annette c. and harold c. simmons transplant …...cirrhosis, which replaces normal liver tissue with...

Innovations in Transplant Medicine2010 Annual ReportAnnette C. and Harold C. Simmons Transplant Institute

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Annette C. and Harold C. Simmons Transplant Institute 2010 Annual Report Contents

Letter from Leadership Team . . . . . . . . . . . . . . 1

Simmons $20 Million Gift . . . . . . . . . . . . . . . . . 4

Thompson Diagnostic Liver Laboratory

to Open at Baylor Dallas . . . . . . . . . . . . . . . 7

Baylor Transplant Biorepository . . . . . . . . . . . . 9

Paired Kidney Donation . . . . . . . . . . . . . . . . . 11

Pancreas After Kidney Transplant . . . . . . . . . 15

LVAD Approved for Destination Therapy . . . . 17

Baylor Liver and Pancreas Disease Center . . 21

NanoKnife® Irreversible Electroporation

System . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Baylor Opens First Pulmonary

Hypertension Clinic in Tarrant County . . . . 25

Baylor Achieves 100 Islet Cell Isolations . . . . 27

Targeted Microbubble Gene Therapy

Advances Islet Cell Transplant Research . . 28

Transfer Information . . . . . . . . . . . . . . . . . . . . 29

Campus Maps . . . . . . . . . . . . . . . . . . . . . . . . 30

1 .800 .774 .2487BaylorHealth .com/Transplant

Annette C. and Harold C. Simmons Transplant Institute Physicians

Transplant SurgeonsGöran B . Klintmalm, M .D ., Ph .D ., FACS Chairman and Chief, Annette C. and Harold C. Simmons Transplant InstituteJeffrey Campsen, M .D .John Capehart, M .D .Robert M . Goldstein, M .D ., FACSMarlon F . Levy, M .D ., FACSGregory J . McKenna, M .D ., FRCS (C)Dan Meyer, M .D ., UT Southwestern FacultyNicholas Onaca, M .D .W . Steves Ring, M .D ., FACS, UT Southwestern FacultyRichard M . Ruiz, M .D .

CardiologistsShelley Hall, M .D ., FACCBrian Hardaway, M .D . Johannes Kuiper, M .D .Clyde W . Yancy, M .D ., FACC, FAHA, MACP

HepatologistsGary L . Davis, M .D .Manjushree Gautam, M .D ., M .A .Stevan A . Gonzalez, M .D .Linsheng Guo, M .D . Carmen Landaverde, M .D .Maria Lepe-Suastegui, M .D .Natalie G . B . Murray, M .D .Jacqueline O’Leary, M .D ., M .P .H .Robert Perrillo, M .D .James Trotter, M .D .Jennifer T . Wells, M .D .

NephrologistsYousri M . H . Barri, M .D ., FASNArun Chandrakantan, M .D ., FASNBernard V . Fischbach, M .D .Larry B . Melton, M .D ., Ph .D ., FACPPatrick Nef, M .D . Arthi Rajagopal, M .D .Kim M . Rice, M .D .Balamurugan Sankarapandian, M .D .Angelito Yango, M .D .

PulmonologistsKenneth Ausloos, M .D .Robert D . Black, M .D .Randall Rosenblatt, M .D ., FACP, FACCP

3410 Worth Street, Suite 950 Dallas, Texas 75246

1400 Eighth Avenue, Fort Worth, Texas 76104

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For more than 25 years, the Annette C. and Harold C. Simmons Transplant Institute

has played a significant role in creating innovations in transplant medicine. Due in

large part to the work of the institute, transplant medicine has evolved into a viable

technology that saves thousands of lives every year.

Currently, more than 7,400 patients have received a solid organ transplant through

the transplant centers at Baylor University Medical Center at Dallas and Baylor All

Saints Medical Center at Fort Worth. Many patients who have been treated at Baylor

Dallas are approaching 10-, 15-, 20- and even 25-year survival milestones. This

success is based on a number of key factors:

• Ourworkisdrivenbyapatient-centered approach—a caring, focused

commitment to the needs of the individual patient with end-stage organ failure.

• Weworkasateam.Solidorgantransplantationissocomplexandmultifaceted

that our commitment to teamwork is essential to a successful transplantation

program.

• Wearededicatedtostayingonthe leading edge of transplant medicine.

Physicians and researchers on the medical staff at Baylor refined and implemented

new transplant techniques and technologies and made it possible for patients to

have access to treatments that simply were not available elsewhere.

• Muchofourresearchisfocusedon improving ways to prevent and treat

organ disease in the first place. The best way to move the field forward is to

eliminate the need for organ transplantation.

