Inside this issueCover storiesA major boost for recruiting top doctorsOf moths and mice: jumping genes make big leap to mammalsProgram aims to close the gender gap in medical researchPartnershipsYale and Donaghue partnership treats research advances as a practical matterStudents come north and aid flows south as Yale lends a hand in wake of KatrinaBenefit bike ride raises $250,000 for Yale survivors’ clinicGrants & contractsPeopleLifelines: Gail D’Onofrio on saving and changing livesDiabetes expert is named dean of nursingBorgstrom named president/CEO of Yale-New HavenNeuroscientist Horvath will chair Comparative MedicineOut & aboutAwards & honorsScienceAdvances: When it comes to taste, the nose knows | Cellular power plants help explain diabetesHealthLiver transplantation program formed with an international team of expertsDatabase promises early alerts of outbreaksDefusing vascular “time bombs” calls for group effortNew lens implant for cataracts is a bionic-style bifocalAdvances: A stubborn inequity in heart treatments | An upside to aneurysms? |
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Liver transplantation program formed with an international team of expertsThe School of Medicine has launched an ambitious new liver transplant program with a team of doctors recruited from across the United States and Europe. David C. Cronin II, M.D., Ph.D., one of the world’s most experienced pediatric and adult liver transplant surgeons, joined the Department of Surgery in December 2003 as chief of the Liver Transplantation Program. An associate professor of surgery, Cronin came to Yale from the University of Chicago, where he performed or participated in more than 600 adult and pediatric liver transplants. Cronin spent a year working to assemble a team of surgeons, anesthesiologists, nurses, social workers, dieticians, pharmacists and transplant coordinators. In addition, Mario Strazzabosco, M.D., Ph.D., medical director of the adult liver transplantation program at the Ospedali Riuniti di Bergamo in Italy, joined the Yale faculty in September as chief of transplant hepatology and professor of medicine. Strazzabosco, who trained as a fellow at Yale from 1987 to 1990 under James L. Boyer, M.D., Ensign Professor of Medicine and director of the Yale Liver Center, helped create Italy’s third-largest liver transplant program six years ago in Bergamo. Last year, the Bergamo program performed 90 liver transplants. Cronin had previously recruited transplant surgeon Sanjay Kulkarni, M.D., from Chicago and anesthesiologist Stephen Luczycki, M.D., from the University of Rochester, one of the world’s busiest live-donor programs. Between 1983 and 1998, there were 123 liver transplants performed at Yale, but the program was curtailed for re-evaluation after a series of poor outcomes. The revamped transplant service, the result of joint investment by the medical school and Yale-New Haven Hospital through the New Clinical Program Development Fund, listed its first patient in April and performed its first two liver transplants in July and a third in September. Cronin estimates that 10 liver patients will receive transplants by the end of December and another 20 during 2006, given the service’s current capacity. A search is under way for a third liver transplant surgeon, and Robert Udelsman, M.D., M.B.A., the chair and Lampman Memorial Professor of Surgery and Oncology, expects the program to grow rapidly, to 60 liver transplants annually. Since few surgeons have Cronin’s experience with pediatric cases, Yale’s program is likely to become the first significant pediatric transplant program in New England.
More than 17,000 people are registered on the national waiting list for livers, including 1,121 in New England, according to the United Network for Organ Sharing. Only 6,169 liver transplants were performed in 2004 due to a shortage of donor organs. Cronin estimates that two-thirds of liver patients on the national list will die before an organ is available. It is Cronin’s goal to introduce live-donor transplants, a remarkable procedure in which a healthy donor gives only a portion of his or her liver to the patient. “Liver transplantation is
an extremely challenging operation,” Udelsman says. “It’s also
the ultimate kind of transplantation in that the patient will not survive
without the organ. Unlike kidney and pancreas [cases], where the patients
have other options to keep them alive, these patients have no other options,
and they will die from their disease. That’s why it’s so gratifying to see
the operation being performed.”
“Amazing” operation gives patients new life
Even after performing hundreds of liver transplants, surgeon David Cronin still marvels at the capacity of a healthy liver to rejuvenate a direly ill patient. “It’s amazing what happens when you get a new liver that works. You get better so quickly,” he says. “By the time the breathing tube is out the next day, I always ask the patients, ‘How do you feel?’ And they always tell me, ‘I feel great! I’ve never had so much energy before in my entire life.’” Cronin’s colleague, hepatologist Mario Strazzabosco, agrees. “After this operation, their whole appearance and demeanor change so dramatically. You sometimes don’t recognize your own patient,” Strazzabosco says. One of Cronin’s patients, Ray Bellemare of Meriden, Conn., received a liver during a six-hour operation on July 11 and left the hospital 18 days later. He had been on the waiting list only three weeks, but rose to the top because of the severity of his condition. Bellemare, whose liver was damaged by alcohol before he stopped drinking two years ago, was overwhelmed by his new lease on life. “Every day when I wake up, I can feel my body getting stronger and stronger,” he said at a news conference in August. “The good Lord gave me a second chance and now I’m going to go for it. I’m going to change my life around and help other people. I want to give something back.” “His life expectancy was three months without a transplant,” Cronin
said at the press conference. “Now he can expect to live a normal lifespan.”
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Medicine@Yale Magazine
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October/November 2005 Volume 1 Issue 3
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