Summer 2020

In this summer newsletter, the Department of Surgery has several opportunities to highlight and celebrate our outstanding faculty, innovative research and accomplished trainees over the past few extraordinary months.

The COVID-19 pandemic has affected — directly or indirectly — the lives of people all around the globe. At MUSC, we are adapting to the pandemic with a focus on the health and wellness of our patients, care team members, and our community. As the department pivoted to prepare for our “new normal,” we continued to provide surgical care using best-practices to protect the health of our patients and care teams and transitioned to telehealth visits when possible.

Our faculty members with extensive expertise in public and global health assisted leadership with disaster management, infectious disease policies, and operationalizing the many aspects of the new COVID-19 world in the operating rooms, ICU, and clinics.

In our feature articles, we highlight a heart transplant patient and lung transplant patient during the early phase of the pandemic. Their journeys highlight how MUSC care teams were ready and willing to go that extra mile to provide compassionate care for these seriously ill transplant patients whose families could not be by their bedside due to the COVID-19 visitor restrictions. 

In this issue, we also highlight the MUSC Children’s Health ECMO program, which received the Platinum Level ELSO Award for Excellence in Life Support from the Extracorporeal Life Support Organization (ELSO). This award is the highest attainable level as an ELSO Center of Excellence and recognizes select programs worldwide who have demonstrated the highest level of performance, innovation and quality in the delivery of extracorporeal life support. 

On the education front, our programs adapted to our new normal with virtual classrooms and simulation trainings. And, even though our world changed dramatically this year, that didn’t stop us from celebrating our graduates’ significant accomplishments virtually. 

In the research arena, our special section Responding to the Pandemic highlights how the Department of Surgery and the Center for Cellular Therapy led the charge to develop a COVID antibody test and how a team of innovators created 3D mask and cartridge system plans to answer the urgent need of the N-95 mask shortage. The newsletter also highlights new NIH awards and recognitions, and an STTR grant to develop a novel cancer immunotherapy technology.

And lastly, the Department of Surgery is delighted to recognize and honor two pediatric cardiothoracic surgeons: Robert M. Sade, M.D., whose vision and remarkable generosity provided the ability to establish the Robert M. Sade, M.D. Endowed Chair in Pediatric Cardiac Surgery, and Scott Bradley, M.D., a gifted surgeon and inaugural chair holder of the Robert M. Sade, M.D. Endowed Chair in Pediatric Cardiac Surgery.  

This is a transformational time for the country and American medicine. Holding on to our true north and our mission of providing exceptional patient care, education and innovation, I am confident the MUSC Department of Surgery will emerge in unison and stronger than ever.

Prabhakar Baliga, M.D. FACSChair, MUSC Department of Surgery

The Center for Cellular Therapy (CCT) is an FDA registered cGMP level facility that meets the most rigorous standards in the aspect of processing of cells. When MUSC leadership reached out to Satish Nadig, M.D., D.Phil., medical director for the CCT, and asked him to lead a task force to develop a diagnostic antibody test as a response to the COVID pandemic, he organized an interdisciplinary group of MUSC researchers.

The team, led by Nadig and Shikhar Mehrotra, Ph.D., co-scientific director of the CCT, developed an antibody test in less than a month using plasmid from Mount Sinai Laboratory. According to Tara Duke, MLS, Quality Assurance Director of the CCT, developing this type of protocol could typically take up to six months, if not longer.

“What this team did was quite impressive,” she said. “And it’s a testament to their dedication and hard work - especially our lab technicians, who worked around the clock.”

Colleen Cloud, Program Manager, concurs. “It was amazing to see so many people working together on all the different aspects to get the antibody test up and running as quickly as possible.” Cloud adds that the core CCT lab technicians Philip Heidt and Cindy Wang are trained to work under pressure and tight timelines when working with cellular therapies.

“Working in a clean cell facility, our team is accustomed to a rigorous level of intensity,” said Cloud. “The same high standards we apply to cellular products helped as we pivoted to diagnostic studies.” One week after the test was validated, the team notified the FDA. Nadig said MUSC is highly confident in the testing done here because of the two-step process and because of the extensive validation done before it began offering the tests.

The lab started receiving requests for antibody testing from organizations outside of MUSC. As demand for the test grew, the lab needed more staffing. Many members of existing Department of Surgery labs volunteered while new personnel were recruited to join the effort.

During the first week that MUSC began offering this service, The Blood Connection sent between 1,000 and 1,400 samples each day, collected from donors across both states. The lab is now processing up to 3000 antibody tests a day. The test is useful at the population level to show how much COVID-19 is circulating in the community. And as tests continue to improve and scientists learn more about the novel coronavirus, individuals will be better able to make informed decisions about work and community events.

Contact MUSC 843-792-2300

For human centered designers, there’s always a story behind the innovation.  That’s because Human Centered Design begins with the people you are designing for and finding a solution that fits their needs. The human-centered design methodology uses empathy as a core value and creates an innovative solution.

“Once you empathize with your user group, you start defining the problem, narrowing it down from something really big to something smaller and more measurable,” explained Joshua Kim, MS, Senior Designer in the Department of Surgery.  

The next step is the ideation process where the designers create new ideas. “One of the favorite brainstorming exercises some designers use is what we call a ‘magic wand idea,’” said Kim. “Where we basically say if we have a magic wand and finances weren't an obstacle and technology was limitless what kind of solution could we create.”

According to Kim, this ideation process really opens up the possibilities for your future design and can help generate new ideas that are a better fit for the end user. Moving into the next phase of design – prototyping and testing – it’s critical to design without the fear of failure in order to discover the best possible prototype for the end user.

Using this design process, Kim and a team of innovators at MUSC were able to find a solution to the N95 mask shortage in less than a week.