Göran Klintmalm, M.D., Ph.D., FACS

Dan Meyer, M.D., UT Soutwestern Faculty

JaNeene Jones, R.N., FACHE

• Wearesteadfastinourdeterminationtofind alternative treatments for patients

who are not candidates for transplantation. In concert with the advances seen in

transplant medicine, there have been important advances in medical therapy for

advanced organ disease. Using an innovative, multidisciplinary approach, our

experiencedtransplantteamcanoftenmakeitpossibleforapatienttoforego

transplantation altogether.

All of us at the Annette C. and Harold C. Simmons Transplant Institute believe it is a

privilegetocareforeachandeveryoneofourpatients.Aswemoveintoournext25

years, we pledge to reach new heights in research, medical education and academic

contributions on their behalf.

Göran Klimtmalm, M.D., Ph.D., FACSChairman and ChiefAnnette C. and Harold C. Simmons Transplant Institute

Dan Meyer, M.D.Surgical Director of Heart and Lung TransplantationBaylor University Medical Center at DallasA collaboration with the University of Texas Southwestern Medical Center

JaNeene Jones, R.N., FACHEVice President, Transplantation Annette C. and Harold C. Simmons Transplant Institute

The administrative offices of the Annette C. and Harold C. Simmons Transplant Institute occupy space on the ninth floor of the new Baylor Charles A. Sammons Cancer Center, and the abdominal transplant clinic resides in a spacious area on the eighth floor.

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Annette C . and Harold C . Simmons have made a pledge of $20 million to benefit transplantation

initiatives within Baylor Health Care System . In recognition of this transformational gift, Baylor will

rename the institute the Annette C . and Harold C . Simmons Transplant Institute .

“Because of our own experience with transplantation, we knew we wanted to give others the same

opportunity to have a future,” Harold Simmons said . “We believe this gift will enable Baylor to make

our vision a reality by advancing transplant science and creating one of the finest transplant

institutes in the nation .”

“This generous gift will help us continue to provide life-changing treatments

for transplant patients and conduct leading-edge clinical research that will

further advance knowledge in the field of transplantation,” said Joel Allison,

president and chief executive officer of Baylor Health Care System . “Baylor

is most grateful for the generosity of the Simmons family that will provide us

the opportunity to impact our patients’ quality of life .”

Göran Klintmalm, M .D ., Ph .D ., has led the Annette C . and Harold C .

Simmons Transplant Institute as its chairman since it began in 1984 .

“This tremendous gift is an investment in the future of this institute and will

help us continue to reach new heights in research, medical education and

academic contributions on behalf of our patients,” said Dr . Klintmalm . “This

gift will allow us to increase our research infrastructure, support scholarly and

Simmons’ $20 Million Gift to Benefit Transplant Institute

Left: Harold and Annette Simmons

Right: Rowland K. Robinson, Dr. Göran Klintmalm and Norm Bagwell ring the bell, a Foundation tradition when good news is announced.

Opposite: The new Baylor Charles A. Sammons Cancer Center anchors the southeast corner (right side) of the Baylor Dallas campus.

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academic initiatives, expand our transplant

fellowship programs, and anchor our trans-

plant leadership for the future .”

Annette and Harold Simmons are among

the nation’s foremost philanthropists, and

their support of Baylor will help transform

the transplant institute .

“We are grateful beyond words for the

incredible support we have been given

by the Simmons family,” said Rowland K .

Robinson, president of the Foundation .

“This gift is truly extraordinary, and we are

excited about the plans Baylor has for the

institute’s future .”

Institute Moves to New Baylor Charles A. Sammons Cancer Center

The abdominal transplant clinic and the administrative offices of the Annette C . and Harold C .

Simmons Transplant Institute have moved into the new Sammons Cancer Center on the Baylor

Dallas campus . The administrative offices will occupy space on the ninth floor of the center, and

the abdominal transplant clinic will be in a spacious area on the eighth floor . These moves will give

all transplant programs an opportunity for growth and expansion .

Offices for hepatologists on the medical staff of Baylor Dallas and the hepatology clinic will both

be located within the cancer center . In addition to creating room for growth, the cancer center is

designed as a patient-centered facility, making it a very customer-friendly and accessible space

for transplant patients .

The Future

The Annette C . and Harold C . Simmons

Transplant Institute seeks to continue its leadership

in research, medical education and academic con-

tributions while delivering quality, compassionate

patient care . Its goals, which can met with the help

of continuing philanthropy, are to:

• Recruitandretainthefinesttransplant

physicians and scientists

• Growtheresearchprogramindiseasepreven-

tion and innovative therapies

• Increasepatientparticipationinadvanced

clinical trials

• Trainthenextgenerationoftransplantsurgeons

• Continuetomakeimportantacademiccontribu-

tions to the field

• Raiseawarenessoftheinstitute’slife-saving

transplant services in the public and the

medical community

“The transplant team at

Baylor Fort Worth was

fabulous. I couldn’t ask

for a better experience.”

