Biography
My group is interested in identifying why obese individuals are at greater risk of liver injury in the setting of trauma or surgery. My long-term goal is to understand the relationship between metabolic and immunologic processes in the liver. One potential link between these underlying mechanisms could be the peptide leptin, which can profoundly modify inflammatory and metabolic pathways. The goal of this research effort is to improve understanding of the impact of leptin on acute inflammatory cascade and metabolic response during hepatic ischemia-reperfusion. This will benefit patients by improving risk-stratification of candidates for hepatic surgery and possibly lead to preventive therapies for ischemia-reperfusion injury.
Education
- 1986-93, Ludwig-Maximilians University, Munich, Germany, M.D.
- 1993-94 Intern ; City Hospital St. Georg,, University of Hamburg, Germany and Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany
- 1996-99, University of California, San Francisco, Resident, Anesthesia
- 1994-96, Department of Anesthesiology, Northwestern University, Chicago, Illinois, Fellow, Postdoctoral Research
Board Certifications
- American Board of Anesthesiology
Clinical Expertise
Pancreas Transplantation
Liver Transplantation
Kidney Transplantation
Clinical Trials
- Prevention of De Novo HCV With Antiviral HCV Therapy Post-Liver and Post-Kidney Transplant (NCT03619837)Related Conditions: Hepatitis C, Transplantation Disease Transmission, Kidney Transplant, Transplants| Start Date: | End Date:
- Related Conditions: Organ Donation, Hypothermia, Renal Function| Start Date: | End Date:
- Intensive Insulin Therapy in Deceased Donors (NCT01140035)Related Conditions: Kidney Transplant, Transplants, Insulin Resistance| Start Date: | End Date:
Program Affiliations
- Department of Anesthesia and Perioperative Care
- Department of Surgery, Division of Transplantation
- UCSF Liver Center
In the News
Research Narrative
My group is interested in identifying why obese individuals are at greater risk of liver injury in the setting of trauma or surgery. My long-term goal is to understand the relationship between metabolic and immunologic processes in the liver. One potential link between these underlying mechanisms could be the peptide leptin, which can profoundly modify inflammatory and metabolic pathways. The goal of this research effort is to improve understanding of the impact of leptin on acute inflammatory cascade and metabolic response during hepatic ischemia-reperfusion. This will benefit patients by improving risk-stratification of candidates for hepatic surgery and possibly lead to preventive therapies for ischemia-reperfusion injury.
Research Interests
Inflammatory response to injuryIschemia reperfusion injury
Liver transplantation
Metabolomics
Organ donation
Renal and hepatic injury during surgery
Intensive Insulin Therapy in Deceased Donors-to improve renal allograft function and transplanted allograft outcomes
View Research Profile at UCSF Clinical & Translational Science Institute
Publications
- Therapeutic Hypothermia in Low-Risk Nonpumped Brain-Dead Kidney Donors: A Randomized Clinical Trial.| | PubMed PubMed
- International Liver Transplantation Society Global Census: First Look at Pediatric Liver Transplantation Activity Around the World.| | PubMed PubMed
- Lactate concentration at the end of liver transplant: Early predictor of graft function or just one piece of the puzzle?| | PubMed PubMed
- Hypothermia or Machine Perfusion in Kidney Donors.| | PubMed PubMed
- Enhanced recovery for liver transplantation: recommendations from the 2022 International Liver Transplantation Society consensus conference.| | PubMed PubMed
- Perioperative mortality in liver transplantation before and after the implementation of the organ allocation policy Share 35.| | PubMed PubMed
- Advantages and Limitations of Clinical Scores for Donation After Circulatory Death Liver Transplantation.| | PubMed PubMed
- Expedited evaluation for liver transplantation: A critical look at processes and outcomes.| | PubMed PubMed
- Organ donor management goals and delayed graft function in adult kidney transplant recipients.| | PubMed PubMed
- Perioperative Normal Saline Administration and Delayed Graft Function in Patients Undergoing Kidney Transplantation: A Retrospective Cohort Study.| | PubMed PubMed