 “When the shortage of N95 masks became a major concern in the United States, Dr. Baliga, chair of the Department of Surgery, asked if there was anything I could think of that would be a possible solution,” explains Kim. “What we knew was they were in short supply and there were ineffective masks that were being used or N95 masks were being overused due to shortages that basically rendered them ineffective, putting healthcare workers at risk.” 

Kim reviewed the design problem by breaking down the biggest question of “what’s special about these N95 masks that makes them in such short supply?” and realized the problem wasn’t with the masks but with the filter.

So the design plan for this project then became to understand what the N95 filter does, set the bar to replicate a filter that is equal to or better than the 95% filtration rate and fit it to an easy-to-produce, comfortable 3D mask with a proper seal and airflow.

Although the cartridge system can be retrofitted onto an aerosol mask, they were in short supply.

As with any good design process, Kim set his sights on prototyping the filtration system from his home while a collaboration was occurring concurrently in the lab where dentists Walter Rene, DMD, Christian Brenes Vega, DDS and John Yost, a student and independent contractor, were developing the 3D mask prototype to resolve the shortage of aerosol masks.  

As a result of the iteration process, Kim and his team broke down the global N95 mask shortage into a simplified concept that focuses on creating major design requirements for a project to be considered a success: Create a filtration system that can not only be retrofitted to an aerosol mask but also fitted to a 3D printed mask.

 “This was an incredibly accelerated process,” Kim said, “in large part due to collaboration, where a lot of credit goes towards our interdisciplinary team that was able to tackle this project from multiple angles simultaneously.” Within four days and with the guidance and support from Michael Yost, Ph.D., vice chairman of Research in the Department of Surgery and David Mahvi, M.D., chief of Surgical Oncology, the team was able to go from concept design to completion.

Once the plans were completed, MUSC created a press release on the masks, a website was built where the design plans were hosted, and the information was also disseminated through social media.

The impact was great. Within a week, the article posted to the website received 45 percent of all web traffic in the MUSC news center, with over 92,000 visits coming to the website specifically for the information. The article was shared over 2,000 times in social media platforms, and the team has been contacted by the U.S. Air Force and Navy, as well as requests for the design from a hospital in Turkey and groups in the U.K., Canada, Ireland, and across the U.S.

Locally, groups all across the Lowcountry responded to the call to action to create 3D masks. Local high schools and colleges printed the masks. Most recently, MUSC received 500 3D printed masks produced by the Citadel Baker Business School headed by Dr. James Bezjian, Director of the Business Innovation Lab, using the MUSC 3D-printed design. The masks were assembled by the Charleston Historic Rotary Club, Citadel alumni, and students, and delivered with notes of gratitude written on them.

“Although we don’t know exactly how the designs are being used, it’s clear our S.A.F.E. Cartridge system and 3D mask design has had a global impact,” said Kim. “This accelerated innovative design shows the medical community how human-centered design can create a new future in medical device innovation.”

May 1 was the first time John McDonald was able to see his wife Lisa Gabriel since 18 days after he was first transferred to MUSC. He was diagnosed with pulmonary fibrosis in January after a CT of his abdomen fortuitously showed something of concern in the lower lobe of his lungs.

By April, his lungs were failing. Rapidly.

On April 11, McDonald was started at 40% oxygen. Two days later, he required 100% oxygen and was brought to MUSC.

But with the prevalence of COVID-19, hospitals across the country have had to limit the number of visitors inside their facilities. “When he was transferred, a nurse called me and asked me if I could come to the hospital,” said Gabriel. “I was excited to be able to visit him – and kind of surprised, too – since hospitals weren’t allowing visitors.”

It wasn’t until she was driving down to Charleston from their home in Myrtle Beach that she received the second call asking how quickly she could get there.

“That’s when I realized how serious it was,” she said.“We were really lucky to get here when we did,” Gabriel said. “If it had been a day later, it would have been a different scenario.”

They met with the transplant team to discuss his options just before his breathing became so labored that he was placed on a ventilator.

Thoracic Surgeon Chadrick Denlinger, M.D., performed McDonald’s transplantation. He said McDonald was a transplant candidate because, even with fibrosis, he was living a relatively normal life until just a few weeks ago. 

“He’s very strong, both physically and mentally. And even though he was requiring significant support and 100% supplemental oxygen when I first met him, he was still able to understand the risks and benefits of surgery. We luckily had the opportunity to discuss multiple potential outcomes if he required intubation even before we were able to complete the transplant evaluation,” he said.

However, once the couple decided to move forward with the procedure, McDonald was moved to a different unit, and his wife was no longer able to be with him in the hospital. Rather quickly, a donor became available, and Denlinger performed the transplant on April 21.

One day later, McDonald no longer required the support of ECMO, the machine that circulated his blood through an artificial lung and back into his bloodstream. Three days later, he was breathing on his own – without the help of a ventilator. Throughout the ordeal, he never saw his family.

The first thing McDonald did after being taken off the ventilator was to ask to FaceTime his wife. “It was so important to me to stay in touch with my family,” he said.

“At 6:30 a.m., he called me via FaceTime, and I heard his voice again. It was a miracle. I was so excited, thankful and overwhelmed with relief,” adding that it was the FaceTime sessions that made the situation bearable. 

Gabriel said she won’t soon forget the constant support and encouragement they both received. “I cannot tell this story enough and give enough praise and thanks to the team of doctors, nurses and support staff who saved John’s life. There are a lot of doctors in the world, but it takes a special team of people to have compassion and show the true love for what they do.” “They saved his life. And we are so grateful.”

The call came at 3 a.m. Allison Addis was getting a new heart. The rest of South Carolina had spent the month of March using its best hurricane prep know-how, attempting to prepare for something that hadn’t occurred in generations – a global pandemic. Addis had spent the month following the advice of the MUSC Health Heart Transplant team in anticipation of one day getting a new heart, as well as spending time with her ailing father, who died March 14. She never expected the call to come so soon. In three weeks, the 55-year-old Addis went from being listed for a heart transplant to receiving news she was about to have a new heart.