Gary Kirby, Bedford, Texas

When Gary Kirby received a liver

transplant at Baylor All Saints Medical

Center at Fort Worth, he had less than

a month to live . Eleven months earlier,

he had been diagnosed with non-

alcoholic steatohepatitis or NASH, an

inflammation of the liver . “I really couldn’t

do anything,” he says . “It was a chore

to even stand up or talk .” Gary lost 60

pounds and experienced bouts of severe

confusion due to high ammonia levels .

After his transplant, Gary regained his

weight and feels great . “The transplant

team at Baylor Fort Worth was fabulous .

I couldn’t ask for a better experience .”

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Thompson Diagnostic Liver Lab to Open at Baylor DallasThe Jim and Angela Thompson Foundation have made a generous gift of $1 million that will create

a diagnostic liver laboratory and a chair in hepatology at Baylor University Medical Center at Dallas .

This initiative will lead to more accurate diagnoses for patients with liver disease and promote

advances in treatments .

This is a transformative gift for the hepatology program at Baylor Dallas . Opening in the first part

of 2011, it will provide the equipment and measurement tools to perform a variety of tests that will

document and monitor the function and capacity of patients’ livers—all in one location . The devel-

opment of this lab could represent an important enhancement of liver disease management that

would be unique in the United States .

“Angela and I are pleased to contribute to an effort that has the potential to more precisely guide

treatment decisions made by liver patients and their physicians . Baylor’s leading position in solid

organ transplants, the vision of Dr . Jim Trotter for this clinic, along with the leadership of Dr . Göran

Klintmalm, were the inspiration for this gift,” said Mr . Thompson .

The number of patients with advanced liver disease has steadily increased in recent years . More

than 30 million Americans are afflicted . Cirrhosis, which replaces normal liver tissue with scar

tissue, is a primary cause of liver failure and kills about 27,000 Americans every year .

Current methods of assessing liver function are often circuitous and inaccurate . A panel of tests to

provide a more reliable assessment of hepatic function over time is required . The goal of these tests

is to enable physicians to identify liver deterioration earlier, assess response to medical therapy and

provide a more accurate prognosis .

The Jim and Angela Thompson Diagnostic Liver Laboratory will offer greater diagnostic capabili-

ties that can lead to more comprehensive, pre-emptive and accurate treatment . The lab will bring

Volume Trend–Liver 200

175

150

125

100

75

50

25

0 CY2004 CY2005 CY2006 CY2007 CY2008 CY2009 CY2010

19

3043

53

132117

135158

177185

160165

Baylor Dallas Baylor Fort Worth

42 32 24

1079889

131130131

SRTR

Time Period 1 Mo. Survival 1 Yr. Survival 3 Yr. Survival

Observed 94.14 86.73 76.21

Expected 95.01 85.53 73.65

National 94.92 85.30 74.10

SRTR


Observed 96.82 90.12 82.33

Expected 97.21 89.52 80.79

National 96.97 88.68 79.21

SRTR


Observed 95.83 88.75 73.20

Expected 95.53 86.80 74.88

National 94.92 85.30 74.10

SRTR


Observed 96.74 91.94 75.00

Expected 97.52 90.58 80.67

National 96.97 88.68 79.21

Baylor Dallas Liver Patient Survival Rates

Baylor Dallas Liver Graft Survival Rates Baylor Fort Worth Liver Graft Survival Rates

Baylor Fort Worth Liver Patient Survival Rates

Source: SRTR/UNOS semi-annual program speci�c report released January 11, 2011, based on data available 10/31/2010. This work was supported in part by Health Resources and Services Administration contract 234-2005-370011C. The content is the responsibility of the authors alone and does not necessarily re�ect the view or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the U.S. Government.

For patients transplanted between 07/01/2007 and 12/31/2009 for the one month and one year cohorts; between 01/01/2005 and 06/30/2007 for the three year cohort.

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together a number of diagnostic methods and give hepa-

tologists the ability to study the role and effectiveness

of these tests . This could provide patients more reliable

information on what to expect, as well as the opportunity

to review options for pre-emptive therapy .

The addition of the lab and this equipment is also expected

to open the doors to new research opportunities . Data on

patient outcomes will be recorded in a research database

that can be used to identify trends and measure the effec-

tiveness of treatment .

The Jim and Angela Thompson Chair in Hepatology will

provide funding for education, as well as programmatic and operational support, of the liver diag-

nostic lab and the work of Jim Trotter, MD, the first holder of the chair . The support from the chair will

provide the means necessary for the Baylor liver program to continually evolve as a recognized world

leader in comprehensive hepatology medicine, research and practice .

Jim and Angela Thompson

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A unique resource at Baylor is the transplant biorepository . The biorepository is a bank of serum

and cells from previous liver transplant recipients and donors that have been collected and stored

since the program’s inception in 1984 . This is a priceless resource that does not exist anywhere else

in the world .

The biorepository collects serum and cells throughout the patient’s life . The first blood sample is

drawn before transplant, and then samples are collected on an annual basis thereafter . More than

18,000 samples are currently housed in Baylor’s biorepository .