- Machine Learning Prediction of Liver Allograft Utilization From Deceased Organ Donors Using the National Donor Management Goals Registry.| | PubMed PubMed
- Enhanced recovery after surgery programs improve short-term outcomes after liver transplantation-A systematic review and meta-analysis.| | PubMed PubMed
- Assessment of the global practice of living donor liver transplantation.| | PubMed PubMed
- Raster Thomson scattering in large-scale laser plasmas produced at high repetition rate.| | PubMed PubMed
- Critical care and ventilatory management of deceased organ donors impact lung use and recipient graft survival.| | PubMed PubMed
- Shared B cell memory to coronaviruses and other pathogens varies in human age groups and tissues.| | PubMed PubMed
- Prospective Multicenter Study of Early Antiviral Therapy in Liver and Kidney Transplant Recipients of HCV-Viremic Donors.| | PubMed PubMed
- Weighing the waitlist: Weight changes and access to kidney transplantation among obese candidates.| | PubMed PubMed
- COVID-19 and Abdominal Transplant: A Stepwise Approach to Practice During Pandemic Conditions.| | PubMed PubMed
- The Association Between Vena Cava Implantation Technique and Acute Kidney Injury After Liver Transplantation.| | PubMed PubMed
- Measurements of ion velocity distributions in a large scale laser-produced plasma.| | PubMed PubMed
- Longer Distance From Dialysis Facility to Transplant Center Is Associated With Lower Access to Kidney Transplantation.| | PubMed PubMed
- Senolytics prevent mt-DNA-induced inflammation and promote the survival of aged organs following transplantation.| | PubMed PubMed
- Impact of Deceased Donor Management on Donor Heart Use and Recipient Graft Survival.| | PubMed PubMed
- Bacchus Listed for a Liver Transplant: Comment.| | PubMed PubMed
- Vasopressor selection during critical care management of brain dead organ donors and the effects on kidney graft function.| | PubMed PubMed
- The role of deceased donor liver biopsy: An analysis of 5449 liver transplant recipients.| | PubMed PubMed
- Transplant anesthesia and critical care: Current research and possible future developments.| | PubMed PubMed
- Therapeutic Hypothermia in Organ Donors: Follow-up and Safety Analysis.| | PubMed PubMed
- Modeling the economic benefit of targeted mild hypothermia in deceased donor kidney transplantation.| | PubMed PubMed
- The Continued Need for Clinical Trials in Deceased Organ Donor Management.| | PubMed PubMed
- Deceased organ donor factors influencing pancreatic graft transplantation and survival.| | PubMed PubMed
- The Impact of Deceased Donor Liver Extraction Time on Early Allograft Function in Adult Liver Transplant Recipients.| | PubMed PubMed
- Intraoperative Management of Liver Transplant Patients Without the Routine Use of Renal Replacement Therapy.| | PubMed PubMed
- Central venous pressure monitoring in living donor kidney recipients does not affect immediate graft function: A propensity score analysis.| | PubMed PubMed
- Organ Donor Management: Part 1. Toward a Consensus to Guide Anesthesia Services During Donation After Brain Death.| | PubMed PubMed
- Comments on "Impact of spontaneous donor hypothermia on graft outcomes after kidney transplantation".| | PubMed PubMed
- Potentially inappropriate liver transplantation in the era of the "sickest first" policy - A search for the upper limits.| | PubMed PubMed
- Protecting the Kidney in Liver Transplant Recipients: Practice-Based Recommendations From the American Society of Transplantation Liver and Intestine Community of Practice.| | PubMed PubMed
- Therapeutic Hypothermia in Deceased Organ Donors and Kidney-Graft Function.| | PubMed PubMed
- Impact of a quality improvement project on deceased organ donor management.| | PubMed PubMed
- Therapeutic Hypothermia in Deceased Organ Donors and Kidney-Graft Function.| | PubMed PubMed
- Management of the Potential Organ Donor in the ICU: Society of Critical Care Medicine/American College of Chest Physicians/Association of Organ Procurement Organizations Consensus Statement.| | PubMed PubMed
- The Impact of Hydroxyethyl Starch Use in Deceased Organ Donors on the Development of Delayed Graft Function in Kidney Transplant Recipients: A Propensity-Adjusted Analysis.| | PubMed PubMed
- A role for Rac1 activity in malignant progression of sebaceous skin tumors.| | PubMed PubMed
- Exercise-induced changes in basal ganglia volume and cognition in older adults.| | PubMed PubMed
