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
- 1999-01, University of California, San Francisco, Fellow, Liver Transplant Research
- 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:
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.| | View in PubMed
- International Liver Transplantation Society Global Census: First Look at Pediatric Liver Transplantation Activity Around the World.| | View in PubMed
- Lactate concentration at the end of liver transplant: Early predictor of graft function or just one piece of the puzzle?| | View in PubMed
- Hypothermia or Machine Perfusion in Kidney Donors.| | View in PubMed
- Enhanced recovery for liver transplantation: recommendations from the 2022 International Liver Transplantation Society consensus conference.| | View in PubMed
- Perioperative mortality in liver transplantation before and after the implementation of the organ allocation policy Share 35.| | View in PubMed
- Advantages and Limitations of Clinical Scores for Donation After Circulatory Death Liver Transplantation.| | View in PubMed
- Expedited evaluation for liver transplantation: A critical look at processes and outcomes.| | View in PubMed
- Organ donor management goals and delayed graft function in adult kidney transplant recipients.| | View in PubMed
- Perioperative Normal Saline Administration and Delayed Graft Function in Patients Undergoing Kidney Transplantation: A Retrospective Cohort Study.| | View in PubMed
- Machine Learning Prediction of Liver Allograft Utilization From Deceased Organ Donors Using the National Donor Management Goals Registry.| | View in PubMed
- Enhanced recovery after surgery programs improve short-term outcomes after liver transplantation-A systematic review and meta-analysis.| | View in PubMed
- Assessment of the global practice of living donor liver transplantation.| | View in PubMed
- Raster Thomson scattering in large-scale laser plasmas produced at high repetition rate.| | View in PubMed
- Critical care and ventilatory management of deceased organ donors impact lung use and recipient graft survival.| | View in PubMed
- Shared B cell memory to coronaviruses and other pathogens varies in human age groups and tissues.| | View in PubMed
- Prospective Multicenter Study of Early Antiviral Therapy in Liver and Kidney Transplant Recipients of HCV-Viremic Donors.| | View in PubMed
- Weighing the waitlist: Weight changes and access to kidney transplantation among obese candidates.| | View in PubMed
- COVID-19 and Abdominal Transplant: A Stepwise Approach to Practice During Pandemic Conditions.| | View in PubMed
- The Association Between Vena Cava Implantation Technique and Acute Kidney Injury After Liver Transplantation.| | View in PubMed
- Measurements of ion velocity distributions in a large scale laser-produced plasma.| | View in PubMed
- Longer Distance From Dialysis Facility to Transplant Center Is Associated With Lower Access to Kidney Transplantation.| | View in PubMed
- Senolytics prevent mt-DNA-induced inflammation and promote the survival of aged organs following transplantation.| | View in PubMed
- Impact of Deceased Donor Management on Donor Heart Use and Recipient Graft Survival.| | View in PubMed
- Bacchus Listed for a Liver Transplant: Comment.| | View in PubMed
- Vasopressor selection during critical care management of brain dead organ donors and the effects on kidney graft function.| | View in PubMed
- The role of deceased donor liver biopsy: An analysis of 5449 liver transplant recipients.| | View in PubMed
- Transplant anesthesia and critical care: Current research and possible future developments.| | View in PubMed
- Therapeutic Hypothermia in Organ Donors: Follow-up and Safety Analysis.| | View in PubMed
- Modeling the economic benefit of targeted mild hypothermia in deceased donor kidney transplantation.| | View in PubMed
- The Continued Need for Clinical Trials in Deceased Organ Donor Management.| | View in PubMed
- Deceased organ donor factors influencing pancreatic graft transplantation and survival.| | View in PubMed
- The Impact of Deceased Donor Liver Extraction Time on Early Allograft Function in Adult Liver Transplant Recipients.| | View in PubMed
- Intraoperative Management of Liver Transplant Patients Without the Routine Use of Renal Replacement Therapy.| | View in PubMed
- Central venous pressure monitoring in living donor kidney recipients does not affect immediate graft function: A propensity score analysis.| | View in PubMed
- Organ Donor Management: Part 1. Toward a Consensus to Guide Anesthesia Services During Donation After Brain Death.| | View in PubMed
- Comments on "Impact of spontaneous donor hypothermia on graft outcomes after kidney transplantation".| | View in PubMed