Collaborations have been initiated with leading investigators around the United States to pursue

answers for questions that have been asked about liver disease for many years, but no one had the

material to find the answers . As scientific technology has progressed, there now exists opportunities

to analyze these materials in a way that has never been possible before .

Baylor Transplant Biorepository

“ I wanted to give up, but

everyone at Baylor wouldn’t

give up on me, so I couldn’t

give up on myself.”

Shamequia Cason, Duncanville, Texas

Shamequia Cason struggled with kidney

disease for almost 10 years, including

five years on dialysis . “I wanted to give

up, but everyone at Baylor wouldn’t

give up on me, so I couldn’t give up on

myself,” she says . When Shamequia

received a kidney transplant at Baylor,

she immediately saw and felt a differ-

ence . “I felt healthy again . My skin

changed, my whole physical appearance

changed . I could see the difference in

my face instantly . I’m a new person . It

feels good to be ‘new’ on the inside .”

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Approximately one-third of all willing, living kidney donors have an incompatible blood type with

their intended recipient . Others may have a positive cross-match against the recipient . Patients are

then faced with finding someone else who is a suitable donor or waiting on the transplant list until an

organ from a deceased donor becomes available .

Paired kidney transplantation, which became available at Baylor University Medical Center at Dallas

and Baylor All Saints Medical Center at Fort Worth in 2010, allows incompatible living donor/recipi-

ent pairs to donate and receive kidney transplants despite the original incompatibility . By joining the

Alliance for Paired Donation, Baylor has access to all of their potential donors and recipients in the

United States .

In paired kidney donation, patients with a non-compatible donor enroll in the Alliance for Paired

Donation registry . A specialized computer program will search for a compatible match . Two incom-

patible donor/recipient pairs (A and B) must be identified . The donor of pair “A” must be identified to

be compatible with the recipient of pair “B .” Additionally, the donor of pair “B” must be identified to

be compatible with the recipient of pair “A .”

Paired kidney donation offers patients the opportunity to move off the waiting list much faster . In

addition, there is the advantage of living donation . Statistically, living donor kidneys last longer and

function better than those from deceased donors .

Paired Kidney Donation

Donor #1Blood Type A

Donor #2Blood Type B

Recipient #1Blood Type B

Donor #3Tissue IncompatibleBlood Type O

Recipient #2Blood Type A

Recipient #3Tissue IncompatibleBlood Type B

SRTR


Observed 97.88 94.40 86.48

Expected 97.82 94.20 86.41

National 97.54 93.51 84.72

SRTR


Observed 99.22 97.13 94.69

Expected 99.46 97.57 93.87

National 99.28 93.51 84.72

SRTR


Observed 96.76 92.48 82.92

Expected 97.46 93.10 82.90

National 97.54 93.51 84.72

SRTR


Observed 99.09 96.69 91.88

Expected 99.38 97.23 91.06

National 99.28 96.81 91.65

Baylor Dallas Kidney Patient Survival Rates

Baylor Dallas Kidney Graft Survival Rates Baylor Fort Worth Kidney Graft Survival Rates

Baylor Fort Worth Kidney Patient Survival Rates



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Volume Trend–Kidney 300

250

200

150

100

50

0 CY2004 CY2005 CY2006 CY2007 CY2008 CY2009 CY2010

4460 84

112

145117

15

197

257

203188


10593

90

121130140

211223

245

SRTR


Observed 94.29 76.19 93.10

Expected 97.53 93.80 88.27

National 97.27 93.19 86.93

SRTR


Observed 97.14 85.41 96.55

Expected 98.96 96.14 92.97

National 98.88 98.85 92.08

SRTR


Observed 100.00 100.00 92.31

Expected 97.34 93.33 88.45

National 97.27 93.19 86.93

SRTR


Observed 100.00 100.00 92.31

Expected 99.01 96.29 93.01

National 98.88 98.85 92.08

Baylor Dallas Kidney/Pancreas Patient Survival Rates*

Baylor Dallas Kidney Graft Survival Rates Baylor Fort Worth Kidney Graft Survival Rates

Baylor Fort Worth Kidney/Pancreas Patient Survival Rates*



SRTR


Observed 94.29 76.57 88.80

Expected 92.16 86.83 79.94

National 92.01 86.71 79.03

SRTR


Observed 90.00 90.00 84.62

Expected 90.86 84.85 80.49

National 92.01 86.71 79.03

Baylor Dallas Pancreas Patient Survival Rates Baylor Fort Worth Pancreas Patient Survival Rates

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Kidney-Pancreas Transplantation

17

Volume Trend–Pancreas 30

25

20

15

10

5

0 CY2004 CY2005 CY2006 CY2007 CY2008 CY2009 CY2010

2

34

11

1715

7

9

28

1920


6 2

1512

0

1718

“ My experience

at Baylor was

tremendous. On

a scale of 1 to 10,

the care was a 15.”