- Abdominal transplantation.| | PubMed PubMed
- Patients with chronic kidney disease.| | PubMed PubMed
- Peri-operative hyperglycemia is associated with delayed graft function in deceased donor renal transplantation.| | PubMed PubMed
- Functional elements associated with hepatic regeneration in living donors after right hepatic lobectomy.| | PubMed PubMed
- Deceased organ donor research: the last research frontier?| | PubMed PubMed
- Liver transplantation outcome in patients with angiographically proven coronary artery disease: a multi-institutional study.| | PubMed PubMed
- Infrared pupillometry to detect the light reflex during cardiopulmonary resuscitation: a case series.| | PubMed PubMed
- Optimizing cost-effectiveness in perioperative care for liver transplantation: a model for low- to medium-income countries.| | PubMed PubMed
- Intraoperative hyperglycemia augments ischemia reperfusion injury in renal transplantation: a prospective study.| | PubMed PubMed
- Transplant critical care: standards for intensive care of the patient with liver failure before and after transplantation.| | PubMed PubMed
- Intraoperative management of liver transplant patients.| | PubMed PubMed
- Donor pre-treatment with everolimus or cyclosporine does not reduce ischaemia-reperfusion injury in a rat kidney transplant model.| | PubMed PubMed
- Multivessel coronary artery disease predicts mortality, length of stay, and pressor requirements after liver transplantation.| | PubMed PubMed
- Liver transplant perioperative pathways: which way towards high-quality care and better outcomes?| | PubMed PubMed
- Mapping the ionization state of laser-irradiated Ar gas jets with multiwavelength monochromatic x-ray imaging.| | PubMed PubMed
- 1H-NMR-based metabolic signatures of clinical outcomes in trauma patients--beyond lactate and base deficit.| | PubMed PubMed
- Chronic kidney disease: implications for the perioperative period.| | PubMed PubMed
- Induction of intestinal ischemia reperfusion injury by portal vein outflow occlusion in rats.| | PubMed PubMed
- Quality improvement in transplant anesthesia: which way forward?| | PubMed PubMed
- Short passive cooling protects rats during hepatectomy by inducing heat shock proteins and limiting the induction of pro-inflammatory cytokines.| | PubMed PubMed
- Evolution of elastic x-ray scattering in laser-shocked warm dense lithium.| | PubMed PubMed
- Acute hyperglycemia worsens hepatic ischemia/reperfusion injury in rats.| | PubMed PubMed
- Acute kidney injury during liver transplantation as determined by neutrophil gelatinase-associated lipocalin.| | PubMed PubMed
- Abdominal organ transplantation.| | PubMed PubMed
- Systemic inflammation, coagulopathy, and acute renal insufficiency following endovascular thoracoabdominal aortic aneurysm repair.| | PubMed PubMed
- Predictors associated with terminal renal function in deceased organ donors in the intensive care unit.| | PubMed PubMed
- Postoperative infectious complications of abdominal solid organ transplantation.| | PubMed PubMed
- High contrast Kr gas jet K alpha x-ray source for high energy density physics experiments.| | PubMed PubMed
- Alterations in the proteome of pulmonary alveolar type II cells in the rat after hepatic ischemia-reperfusion.| | PubMed PubMed
- Perioperative liver transplant best practices: weighing the evidence.| | PubMed PubMed
- Transient hyperglycemia affects the extent of ischemia-reperfusion-induced renal injury in rats.| | PubMed PubMed
- Green frequency-doubled laser-beam propagation in high-temperature hohlraum plasmas.| | PubMed PubMed
- Increased severity of renal ischemia-reperfusion injury with venous clamping compared to arterial clamping in a rat model.| | PubMed PubMed
- A multicenter evaluation of safety of early extubation in liver transplant recipients.| | PubMed PubMed
- Remote renal injury following partial hepatic ischemia/reperfusion injury in rats.| | PubMed PubMed
- Biochemical mechanisms of nephrotoxicity: application for metabolomics.| | PubMed PubMed
- Early detection of graft failure using the blood metabolic profile of a liver recipient.| | PubMed PubMed
- Glutamine donor pretreatment in rat kidney transplants with severe preservation reperfusion injury.| | PubMed PubMed
- Central venous pressure monitoring during living right donor hepatectomy.| | PubMed PubMed