But the novel coronavirus pandemic meant things were a little different than usual at hospitals across the state. Newly implemented visitor restrictions meant that Addis would be alone. No one from her large, close-knit family would be allowed at her bedside. Instead, family members waited out the surgery at a nearby hotel.

Heart transplant coordinator Benjamin Thomas, R.N., recognized the burden these restrictions placed on both patients and families. He went to the hotel to explain the entire process to the family and answer their questions.

“Imagine our surprise when Ben Thomas, the nurse coordinator, visited us at the hotel,” said Addis’s sister, Ashley Wargula. “He sat with us in the lobby for two hours and walked us through everything. It really impressed us with how he went that extra mile to make us feel comfortable.”

That was just the start of the many ways the doctors, nurses and therapists stepped in to make this transplant journey as stress-free as possible.

Addis first met with Ryan Tedford, M.D., in October 2019. Tedford is an advanced heart failure and transplant cardiologist and medical director of cardiac transplantation at MUSC Health. He’s one of eight such specialized cardiologists, with a ninth slated to join the team in August, who work with three heart surgeons, with two more set to join in late summer. Addis first met with Ryan Tedford, M.D., in October 2019. 

Despite the pandemic, the transplant  team has remained busy.  “Symptomatic cardiac disease doesn’t wait,” said Marc R. Katz, M.D., MPH, chief of cardiothoracic surgery. “In Fiscal Year 2020, the team performed 40 adult heart transplants, compared to 26 in FY2019.”  Katz said there have been a few patients who have been low risk enough that procedures could be postponed, but for the most part, it’s been business as usual for the heart team.

Katz said there have been a few patients who have been low risk enough that procedures could be postponed, but for the most part, it’s been business as usual for the heart team.The team has plenty of precautions in place, including rapid testing of patients for coronavirus before surgery and testing of all donor hearts before transplantation. These are in addition to the precautions that MUSC Health as a whole has implemented, like increased telehealth visits and a universal masking policy. 

They were all so remarkable,” Addis said. “Not only did they help me heal medically, they helped me heal emotionally.” “They understood the added stress of not having family by my side and did so many things on a daily basis to help get me through the recovery,” Addis said.

Milton Armstrong, M.D. joined MUSC in 2009 as Chief of Plastic and Reconstructive Surgery. Dr. Armstrong is board certified by the American Board of Plastic Surgery and earned a Certificate of Added Qualifications in Hand Surgery.

An accomplished clinician, leader and educator, Dr. Armstrong was appointed Director to the American Board of Plastic Surgery in 2020. He also holds national positions including Senior Director at Large for the American Association for Surgery of the Hand and Oral Examiner for the American Board of Plastic Surgery.

Prior to joining MUSC, Dr. Armstrong’s first faculty position was at Ohio State University, College of Medicine in the Division of Plastic Surgery. In addition to his clinical practice, he served the University as Associate Dean for Student Affairs and Associate Dean for Minority Affairs. 

He then moved to the University of Miami Health System, where he was Chief of the Division of Plastic Surgery at the Veteran’s Hospital.  During his tenure at Miami, he started a microsurgery and a hand surgery fellowship.  At both of these academic medical centers, he was the only Black surgeon. He notes of all places he has worked or trained, MUSC has the most racial diversity.

An educator at heart, Dr. Armstrong is deeply committed to providing strong leadership and guidance to the residents in the Plastic and Reconstructive Surgery training programs at MUSC. Under his leadership, the plastic and reconstructive surgery residents have a 100% board pass rate. 

Throughout his career, he has trained more than 100 surgeons. He keeps in touch with many of his graduates and is gratified to see they are successful, caring clinicians and advocates for diversity and inclusion. 

Dr. Armstrong was the first surgeon highlighted in the Arthur L. Garnes Society’s “Surgeon Spotlight.”

The Society is named after Arthur Garnes, M.D., the first board-certified Black plastic surgeon.  It is committed to fostering mentorship, collaboration, and fellowship among Black, African-American, and other under-represented minorities in Plastic Surgery.  

Contact MUSC 843-792-2300

The Pediatric ECMO Program at the MUSC Shawn Jenkins Children’s Hospital received the platinum-level Award for Excellence in Life Support from the Extracorporeal Life Support Organization (ELSO), an international consortium of centers offering ECMO (extracorporeal membrane oxygenation) for support of failing organ systems in infants, children and adults. This award is the highest attainable level of achievement an ELSO Center of Excellence can receive and recognizes select programs worldwide that have demonstrated the highest level of performance, innovation and quality in the delivery of extracorporeal life support. 

The pediatric ECMO program is one of eight children’s hospitals in the U.S. to achieve this recognition in 2020. It is one of only two pediatric programs in the Southeast and shares the honor with Children’s Healthcare of Atlanta at Egleston.  The MUSC pediatric ECMO program was previously designated an ELSO Center of Excellence, gold level, in 2017.

The ELSO Award for Excellence in Life Support signifies a commitment to exceptional patient care and an assurance of high-quality standards, specialized equipment and supplies, defined patient protocols and advanced education of all staff members.  

“It is an exceptional honor to receive this recognition,” said pediatric surgeon Laura Hollinger, M.D., medical director of the MUSC Pediatric ECMO Program. “It is a testament to the level of excellence of the multidisciplinary team of experts who provide ECMO support to our infants and children.”