Ron Philley, Fort Worth, Texas

Ron Philley was diagnosed

with type 1 diabetes at 6

years old . As an adult, he

experienced numerous

complications, including eye

problems, kidney problems

and nerve damage in his

legs . He was on dialysis

for more than two years . At

Baylor University Medical

Center at Dallas, Ron

received a simultaneous

pancreas-kidney transplant .

“My experience at Baylor

was tremendous,” he says .

“On a scale of 1 to 10, the

care was a 15 .” Today, Ron

is enjoying the freedom to

travel around the country

with his wife .

SRTR


Observed 100.00 0.00 56.25

Expected – – –

National 89.10 79.88 64.52

SRTR


Observed 100.00 100.00 87.50


National 99.16 96.26 93.26

SRTR


Observed 100.00 100.00 100.00


National 89.10 79.88 64.52

SRTR


Observed – – 100.00


National 99.16 96.26 93.26

Baylor Dallas Pancreas Patient Survival Rates

Baylor Dallas Pancreas Graft Survival Rates Baylor Fort Worth Pancreas Graft Survival Rates

Baylor Fort Worth Pancreas Patient Survival Rates



Pancreas After Kidney TransplantPancreas transplantation is currently the closest thing to a cure for diabetes that exists today . For

patients who have had a kidney transplant because of diabetes-related kidney failure, a subsequent

pancreas transplant offers the opportunity to come off insulin . In addition, the new pancreas protects

the existing kidney graft .

At Baylor, pancreas after kidney transplant recipients now enjoy graft and patient survival similar to

simultaneous pancreas-kidney transplant recipients . The results are greater than 80 percent for one-

year graft survival .

Once a patient with type 1 diabetes receives a kidney transplant, they often must take steroids,

which make their diabetes worse . A pancreas transplant cures the diabetes, so the steroids needed

for immunosuppression do not have a negative effect on the patient’s blood sugar . In addition, since

the patient is already on immunosuppression, there is no need for additional anti-rejection medica-

tions . The pancreas also may have some protective benefit to the heart and eyes .

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“ In my book, Baylor is the best.

They’re in tune with their patients’

needs. They told me I’ll be all right,

and here I am today feeling great.”

Chad Wheeler, Heartland, Texas

At 36, Chad Wheeler was diagnosed with heart

failure . At Baylor University Medical Center at

Dallas, he was put on the waiting list for a heart

transplant—the hospital’s youngest heart transplant

patient . When his condition deteriorated, he received

a left ventricular assist device (LVAD), which helped

his heart pump blood for nearly two years until he

received a new heart . “In my book, Baylor is the

best . They told me I’ll be all right, and here I am

today feeling great .”

Baylor University Medical Center at Dallas was the nation’s first hospital to receive the Gold Seal of

Approval™ from The Joint Commission for the Ventricular Assist Device (VAD) program, an accredi-

tation that is renewed every two years .

For patients with advanced heart failure, mechanical left ventricular assist support accomplished

with the use of a left ventricular assist device (LVAD) has substantially improved outcomes and

quality of life for patients who require mechanical support for the failing heart . The Baylor University

Medical Center at Dallas Heart and Lung Transplant Program, a collaboration with UT Southwestern

Medical Center, is actively implanting these systems, either as a bridge to transplantation or as

destination therapy for those who are not candidates for transplant .

Though transplants offer hope for approximately 2,000 advanced heart failure patients each year,

between 50,000 and 100,000 patients in the United States do not qualify for transplant due to age

or other medical problems .

Now these patients have hope . In January 2010, the HeartMate® II LVAS (left ventricular assist

system) received FDA approval for destination therapy . The device is now FDA approved for both

bridge-to-transplantation and destination therapy .

The device is an excellent option for a variety of patients with end-stage heart failure . Patients above

70 who wouldn’t qualify for a transplant but are still active could benefit greatly from the device .

Also, many patients over 65 do not want a transplant because of the need for immunosuppressive

medication .

Left Ventricular Assist Device (LVAD) Approved for Destination Therapy

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The Baylor University Medical Center at Dallas Heart and Lung Transplant Program—A Collaboration with UT Southwestern is comprised of separate but cooperative heart and lung transplant programs operated by Baylor University Medical Center (Baylor Dallas) and The University of Texas Southwestern Medical Center at Dallas at their respective facilities and is not a joint venture or partnership between the parties . Physicians providing transplant services for the program at Baylor Dallas are neither employees nor agents of Baylor Dallas or Baylor Health Care System .