- Ischemia-reperfusion injury is more severe in older versus young rat livers.| | PubMed PubMed
- Pattern recognition and biomarker validation using quantitative 1H-NMR-based metabolomics.| | PubMed PubMed
- Mild hypothermia reduces the inflammatory response and hepatic ischemia/reperfusion injury in rats.| | PubMed PubMed
- Mild hypothermia protects obese rats from fulminant hepatic necrosis induced by ischemia-reperfusion.| | PubMed PubMed
- Recombinant factor VIIa reduces transfusion requirements in liver transplant patients with high MELD scores.| | PubMed PubMed
- Warm ischemia-induced alterations in oxidative and inflammatory proteins in hepatic Kupffer cells in rats.| | PubMed PubMed
- Glutamine does not protect against hepatic warm ischemia/reperfusion injury in rats.| | PubMed PubMed
- Ischemic preconditioning improves energy state and transplantation survival in obese Zucker rat livers.| | PubMed PubMed
- Metabolic profiling of livers and blood from obese Zucker rats.| | PubMed PubMed
- H-NMR-based metabolic signatures of mild and severe ischemia/reperfusion injury in rat kidney transplants.| | PubMed PubMed
- Mild hypothermia provides significant protection against ischemia/reperfusion injury in livers of obese and lean rats.| | PubMed PubMed
- Ischemic preconditioning improves rat kidney graft function after severe ischemia/reperfusion injury.| | PubMed PubMed
- Automated, fast, and sensitive quantification of drugs in human plasma by LC/LC-MS: quantification of 6 protease inhibitors and 3 nonnucleoside transcriptase inhibitors.| | PubMed PubMed
- Beta-adrenergic blockade affects initial drug distribution due to decreased cardiac output and altered blood flow distribution.| | PubMed PubMed
- Intraoperative fluid management of living donor versus cadaveric liver transplant recipients.| | PubMed PubMed
- Influence of donor pretreatment with N-acetylcysteine on ischemia/reperfusion injury in rat kidney grafts.| | PubMed PubMed
- Sirolimus delays recovery of rat kidney transplants after ischemia-reperfusion injury.| | PubMed PubMed
- Mechanism of pupillary reflex dilation in awake volunteers and in organ donors.| | PubMed PubMed
- The effects of desflurane and propofol on portosystemic pressure in patients with portal hypertension.| | PubMed PubMed
- Organ-specific response to inhibition of mitochondrial metabolism by cyclosporine in the rat.| | PubMed PubMed
- Clinically important drug interactions with intravenous anaesthetics in older patients.| | PubMed PubMed
- Intraoperative hemodynamics and liver function in adult-to-adult living liver donors.| | PubMed PubMed
- Elimination of indocyanine green in the perioperative evaluation of donor liver function.| | PubMed PubMed
- Cyclosporine can increase isoflurane MAC.| | PubMed PubMed
- Close association between the reduction in myocardial energy metabolism and infarct size: dose-response assessment of cyclosporine.| | PubMed PubMed
- Evaluation of the splanchnic circulation with indocyanine green pharmacokinetics in liver transplant patients.| | PubMed PubMed
- Comparison of the effects of cyclosporin a on the metabolism of perfused rat brain slices during normoxia and hypoxia.| | PubMed PubMed
- Sirolimus, but not the structurally related RAD (everolimus), enhances the negative effects of cyclosporine on mitochondrial metabolism in the rat brain.| | PubMed PubMed
- Isoflurane alters the recirculatory pharmacokinetics of physiologic markers.| | PubMed PubMed
- Indocyanine green kinetics characterize blood volume and flow distribution and their alteration by propranolol.| | PubMed PubMed
- Ketamine distribution described by a recirculatory pharmacokinetic model is not stereoselective.| | PubMed PubMed
- Modifications of blood volume alter the disposition of markers of blood volume, extracellular fluid, and total body water.| | PubMed PubMed
- The effect of halothane on the recirculatory pharmacokinetics of physiologic markers.| | PubMed PubMed
- A recirculatory model of the pulmonary uptake and pharmacokinetics of lidocaine based on analysis of arterial and mixed venous data from dogs.| | PubMed PubMed
- Use of parallel Erlang density functions to analyze first-pass pulmonary uptake of multiple indicators in dogs.| | PubMed PubMed
- Recirculatory pharmacokinetic models of markers of blood, extracellular fluid and total body water administered concomitantly.| | PubMed PubMed
 
    