- Potentially inappropriate liver transplantation in the era of the "sickest first" policy - A search for the upper limits.| | View in PubMed
- Protecting the Kidney in Liver Transplant Recipients: Practice-Based Recommendations From the American Society of Transplantation Liver and Intestine Community of Practice.| | View in PubMed
- Therapeutic Hypothermia in Deceased Organ Donors and Kidney-Graft Function.| | View in PubMed
- Impact of a quality improvement project on deceased organ donor management.| | View in PubMed
- Therapeutic Hypothermia in Deceased Organ Donors and Kidney-Graft Function.| | View in 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.| | View in 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.| | View in PubMed
- A role for Rac1 activity in malignant progression of sebaceous skin tumors.| | View in PubMed
- Exercise-induced changes in basal ganglia volume and cognition in older adults.| | View in PubMed
- Abdominal transplantation.| | View in PubMed
- Patients with chronic kidney disease.| | View in PubMed
- Peri-operative hyperglycemia is associated with delayed graft function in deceased donor renal transplantation.| | View in PubMed
- Functional elements associated with hepatic regeneration in living donors after right hepatic lobectomy.| | View in PubMed
- Deceased organ donor research: the last research frontier?| | View in PubMed
- Liver transplantation outcome in patients with angiographically proven coronary artery disease: a multi-institutional study.| | View in PubMed
- Infrared pupillometry to detect the light reflex during cardiopulmonary resuscitation: a case series.| | View in PubMed
- Optimizing cost-effectiveness in perioperative care for liver transplantation: a model for low- to medium-income countries.| | View in PubMed
- Intraoperative hyperglycemia augments ischemia reperfusion injury in renal transplantation: a prospective study.| | View in PubMed
- Transplant critical care: standards for intensive care of the patient with liver failure before and after transplantation.| | View in PubMed
- Intraoperative management of liver transplant patients.| | View in PubMed
- Donor pre-treatment with everolimus or cyclosporine does not reduce ischaemia-reperfusion injury in a rat kidney transplant model.| | View in PubMed
- Multivessel coronary artery disease predicts mortality, length of stay, and pressor requirements after liver transplantation.| | View in PubMed
- Liver transplant perioperative pathways: which way towards high-quality care and better outcomes?| | View in PubMed
- Mapping the ionization state of laser-irradiated Ar gas jets with multiwavelength monochromatic x-ray imaging.| | View in PubMed
- 1H-NMR-based metabolic signatures of clinical outcomes in trauma patients--beyond lactate and base deficit.| | View in PubMed
- Chronic kidney disease: implications for the perioperative period.| | View in PubMed
- Induction of intestinal ischemia reperfusion injury by portal vein outflow occlusion in rats.| | View in PubMed
- Quality improvement in transplant anesthesia: which way forward?| | View in PubMed
- Short passive cooling protects rats during hepatectomy by inducing heat shock proteins and limiting the induction of pro-inflammatory cytokines.| | View in PubMed
- Evolution of elastic x-ray scattering in laser-shocked warm dense lithium.| | View in PubMed
- Acute hyperglycemia worsens hepatic ischemia/reperfusion injury in rats.| | View in PubMed
- Acute kidney injury during liver transplantation as determined by neutrophil gelatinase-associated lipocalin.| | View in PubMed
- Abdominal organ transplantation.| | View in PubMed
- Systemic inflammation, coagulopathy, and acute renal insufficiency following endovascular thoracoabdominal aortic aneurysm repair.| | View in PubMed
- Predictors associated with terminal renal function in deceased organ donors in the intensive care unit.| | View in PubMed
- Postoperative infectious complications of abdominal solid organ transplantation.| | View in PubMed
- High contrast Kr gas jet K alpha x-ray source for high energy density physics experiments.| | View in PubMed
- Alterations in the proteome of pulmonary alveolar type II cells in the rat after hepatic ischemia-reperfusion.| | View in PubMed
- Perioperative liver transplant best practices: weighing the evidence.| | View in PubMed
- Transient hyperglycemia affects the extent of ischemia-reperfusion-induced renal injury in rats.| | View in PubMed
- Green frequency-doubled laser-beam propagation in high-temperature hohlraum plasmas.| | View in PubMed
- Increased severity of renal ischemia-reperfusion injury with venous clamping compared to arterial clamping in a rat model.| | View in PubMed
- A multicenter evaluation of safety of early extubation in liver transplant recipients.| | View in PubMed