SRTR


Observed 96.08 90.89 88.24

Expected 95.56 88.61 84.54

National 95.36 88.48 80.50

SRTR


Observed 96.08 90.89 88.24

Expected 95.43 88.42 84.76

National 95.63 89.06 81.30

Baylor Dallas Heart Patient Survival RatesBaylor Dallas Heart Graft Survival Rates



The HeartMate II offers more longevity and durability than the previous version, which lasted approx-

imately 18 months to two years . The HeartMate II is expected to last five to eight years . The device

also has been designed to decrease the risk of infection and other complications . Because the

pump is smaller than the previously used device, more patients can benefit, including more women,

smaller-statured men and younger patients .

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12

Volume Trend–Heart 30

25

20

15

10

5

0 CY2004 CY2005 CY2006 CY2007 CY2008 CY2009 CY2010

151213

Baylor Dallas

20

2724

10

Volume Trend–VAD 30

25

20

15

10

5

0 CY2004 CY2005 CY2006 CY2007 CY2008 CY2009 CY2010

876

Baylor Dallas

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27

“ The care I received at Baylor

was outstanding. After my

transplant, everything started

coming back to me.”

Melvin Jones, Forney, Texas

Complications from a massive heart attack

left Melvin Jones unable to work or do

any of the things he enjoys . While he was

waiting for a new heart, a pacemaker-

defibrillator was implanted in case of

another heart attack . Four years later,

Melvin received a heart transplant at Baylor

University Medical Center at Dallas . “The

care I received at Baylor was outstanding .

After my transplant, everything started

coming back to me . It’s the best thing that’s

ever happened to me .”

“The care I received at Baylor

was very special. Everyone

made me feel like I’m part of

their family.”

Russell Sewell, Amarillo, Texas

Although he had had a screening colonos-

copy two years earlier, Russell Sewell was

diagnosed with Stage IV colon cancer that

had spread to his liver . At Baylor University

Medical Center at Dallas, Russell underwent

a colon resection followed by radiofrequency

ablation, which uses heat to destroy the

tumor in his liver . Today, Russell is cancer

free and once again enjoying an active life-

style . “The care I received at Baylor was very

special . Everyone made me feel like I’m part

of their family .”

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Baylor Liver and Pancreas Disease Center offers a broad spectrum of treatment options for patients

with benign or malignant liver tumors, bile duct cancer, bile duct injury, pancreatic tumors or chronic

pancreatitis . Physicians on the medical staff at Baylor University Medical Center at Dallas and Baylor

All Saints Medical Center at Fort Worth comprise a multidisciplinary team of specialists who work

together to develop the appropriate treatment plan to prolong and enhance the patient’s quality of

life .

Available treatment options for liver cancer include:

CyberKnife®

For qualified patients, this outpatient therapy can eradicate hard-to-reach or inoperable liver tumors

with robotically directed, high-dose, precisely targeted beams of radiation . The targeted radiation

treatment is possible due to a computerized respiratory tracking program that correlates the rise

and fall of the chest with the actual location of the tumor . Radiation exposure to healthy tissue is

minimized . This minimally invasive procedure takes three to five days instead of the six to eights

weeks of typical radiation treatment .

Radiofrequency Ablation

For non-resectable patients, radiofrequency ablation may be an option

to treat primary or metastatic liver cancer . During this innovative

therapy, radiofrequency current is passed through a needle electrode

into the tumor, heating the surrounding area and essentially “cooking”

the tumor . The average temperature during treatment is 105 Celsius .

Chemoembolization

In chemoembolization, chemotherapy is injected into a tumor through

the artery that supplies the tumor’s blood flow . Physicians on the

medical staff at Baylor use microscopic beads, coated with chemo-

therapeutic agents, to deliver a local killing dose to the tumor without

the systemic side effects associated with the traditional technologies

of chemoembolization . In the liver, this method has been found to

effectively “downsize” many tumors that are too large to meet trans-

plant criteria . The chemobeads may shrink the tumor to a size that

allows the patient to undergo a liver transplant . In some cases, the

beads may actually kill the treated cancer .

Baylor Liver and Pancreas Disease Center

Chemoembolization

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TheraSphere®

This advanced technology is offered to qualified patients with primary or secondary liver cancer .

The physician accesses the blood vessels supplying the tumor and then uses a syringe to deliver

millions of tiny glass beads loaded with radioactive yttrium-90 directly into the tumor, effectively

blocking the tumor’s blood supply . TheraSphere is a potentially less toxic treatment option

compared to traditional radiation .

Resection

Despite all the technological advances in the treatment of liver and pancreatic cancer, surgical resec-

tion remains the preferred treatment . The advanced expertise of the surgeons on the medical staff of

Baylor Dallas and Baylor Fort Worth means many cases can be done using laparoscopic techniques .

Transplantation for Cholangiocarcinoma

Baylor is one of the few centers in the United States that offers liver transplantation for bile duct

cancer . Bile duct cancer patients may be eligible for a protocol that combines chemotherapy and

radiation and qualify for listing for transplantation . The criteria are very selective and patients must

be identified at the earliest stages of the disease .