The program’s team is comprised of pediatric surgeons, pediatric heart surgeons, pediatric cardiologists, neonatologists, pediatric critical care physicians, perfusionists, specially trained nurses and respiratory therapists. “The hallmark of this program is that we have this amazing pediatric service line complement that allows us to provide total care for our most critically ill children,” said Hollinger. “Our pediatric ECMO program is the epitome of multidisciplinary collaboration and speaks to the distinct advantage of having a designated children’s hospital with a team of specialists.”  

The goal of the pediatric ECMO program is to ensure outcomes remain excellent for these particularly vulnerable children, which the team strives to achieve through rigorous benchmarking, collegial support and unification through monthly case review conferences. 

Hollinger credits this award to the years of hard work by many pediatric specialists who care for these patients and to program manager Monika Cardona, R.N., MSN,  who joined the team in 2014, for spearheading the program. Recognized as an expert in her field, Cardona has more than 20 years of experience in caring for patients requiring ECMO support and programmatic development. 

 “Platinum designation by ELSO is an incredible honor that has been bestowed upon our program. With only 23 international ECMO programs receiving this elite designation, the work being done here at MUSC Shawn Jenkins Children’s Hospital in extracorporeal life support is now showcased worldwide,” said Cardona. “I am both humbled and honored to provide the programmatic oversight for our ECMO center and to be a part of this extraordinary team of clinicians as we care for these exceptional patients and their families.”

“At MUSC, we have always had exceptional pediatric providers as evidenced by our surgical critical care program designations, including an ACS-designated Level 1  pediatric trauma center, a gold-level ECMO Center of Excellence and  the Pediatric Burn Program” said pediatric surgeon Chris Streck, M.D., chief of the Division of Pediatric Surgery. “With the opening of the Shawn Jenkins Children’s Hospital this year, we have a brand new state-of-the-art facility to match the excellent quality of patient care and platinum-level ELSO award.” 

According to pediatric oncologist Michelle Hudspeth, M.D., director of the Division of Pediatric Hematology and Oncology, ECMO is a resource you hope never to have to utilize.

“However,” she added, “I am enormously grateful for the expertise of our team when our pediatric oncology patients need it.”Hudspeth shared her utmost praise for the team’s level of dedication and skill. “There really aren’t words to express my respect and gratitude when you watch Monika and her team, the pediatric surgeons and the pediatric intensive care physicians and nurses successfully place a patient on ECMO. This is as life and death as it gets – their work as a team is beautifully orchestrated when every second counts,” she explained.

“Their expertise shines, as our ECMO outcomes for pediatric oncology are far better than the national average, with 100% survival to discharge for the last seven years.”  

Contact MUSC 843-792-2300

The following faculty have been recognized in 2020:

• Andrea Abbott, M.D., MSCR elected Faculty Council Chair-Elect for 2020/2021 and will serve as Faculty Council Chair 2021/2022.
• Milton Armstrong, M.D. appointed Director to the American Board of Plastic Surgery.
• E. Ramsay Camp, M.D., MSCR elected a Fellow in the American Surgical Association.
• Nancy DeMore, M.D. appointed to serve as a Member of the Scientific Program Committee for the Society of Surgical Oncology.
• Heather Evans, M.D. MS appointed to serve as a member of the Surviving Sepsis Campaign Steering Committee for the Society of Critical Care Medicine.
• Evert Erkisson, M.D. named Chair of the Lowcountry Regional Trauma Advisory Council (LC-RTAC).
• Elizabeth Genovese, M.D. MS appointed as the Arterial Research Advisory Committee Chair of the Carolinas Vascular Quality Group.
• Ashley Hink, M.D. MPH accepted to the 2020 EAST INVEST-C Research Hackathon workshop.Steve Kahn, M.D. named Co- chair of the Lowcountry Regional Trauma Advisory Council (LC-RTAC).
• Shikhar Mehrotra, Ph.D. named Co-Leader of Hollings Cancer Center; named to the Cecilia and Vincent Peng Endowed Chair in Melanoma and Cutaneous Oncology.
• Jean Marie Ruddy, M.D. named to the Editorial Board for the Annals of Vascular Surgery.
• Robert M. Sade, M.D. recognized as an Expert Institute World Expert in Professional Ethics.
• David Taber, Pharm.D., MS, BCPS awarded the 2020 ACCP Clinical Practice Award by the Board of Regents and members of the American College of Clinical Pharmacy.
• Cynthia Talley, M.D. selected to join the Board of Directors for the Eastern Association for the Surgery of Trauma(EAST).
• Jared White, M.D. named General Surgery Associate Program Director of Curriculum.
• T. Karl Byrne, M.D., Satish Nadig, M.D., D.Phil., and Mark Rubinstein,Ph.D. named to MUSC chapter of the National Academy of Inventors.
• Distinguished Faculty Recognitions: 
• E. Douglas Norcross, M.D. awarded the 2020 MUSC Foundation Distinguished Faculty Service Award. The other winners of this award include Drs. Cassandra Salgado and Karen Wager.
• Evert Eriksson, M.D. awarded the 2020 MUSC Foundation Outstanding Clinician Award.  The other winners of this award include Drs. Andrew Eisemen and Nagraj Kasi.

Promotion and Tenure: Andrea Abbott, M.D. MSCR  promoted to associate professor

• Evert Eriksson, M.D. promoted to professorAlicia Renee Privette, M.D. promoted to associate professor
• M. Lance Tavana, M.D. promoted to associate professor
• Jason Ulm, M.D. promoted to associate professor

Colston Edgerton, M.D. joins the division of GI and Laparoscopic Surgery as assistant professor of Surgery, effective September 1, 2020. Dr. Edgerton  completed his general surgery residency at MUSC and served as the administrative chief resident. He then pursued a fellowship in advanced minimally invasive GI and bariatric surgery at the Brigham and Women’s Hospital and Harvard Medical School. He returns to the division of GI Surgery with a clinical focus in laparoscopic and robotic bariatric, foregut, and hernia surgery.