- Remote renal injury following partial hepatic ischemia/reperfusion injury in rats.| | View in PubMed
- Biochemical mechanisms of nephrotoxicity: application for metabolomics.| | View in PubMed
- Early detection of graft failure using the blood metabolic profile of a liver recipient.| | View in PubMed
- Glutamine donor pretreatment in rat kidney transplants with severe preservation reperfusion injury.| | View in PubMed
- Central venous pressure monitoring during living right donor hepatectomy.| | View in PubMed
- Ischemia-reperfusion injury is more severe in older versus young rat livers.| | View in PubMed
- Pattern recognition and biomarker validation using quantitative 1H-NMR-based metabolomics.| | View in PubMed
- Mild hypothermia reduces the inflammatory response and hepatic ischemia/reperfusion injury in rats.| | View in PubMed
- Mild hypothermia protects obese rats from fulminant hepatic necrosis induced by ischemia-reperfusion.| | View in PubMed
- Recombinant factor VIIa reduces transfusion requirements in liver transplant patients with high MELD scores.| | View in PubMed
- Warm ischemia-induced alterations in oxidative and inflammatory proteins in hepatic Kupffer cells in rats.| | View in PubMed
- Glutamine does not protect against hepatic warm ischemia/reperfusion injury in rats.| | View in PubMed
- Ischemic preconditioning improves energy state and transplantation survival in obese Zucker rat livers.| | View in PubMed
- Metabolic profiling of livers and blood from obese Zucker rats.| | View in PubMed
- H-NMR-based metabolic signatures of mild and severe ischemia/reperfusion injury in rat kidney transplants.| | View in PubMed
- Mild hypothermia provides significant protection against ischemia/reperfusion injury in livers of obese and lean rats.| | View in PubMed
- Ischemic preconditioning improves rat kidney graft function after severe ischemia/reperfusion injury.| | View in 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.| | View in PubMed
- Beta-adrenergic blockade affects initial drug distribution due to decreased cardiac output and altered blood flow distribution.| | View in PubMed
- Intraoperative fluid management of living donor versus cadaveric liver transplant recipients.| | View in PubMed
- Influence of donor pretreatment with N-acetylcysteine on ischemia/reperfusion injury in rat kidney grafts.| | View in PubMed
- Sirolimus delays recovery of rat kidney transplants after ischemia-reperfusion injury.| | View in PubMed
- Mechanism of pupillary reflex dilation in awake volunteers and in organ donors.| | View in PubMed
- The effects of desflurane and propofol on portosystemic pressure in patients with portal hypertension.| | View in PubMed
- Organ-specific response to inhibition of mitochondrial metabolism by cyclosporine in the rat.| | View in PubMed
- Clinically important drug interactions with intravenous anaesthetics in older patients.| | View in PubMed
- Intraoperative hemodynamics and liver function in adult-to-adult living liver donors.| | View in PubMed
- Elimination of indocyanine green in the perioperative evaluation of donor liver function.| | View in PubMed
- Cyclosporine can increase isoflurane MAC.| | View in PubMed
- Close association between the reduction in myocardial energy metabolism and infarct size: dose-response assessment of cyclosporine.| | View in PubMed
- Evaluation of the splanchnic circulation with indocyanine green pharmacokinetics in liver transplant patients.| | View in PubMed
- Comparison of the effects of cyclosporin a on the metabolism of perfused rat brain slices during normoxia and hypoxia.| | View in PubMed
- Sirolimus, but not the structurally related RAD (everolimus), enhances the negative effects of cyclosporine on mitochondrial metabolism in the rat brain.| | View in PubMed
- Isoflurane alters the recirculatory pharmacokinetics of physiologic markers.| | View in PubMed
- Indocyanine green kinetics characterize blood volume and flow distribution and their alteration by propranolol.| | View in PubMed
- Ketamine distribution described by a recirculatory pharmacokinetic model is not stereoselective.| | View in PubMed
- Modifications of blood volume alter the disposition of markers of blood volume, extracellular fluid, and total body water.| | View in PubMed
- The effect of halothane on the recirculatory pharmacokinetics of physiologic markers.| | View in PubMed
- A recirculatory model of the pulmonary uptake and pharmacokinetics of lidocaine based on analysis of arterial and mixed venous data from dogs.| | View in PubMed
- Use of parallel Erlang density functions to analyze first-pass pulmonary uptake of multiple indicators in dogs.| | View in PubMed
- Recirculatory pharmacokinetic models of markers of blood, extracellular fluid and total body water administered concomitantly.| | View in PubMed