Surgical Repair after Bile Duct Injury

Bile duct injuries can be devastating and difficult to treat . The efforts of the surgeons and interven-

tional radiologists on the medical staff of Baylor Dallas and Baylor Fort Worth work together to

achieve successful treatment . This collaboration, along with their many years of experience,

provides patients a good chance for a positive long-term outcome .

Transplantation for Chronic Pancreatitis

Patients with chronic pancreatitis often experience intractable pain . A select group of patients, who

exhaust traditional therapeutic options, may be eligible for auto-islet cell transplantation following

total pancreatectomy . Baylor is one of a handful of institutions nationwide with a cellular laboratory

approved by the FDA to produce islet cells for therapy . After surgically removing the pancreas, islet

cells are extracted from the diseased organ and then re-infused into the patient’s liver . This reduces

the risk of brittle diabetes and often provides substantial pain relief . In some cases, the patients

become insulin free .

Transplantation

Baylor’s liver transplant program is an essential component of a multimodality management strategy

that helps all types of liver disease patients receive the most appropriate treatment . The first liver

transplant in the Southwest was performed at Baylor Dallas in 1984 . Since that time, the transplant

program has grown into one of the busiest in the nation, performing more than 7,400 solid organ

transplants to date .

davidharper

Sticky Note

Chris: Please note the new line breaks for this paragraph. This was not marked on your proofs.

In 2010, Baylor University Medical Center at Dallas began to offer irreversible electroporation (IRE)

through the NanoKnife® IRE System, a promising new treatment modality for inoperable liver tumors,

especially those in difficult-to-treat positions .

IRE causes cell death in soft-tissue by opening permanent, nano-sized pores in the membranes of

cells in the ablation zone . Electrode probes are positioned in or around the lesion . At least 90 short

electrical pulses, each approximately less than 100 microseconds, are sent between the probes . The

energy delivery portion of the procedure is normally completed in just a few minutes, and cell death

in the ablation zone is detected within minutes . This irreversible damage causes cell death, while

critical and often delicate nearby structures such as ducts and blood vessels remain viable .

The treated area begins to heal shortly after the procedure . The body’s normal healing response

produces cells that surround and remove the dead cells from the region . Recent studies show that

blood vessels, ducts and other delicate parts of the body near the ablation zone remain viable .

At Baylor, IRE treatment is performed as laparoscopic, open and percutaneous procedures with

ultrasound guidance . Treatment planning software provides a calculation of the tissue volume and

shape that will fall within the ablation zone .

NanoKnife® Irreversible Electroporation System

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Electrical PulsesPlacement of ProbesAblation Zone

“ I’m breathing

better than I

ever have in

my life. I can

actually take

a real breath.”

Inez Eadon, Midland, Texas

After being diagnosed

with idiopathic pulmo-

nary fibrosis with

secondary pulmonary

hypertension, Inez

Eaden was given two

years to live . At Baylor

University Medical

Center at Dallas, she

received a double-lung

transplant . “I’m breath-

ing better than I ever

have in my life . I can

actually take a real

breath . My five grand-

kids are so excited that

I can take them to the

park and have fun .”

118

Volume Trend Referrals–Lung 300

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0 CY2004 CY2005 CY2006 CY2007 CY2008 CY2009 CY2010

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Baylor Dallas

142127

204

146

For patients with pulmonary hypertension, there are unique therapies that require expertise in

selecting the appropriate one for the individual patient . Determining the type of lung disease and

the etiology, if possible, can help physicians choose from the available treatment options, as well as

assist in predicting outcomes .

The Pulmonary Hypertension Clinic at Baylor All Saints Medical Center at Fort Worth is part of a plan

to establish a comprehensive advanced lung disease program . This program will bring together the

expertise of numerous physicians on the medical staff of Baylor University Medical Center at Dallas

and Baylor Fort Worth to diagnose and treat patients with pulmonary hypertension, interstitial lung

disease and a variety of other types of advanced lung disease . The ultimate goal of the advanced

lung disease program is to make national multicenter clinical trials that are investigating advanced

treatments available to patients .

The literature shows that specialty clinics around the country are helpful in categorizing what type

of interstitial lung disease a patient has and comparing clinical trials of patients with similar disease .

In addition to pulmonary specialists, the advanced lung disease program utilizes the expertise of

pathologists, radiologists and rheumatologists on the medical staff of Baylor to help characterize

the type of interstitial lung disease a patient has . The advanced lung disease program will allow

physicians on the medical staff of Baylor Dallas and Baylor Fort Worth to select the types of the

disease that may potentially respond to certain treatments .

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Baylor Opens First Pulmonary Hypertension Clinic in Tarrant County

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Baylor Dallas

9811

davidharper

Sticky Note

Ashleigh and Tommy:The name of the program was capitalized in this sentence, but not in the other uses, so the capitals were changed to lower case.

“ I still constantly monitor my

blood sugar because I can’t

believe I have cells doing what

they’re supposed to do.”