His academic interests are in clinical outcomes following bariatric surgery and access to subspecialty surgical care.

 

Lucas McDuffie, M.D. joins the division of Pediatric Surgery as assistant professor of Surgery, effective August 1, 2020. Dr. McDuffie completed his internship and residency training in General Surgery at Indiana University in Indianapolis, Indiana. He spent an additional two years training in oncologic surgery and research at the National Cancer Institute at the National Institutes of Health in Bethesda, Maryland. During this time, he won numerous research and teaching awards, and was elected to the Alpha Omega Alpha Medical Honor Society and the Gold Humanism Honor Society. Dr. McDuffie completed his fellowship in pediatric surgery at Riley Hospital for Children at Indiana University, where he trained to perform both minimally invasive and open operations for all pediatric general and thoracic surgical conditions. 

Dr. McDuffie’s research interest is childhood cancer, specifically chest, abdominal, and pelvic tumors. His clinical interests are broad and include minimally invasive surgery for a variety of conditions in the chest and abdomen.  

 

Nicolas Pope, M.D. joins the division of Cardiothoracic Surgery as assistant professor of Surgery, effective September 1, 2020. Dr. Pope completed his General surgery training at the University of Virginia, during which time he spent two years of dedicated basic science research into the treatment of aortic aneurysms and therapies to improve lung preservation for transplantation. Dr. Pope completed a Surgical Critical Care fellowship, also at the University of Virginia focusing on the care of patients after cardiac surgery.  He remained at the University of Virginia for his Cardiothoracic Surgical Fellowship.

His clinical interests include surgical treatment of heart failure, mechanical circulatory support, coronary artery disease, heart valve disease, treatment of thoracic aortic disease and critical care of patients undergoing heart surgery. Dr. Pope’s research interests include advanced therapies for heart failure and the causes and potential treatment of aortic aneurysms.

 

Konrad Rajab, M.D. joins the division of Cardiothoracic Surgery as a pediatric cardiothoracic surgeon. Dr. Rajab completed his general surgery training at the Brigham and Women’s Hospital and spent time dedicated to translational research at Harvard University. Dr. Rajab remained at the Brigham for a Cardiothoracic Surgery Fellowship. Subsequently, he completed a Congenital Cardiac Surgery Fellowship at Children’s Hospital Colorado.

Isis Scomacao, M.D. joins the division of Plastic and Reconstructive Surgery. Dr. Scomacao is a Brazilian plastic surgeon, earning her medical degree in Brazil, followed by a general surgery residency and then a plastic surgery residency that she completed at the Clinics Hospital, Curitiba, Brazil in 2012. She received a prestigious award for placing second in the Brazilian plastic surgery board examination and was also awarded the ASAPS North American Plastic Surgery Fellowship. Dr. Scomacao pursued further training in the US with a focus on microsurgery reconstruction and surgical treatment of lymphedema at the Cleveland Clinic, Cleveland, OH,  where she completed fellowships in advanced microsurgery, surgical wound care, and craniofacial surgery.

 

Lucas Witer, M.D.  joins the Division of Cardiothoracic Surgery as an assistant professor.

Dr. Witer completed residency in general surgery at the Oakland University – William Beaumont Hospital, a cardiothoracic surgery fellowship at the New York Presbyterian– Weill Cornell Medical Center and the Memorial Sloan Kettering Cancer Center.

He continued advanced subspecialty training at the New York Presbyterian – Columbia University Medical Center in heart failure, advanced mechanical circulatory support, ventricular assist device implantation and cardiac transplantation.

 

ADAPTIVE LEARNING: Zoom in to connect and learn

With social distancing guidelines in place at the start of a new clerkship rotation, the education division needed to develop a curriculum that would cover various topics medical students would come across during the first two weeks of their clerkship.

Mathew Wooster, M.D., general surgery clerkship director, reached out to each surgical sub-specialty inquiring as to whether any of them would be willing to provide the students in Block 7 (March 30-May 8) with virtual classroom instruction, including lectures covering their specialty along with additional modules from various training data banks.

Many attendings offered to provide virtual learning experiences. On Monday, March 30, Rana Pullatt, M.D. provided the inaugural Zoom video session with the surgery clerkship students.

Dr. Pullatt provided an interactive zoom session that included videos of a cholecystectomy, gastric bypass, and sleeve gastrectomy. He provided a live while live narration, pointing out anatomy as well as discussing indications, perioperative care, and post operative complications. According to Wooster, the clerskship students were as engaged and interactive as they are in a live session.  

ADAPTIVE LEARNING: Virtual Simulator Training

Vascular surgeon Mathew Wooster, M.D., developed a virtual simulator training for the vascular surgery integrated residents with the help of his colleague, Elizabeth Genovese, M.D., who joined the effort by formalizing the survey and investigating potential research publication opportunities.

According to Wooster, this is a pilot trial of virtual endovascular simulation training utilizing benchtop simulation model and one-on-one mentoring with a Zoom interface. The trainees will first film themselves attempting a variety of arterial cannulations by selecting the appropriate wire and catheter combinations.

They will then have one-hour Zoom based instructional sessions to review/train their skills with faculty. This will be followed by independent replication of those cannulations.“Using a telephone camera (with Zoom) to display the benchtop model as “live virtual fluoroscopy” and the laptop camera (with Zoom) to watch the trainee’s hands on the catheter, we can give real time feedback and instruction from an appropriate social distance,” said Wooster.

Wooster and Genovese will then compare metrics including subjective analysis of the usability of the model, the benefit of virtual mentoring, perceived improvement in skills and importance to training, number of catheter exchanges required, and time to successful cannulation. They plan to move to the more advanced 3D Systems Simbionix electronic simulators, also with remote instruction.

