1-855-85-TRANSPLANT HENRY FORD TRANSPLANT INSTITUTE OUTREACH CLINICS In addition to the transplant clinics at Henry Ford Hospital in Detroit, 24 convenient outreach clinics are located throughout Michigan. Please contact Michelle “Cookie” Crossley, R.N., at (248) 219-2326 or Christina Somers, R.N., at (313) 622-4352 for more information.

KIDNEY AND PANCREAS LIVER, SMALL BOWEL, AND HEART Hurley Kidney and Pancreas Clinic MULTIVISCERAL TRANSPLANT Advanced Heart Failure Clinic One Hurley Plaza, 5 West Liver, Small Bowel And Multivisceral Ernst Cardiovascular Center Flint, MI 48503 Transplant Clinic Beaumont Hospital Lakeside Kidney and Pancreas Clinic 6240 Rashell, Suite 204 3601 W. 13 Mile Road Henry Ford Medical Center – Lakeside Flint, MI 48507 Royal Oak, MI 48073 14500 Hall Rd. Liver, Small Bowel And Multivisceral Advanced Heart Failure Clinic Sterling Heights, MI 48313 Transplant Clinic Henry Ford Macomb Hospital Lansing Kidney and Pancreas Clinic 600 Health Park Blvd., Suite D 15855 19 Mile Road 1703 E. Michigan Grand Blanc, MI 48439 Clinton Township, MI 48038 Lansing, MI 48912 Liver, Small Bowel, And Multivisceral Advanced Heart Failure Clinic Novi Kidney and Pancreas Clinic Transplant Clinic Henry Ford West Bloomfield Hospital Henry Ford Medical Center – Columbus Henry Ford Medical Center – Columbus 6777 W. Maple Road 39450 W. 12 Mile Road 39450 W. 12 Mile Road West Bloomfield, MI 48322 Novi, MI 48377 Novi, MI 48377 Advanced Heart Failure Clinic Pontiac Kidney and Pancreas Clinic Liver, Small Bowel, and Multivisceral Providence Hospital 44200 Woodward Ave., Suite 109 Transplant Clinic 22250 Providence Dr., Suite 705 Pontiac, MI 48341 Michigan Gastroenterology Institute Southfield, MI 48075 1650 Ramblewood Dr. Advanced Heart Failure Clinic Ypsilanti Kidney and Pancreas Clinic East Lansing, MI 48223 5333 McAuley Drive St. John Hospital and Medical Center Reichert Building, Suite 403 Liver, Small Bowel And Multivisceral 22201 Moross Road, Suite 356 Ypsilanti, MI 48197 Transplant Clinic Detroit, MI 48236 4690 McLeod Drive East Advanced Heart Failure Clinic LUNG Saginaw, MI 48604 Henry Ford Wyandotte Hospital Grand Blanc Lung Clinic Liver, Small Bowel, And Multivisceral 2333 Biddle Ave. 8220 S. Saginaw St., Suite 800 Transplant Clinic Wyandotte, MI 48192 Grand Blanc, MI 48439 Spectrum Health Lung Clinic 4100 Lake Drive Henry Ford Medical Center – Columbus Grand Rapids, MI 43522 39450 W. 12 Mile Road Novi, MI 48377 Macomb Lung Clinic 50505 Schoenherr Dr., Suite 290 Download the Henry Ford Shelby Twp., MI 48315 ON CALL 24/7 Transplant Institute app. For iPhone, iPad and Android platform devices.

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www.henryford.com/transplant 1-855-85-TRANSPLANT 11 Non-proﬁt organization US Postage PAID Permit No. 6785 Henry Ford Transplant Institute Detroit, Michigan Henry Ford Hospital 2799 West Grand Boulevard - CFP 220 Detroit, MI 48202 Phone: 313-916-2941 Fax: 313-916-4353 E-mail: [email protected] ©2018. All rights reserved

Henry Ford Transplant Institute Pledge

To improve and extend life by meeting the needs of transplant patients and their families with compassionate, innovative and personalized quality care.

SAVE THE DATE: NOVEMBER 2, 2018 In honor of our 50th Anniversary, please jjoinoio n usus ffororor the following one-day celebration events. SaSSaveavev ttheheh ddateata e now, and watch for further details during thtthehe yeyyeararr aatt www.henryford.com/transplant50.

Henry Ford Transplant Institute Symposium— Where is the Future of Transplant Going? Henry Ford Hospital Campus, Detroit, MI Join us for our multi-organ scientiﬁc symposium, including transplantation of the liver, kidney, heart, lung, bone marrow stem cell, pancreas, intestine and multivisceral organs. Discover the latest treatments, techniques and trends that will give hope to tomorrow’s transplant patients. The day includes breakout sessions and can be used for CME/CEU credits.

50th Anniversary Celebration – Gardenss ooff LLifeife JJubJubileeuubbiillee GGalaala 6 p.m. MGM Grand, Detroit Join us for this celebration as we look back att ouourur rorroots,oto s,s, our shared successes, and the future of transplant.ntnt.