“Drs. Wooster and Genovese have consistently leveraged technology to create new educational and clinical opportunities. This is a novel program that demonstrates how MUSC Vascular is leading the way and changing what’s possible,” said Ravi Veeraswamy, M.D., chief of Vascular Surgery. “Kudos to them for once again putting MUSC Vascular at the forefront of innovation and education.”

Contact MUSC 843-792-2300

Clinical trial to test immunotherapy combination in surgical pancreatic cancer patients    

 

Hollings Cancer Center researchers at the Medical University of South Carolina received $900,000 in funding for a three-year oncology translational studies program concept from Merck to do a Phase II study that potentially can offer a new treatment for pancreatic cancer patients, a population in desperate need of new treatment options, said one of the leading researchers and surgeon E. Ramsay Camp, M.D.Camp, who joins forces with Mark Rubinstein, Ph.D., on this study, said it capitalizes on the innovative immunotherapy research happening in Rubinstein’s lab.

Lipo-ImmunoTech,receives grant to develop a novel cancer immunotherapy technology

Lipo-ImmunoTech, LLC, a startup based in Charleston, South Carolina, recently received a Phase I Small Business Technology Transfer (STTR) grant of just over $224,000 to continue to develop its novel adoptive cell therapy technology for cancer. The startup is a joint venture involving Shikhar Mehrotra, Ph.D., an immunologist, and Besim Ogretmen, Ph.D., a sphingolipid expert, both of whom are Hollings Cancer Center researchers at the Medical University of South Carolina. Lipo-ImmunoTech also executed an option agreement with the MUSC Foundation for Research Development, which gives it the rights to evaluate the technology further with an eye toward eventually licensing it for commercialization.

Ashley Hink, M.D., MPH leads national collaborative research study on gun violence 

Firearm injury is one of the leading causes of death in the U.S. for youth and young adults, and those who survive their injuries may suffer long-term poor physical, mental health and social outcomes. Ashley Hink, M.D., MPH, is a key member of a research team with the American College of Surgeons Committee on Trauma who secured a grant from the National Collaborative on Gun Violence Research to prospectively study risk factors and outcomes of firearm injuries treated at over 70 trauma centers across the U.S. Dr. Hink and Dr. Anne Andrews from the Department of Pediatrics are also laying the groundwork to initiate an MUSC Hospital and Community Violence Prevention & Intervention Program for our patients and community members. 

Hongjun Wang, Ph.D.named to prestigious NIH Study Section  

Dr. Hongjun Wang has been invited by the NIH to serve as a  permanent member of the Cellular Aspects of Diabetes and Obesity Study Section, Center for Scientific Review, for the term beginning July 01, 2020 and ending June 30, 2024.  They will meet three times a year and review 70-80 submissions per meeting. Wang has been a temporary reviewer for the NIH since 2016. She had been invited to participated in more than 20 NIH study sections sessions and has served as chair of two NIH special emphasis panels. A highly rigorous process, members are selected on the basis of their demonstrated competence and achievement in their scientific discipline.   “It is a great honor to serve the NIH as a permanent member of this Study Section,” said Wang. 

 

Contact MUSC 843-792-2300

Virtual antibody crossmatching is a safe and efficient way of selecting kidney transplant recipients. Two years after implementing the process, the Medical University of South Carolina division of transplant surgery concluded that the technique was just as accurate and sensitive as physical crossmatch, the current gold standard, and much quicker.

Virtual crossmatching reduced the time kidneys were kept on ice while awaiting identification of a suitable recipient,improved scheduling for surgeons and operating room staff, and alleviated emotional and logistical stress on patients who were called to the hospital only to be sent home hours later after a more suitable recipient was identified.

A study of the process and its effects on clinical and surgical practice outcomes appears on the Journal of the American College of Surgeons website in advance of print publication.A physical crossmatch is highly sensitive, but it eats up valuable time. Donor lymph nodes are shipped to the transplant center, cells are mixed with serum from the potential recipient, and surgeons, recipient, and the transplant center then must wait six hours to learn whether there is an antibody reaction before scheduling the operation.

Because of the concern about potential immune system incompatibility, transplant centers typically call in three possible recipients for every donated organ. “We ask three patients who are next on the transplantation list to come into the hospital just in case there are problems with incompatibility.

Think about the time, effort, and stress that puts on a patient. It’s not uncommon for a patient to be called in two, three, or four times before they actually go forward with transplantation,” said David Taber, PharmD, senior author of the study and a professor of surgery in the senior author of the study and a professor of surgery in the division of transplant surgery at MUSC. Delays are particularly problematic since the Kidney Allocation System was revised in 2014 and now allows transplantations to patients who are highly sensitized.“Previously, donor organs were obtained locally, so transplant centers could afford to wait six hours for the physical crossmatch results.

Now, in South Carolina, we are getting organs from California. Shipping them takes long enough. If you cannot predict what is going to happen for six more hours, you may not be able to give the organ to the intended recipient and do a disservice to the purpose of the allocation system,” said Vinayak Rohan, M.D., lead author of the study and an assistant professor of surgery in the division of transplant surgery at MUSC. The study is a before-and-after comparison of patient outcomes two years after the transplant surgery team implemented virtual crossmatching.

Of 825 patients who received a kidney transplant between 2014 and 2018,505 underwent surgery before — and 227 after — virtual crossmatching was instituted.Standard measures of clinical quality were the same in both groups. The incidence of delayed graft function was 19%before and 17% after implementation; graft failure within a year was 4% before and 3% after; mortality within a year was 2% before and 1% after. CIT for long-distance donor organs decreased by 24 hours, and delayed graft function declined by 26%.“Because we don’t need to do physical crossmatching for the majority of patients, we also can improve surgeons’quality of life by being able to schedule the operation even before an organ arrives,” Rohan said.  

American College of Surgeons article (abridged version), photo by Emma Vought

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The following faculty have been recognized in 2020:

• Andrea Abbott, M.D., MSCR elected Faculty Council Chair-Elect for 2020/2021 and will serve as Faculty Council Chair 2021/2022.
• Milton Armstrong, M.D. appointed Director to the American Board of Plastic Surgery.
• E. Ramsay Camp, M.D., MSCR elected a Fellow in the American Surgical Association.
• Nancy DeMore, M.D. appointed to serve as a Member of the Scientific Program Committee for the Society of Surgical Oncology.
• Heather Evans, M.D. MS appointed to serve as a member of the Surviving Sepsis Campaign Steering Committee for the Society of Critical Care Medicine.
• Evert Erkisson, M.D. named Chair of the Lowcountry Regional Trauma Advisory Council (LC-RTAC).
• Elizabeth Genovese, M.D. MS appointed as the Arterial Research Advisory Committee Chair of the Carolinas Vascular Quality Group.
• Ashley Hink, M.D. MPH accepted to the 2020 EAST INVEST-C Research Hackathon workshop.Steve Kahn, M.D. named Co- chair of the Lowcountry Regional Trauma Advisory Council (LC-RTAC).
• Shikhar Mehrotra, Ph.D. named Co-Leader of Hollings Cancer Center; named to the Cecilia and Vincent Peng Endowed Chair in Melanoma and Cutaneous Oncology.
• Jean Marie Ruddy, M.D. named to the Editorial Board for the Annals of Vascular Surgery.
• Robert M. Sade, M.D. recognized as an Expert Institute World Expert in Professional Ethics.
• David Taber, Pharm.D., MS, BCPS awarded the 2020 ACCP Clinical Practice Award by the Board of Regents and members of the American College of Clinical Pharmacy.
• Cynthia Talley, M.D. selected to join the Board of Directors for the Eastern Association for the Surgery of Trauma(EAST).
• Jared White, M.D. named General Surgery Associate Program Director of Curriculum.
• T. Karl Byrne, M.D., Satish Nadig, M.D., D.Phil., and Mark Rubinstein,Ph.D. named to MUSC chapter of the National Academy of Inventors.
• Distinguished Faculty Recognitions: 
• E. Douglas Norcross, M.D. awarded the 2020 MUSC Foundation Distinguished Faculty Service Award. The other winners of this award include Drs. Cassandra Salgado and Karen Wager.
• Evert Eriksson, M.D. awarded the 2020 MUSC Foundation Outstanding Clinician Award.  The other winners of this award include Drs. Andrew Eisemen and Nagraj Kasi.

Promotion and Tenure: Andrea Abbott, M.D. MSCR  promoted to associate professor

• Evert Eriksson, M.D. promoted to professorAlicia Renee Privette, M.D. promoted to associate professor
• M. Lance Tavana, M.D. promoted to associate professor
• Jason Ulm, M.D. promoted to associate professor

Colston Edgerton, M.D. joins the division of GI and Laparoscopic Surgery as assistant professor of Surgery, effective September 1, 2020. Dr. Edgerton  completed his general surgery residency at MUSC and served as the administrative chief resident. He then pursued a fellowship in advanced minimally invasive GI and bariatric surgery at the Brigham and Women’s Hospital and Harvard Medical School. He returns to the division of GI Surgery with a clinical focus in laparoscopic and robotic bariatric, foregut, and hernia surgery.

His academic interests are in clinical outcomes following bariatric surgery and access to subspecialty surgical care.

 

Lucas McDuffie, M.D. joins the division of Pediatric Surgery as assistant professor of Surgery, effective August 1, 2020. Dr. McDuffie completed his internship and residency training in General Surgery at Indiana University in Indianapolis, Indiana. He spent an additional two years training in oncologic surgery and research at the National Cancer Institute at the National Institutes of Health in Bethesda, Maryland. During this time, he won numerous research and teaching awards, and was elected to the Alpha Omega Alpha Medical Honor Society and the Gold Humanism Honor Society. Dr. McDuffie completed his fellowship in pediatric surgery at Riley Hospital for Children at Indiana University, where he trained to perform both minimally invasive and open operations for all pediatric general and thoracic surgical conditions. 

Dr. McDuffie’s research interest is childhood cancer, specifically chest, abdominal, and pelvic tumors. His clinical interests are broad and include minimally invasive surgery for a variety of conditions in the chest and abdomen.  

 

Nicolas Pope, M.D. joins the division of Cardiothoracic Surgery as assistant professor of Surgery, effective September 1, 2020. Dr. Pope completed his General surgery training at the University of Virginia, during which time he spent two years of dedicated basic science research into the treatment of aortic aneurysms and therapies to improve lung preservation for transplantation. Dr. Pope completed a Surgical Critical Care fellowship, also at the University of Virginia focusing on the care of patients after cardiac surgery.  He remained at the University of Virginia for his Cardiothoracic Surgical Fellowship.

His clinical interests include surgical treatment of heart failure, mechanical circulatory support, coronary artery disease, heart valve disease, treatment of thoracic aortic disease and critical care of patients undergoing heart surgery. Dr. Pope’s research interests include advanced therapies for heart failure and the causes and potential treatment of aortic aneurysms.

 

Konrad Rajab, M.D. joins the division of Cardiothoracic Surgery as a pediatric cardiothoracic surgeon. Dr. Rajab completed his general surgery training at the Brigham and Women’s Hospital and spent time dedicated to translational research at Harvard University. Dr. Rajab remained at the Brigham for a Cardiothoracic Surgery Fellowship. Subsequently, he completed a Congenital Cardiac Surgery Fellowship at Children’s Hospital Colorado.

Isis Scomacao, M.D. joins the division of Plastic and Reconstructive Surgery. Dr. Scomacao is a Brazilian plastic surgeon, earning her medical degree in Brazil, followed by a general surgery residency and then a plastic surgery residency that she completed at the Clinics Hospital, Curitiba, Brazil in 2012. She received a prestigious award for placing second in the Brazilian plastic surgery board examination and was also awarded the ASAPS North American Plastic Surgery Fellowship. Dr. Scomacao pursued further training in the US with a focus on microsurgery reconstruction and surgical treatment of lymphedema at the Cleveland Clinic, Cleveland, OH,  where she completed fellowships in advanced microsurgery, surgical wound care, and craniofacial surgery.

 

Lucas Witer, M.D.  joins the Division of Cardiothoracic Surgery as an assistant professor.

Dr. Witer completed residency in general surgery at the Oakland University – William Beaumont Hospital, a cardiothoracic surgery fellowship at the New York Presbyterian– Weill Cornell Medical Center and the Memorial Sloan Kettering Cancer Center.

He continued advanced subspecialty training at the New York Presbyterian – Columbia University Medical Center in heart failure, advanced mechanical circulatory support, ventricular assist device implantation and cardiac transplantation.

 

Botox may be most famous for helping celebrities maintain an illusion of youthfulness, but the drug is increasingly used by doctors far from the cosmetic realm – including MUSC Health trauma surgeon Evert Eriksson and physiatrist Emily Darr, who used the toxin to prepare a patient for an otherwise unfeasible hernia repair.

“When he came up with the Botox, I thought ohhhh-kayyy,” recalled patient Jacqueline Goff.

But, she added, she trusts Eriksson with her life.

That’s because Eriksson, Trauma medical director in the Division of General and Acute Care Surgery, was on call the night of June 22, 2018. That’s the night that a wrong-way driver crashed into a car that Goff and her best friend, then-Congressional candidate Katie Arrington, were in. The pair suffered severe traumatic injuries. The other driver died at the scene.

“Jackie’s injury is considerably more complex than Katie’s. Katie’s is a more typical car wreck injury that we see. Her injuries are something we deal with every day. Jackie’s injury is a whole different ball game and much harder to get a good outcome from,” he said.

The seatbelt had sliced through Goff’s abdomen like a taut nylon cord through wet clay. The injury required multiple surgeries during Goff’s initial hospital stay just for basic repairs to internal organs. While Arrington went home after two weeks, Goff remained in the hospital for 62 days before transferring out for rehab.

“This is the worst seatbelt injury I’ve ever seen,” Eriksson said. “Among all the attending doctors as well, no one’s seen this bad of an injury from a seatbelt.” Goff needed an entire reconstruction of the left side of her abdominal wall after all the muscle was pulled off of the pelvis bones.

Goff left the hospital with a bridging biologic mesh acting as a stand-in for her abdominal wall – the muscles that normally “keep all her insides inside,” according to Eriksson. Because of the injury, her right and left abdominal muscles no longer met in the middle. Even with the mesh and the stiffest Spanx she could find, she still had a visible hernia.

Finally, in the summer of 2019, it was time to plan the hernia repair surgery. Eriksson knew he wouldn’t be able to pull the muscles back into place manually.But he’d heard about cases where Botox was used to relax muscles enough that they could be pulled and stretched back into position. He didn’t know of anyone at MUSC Health who had used such a technique, so he spoke to hernia experts around the country and came to the conclusion that Botox was Goff’s best chance for recovery. Without it, he said, she’d likely have a bridging repair – a surgical fix that could lead to ongoing issues with mobility and strength and had a high chance of hernia recurrence.

Eriksson then reached out to Darr, a physical medicine and rehabilitation doctor who uses Botox in her practice. Darr, relying on her experience and the latest research, calculated that 300 units would be an appropriate dose for Goff. She used ultrasound to guide her with precision as she injected the neurotoxin into the muscle.

Eriksson and Goff returned to the operating room in August for the final hernia repair. With Goff’s muscles now relaxed from the Botox, Eriksson could pull them from their shortened and thickened state – rather like Silly Putty, he explained – to a longer, thinner position where they met in the middle. He sewed the muscles together, giving her a functional abdominal wall. Once the Botox wore off, he explained, the muscles began to adapt to their new stretched position.

She remains amazed that she and Arrington survived the crash. And she thinks constantly about Eriksson and his team. “When I wake up in the morning, he’s in my prayers,” she said.

 

In what has been a memorable year on many fronts for MUSC Children’s Health, new rankings from U.S. News & World Report place the MUSC Shawn Jenkins Children’s Hospital in the No. 1 position for the state. The rankings come just four months after the hospital opened, and as South Carolina deals with the ongoing coronavirus pandemic.

Four specialty programs within the hospital have been singled out by U.S. News & World Report for national recognition: cardiology and heart surgery, nephrology (kidney), gastroenterology and gastrointestinal (GI) surgery and cancer. U.S. News & World Report issues the annual rankings “to help families with complex and rare conditions find the best medical care for their children,” according to the publication’s website.

They’re designed to steer children and their parents to the hospitals that are best equipped to treat them.

The cardiology program maintains its spot among the top 10 children’s heart programs in the United States. Criteria include children’s survival rate after complex heart surgery, along with the level of specialized staff, services and technologies and the ability to prevent infections. 

The nephrology program at the MUSC Shawn Jenkins Children’s Hospital ranks No. 30 in the U.S.

That means it excels when it comes to the survival rate of children who have kidney transplants, the management of dialysis and infection prevention and other factors. It maintains its status as the highest ranked children’s kidney program in South Carolina.

The GI and GI surgery program is no stranger to the U.S. News rankings, either. For the 13th year in a row, it made the grade, coming in at No. 43.

The rankings factor in the survival rate for children who have liver transplants, the effectiveness of the hospital’s treatment of children who have inflammatory bowel issues and other key measures.