Marian Spencer, Fort Worth, Texas

For Marian Spencer, who was diagnosed

with type 1 diabetes at 13, managing her

blood sugar was a constant battle . At Baylor

University Medical Center at Dallas, Marian

underwent two islet cell transplants . For a

year, Marian was completely off insulin . While

she has had to resume taking insulin, the

dosage is greatly reduced and she now can

tell when her blood sugar is dropping . “That

alone makes it all worthwhile,” she says .

“I feel more relaxed than I ever did . I still

constantly monitor my blood sugar because

I can’t believe I have cells doing what they’re

supposed to do .”

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Since 2005 when physicians on the medical staff of Baylor University Medical Center at Dallas

performed North Texas’ first islet cell transplant, researchers have made significant progress toward

making islet cell transplantation standard therapy for type 1 diabetes . Researchers at Baylor Dallas

and Baylor All Saints Medical Center at Fort Worth recently celebrated an important milestone with

the 100th islet cell isolation .

A simplified method of islet cell isolation now allows the procedure, which originally took more than

five hours, to be accomplished within three to four hours . In the early days of the program, at least

two islet cell infusions were required to make a patient insulin independent . In addition, more than 50

percent of islet cell isolation failed .

Today, Baylor’s rate of islet cell isolation failure is virtually zero, and one islet cell infusion may be

enough to make a patient insulin free for a period of time .

New NIH grant supports study to increase insulin-producing cells for transplant

The National Institutes of Health (NIH) has awarded Shinichi Matsumoto, M .D ., Ph .D ., director of the

islet cell laboratory at Baylor Research Institute, a two-year, $431,200 grant to continue studying his

ductal preservation method . Researchers at Baylor Fort Worth are studying a solution they believe

will improve the quantity and quality of isolated human pancreatic islet cells . Preliminary research

data indicates that his method increases islet yield more than three times that previously achieved .

While islet cell transplantation has been shown to be a promising treatment and possible cure for

Type 1 or juvenile onset diabetes, major challenges remain . These challenges include a low success

rate of islet isolation, the necessity for multiple donor organs and the difficulty of maintaining insulin-

free status . If this preservation method proves successful, larger quantities and a higher quality of

human islet cells may be obtained, therefore helping to resolve these issues .

Baylor Achieves 100 Islet Cell Isolations

davidharper

Sticky Note

Ashleigh and Tommy:A hyphen was deleted after the $431,200 copy.

Researchers in the Islet Cell Laboratory at Baylor All Saints Medical Center at Fort Worth are col-

laborating with Paul A . Grayburn, M .D ., medical director of Cardiology Research and Education at

Baylor University Medical Center at Dallas, on targeted microbubble gene therapy to advance type 1

diabetes therapy .

The research focuses on the use of ultrasound targeted microbubble destruction (UTMD) technology

to deliver genes to the pancreas with a new type of therapy that can impact the degenerative symp-

toms of diabetes . The method—originally used in gene therapy in the heart—uses gas-filled micro-

scopic bubbles to inject genes or other agents into the bloodstream and the pancreas . An ultrasound

beam is then used to burst the bubbles, letting the genes escape and helping them gain access to

the membranes of pancreatic cells .

A paper published in Diabetologia—authored by Masayuko Shimoda, M .D ., Ph .D ., Shuyuan Chen,

M .D ., Hirofumi Noguchi, M .D ., Ph .D ., Shinichi Matsumoto, M .D ., Ph .D ., and Dr . Grayburn—describes

the research team’s experience in putting human vascular endothelial growth factor (VEGF) in a

recipient mouse liver that received human islet cells . The human islet cells increased their blood

supply, lived longer and cured diabetes more efficiently than plain islets delivered without VEGF .

The research team hopes the technique will be a method to either treat a donor pancreas or the liver

of an islet cell transplant recipient with genes that would protect the islets against immune attack,

as well as increase their vascularity .

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Targeted Microbubble Gene Therapy Advances Islet Cell Transplant Research

Transfer Information

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The Annette C . and Harold C . Simmons Transplant Institute is the integration of transplant services

at Baylor University Medical Center at Dallas and Baylor All Saints Medical Center at Fort Worth .

Together, Baylor Dallas and Baylor Fort Worth are one of the largest multi-specialty transplant

centers in the country .

For more information, please call 1.800.774.2487.

With one phone call, a physician can request additional information, an appointment for a patient,

or a consult . Call 1 .800 .774 .2487 and an Annette C . and Harold C . Simmons Transplant Institute

representative will assist you .

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Campus Maps

Baylor University Medical Center at Dallas

Baylor University Medical Center at Dallas is accessible from U .S . 75 (North Central Expressway/

I-45 and I-30 . A map on page 32 illustrates freeway access to the medical center .

Valet parking and self parking are available in convenient locations around the campus .

The campus is also accessible riding the DART Green Line to the Baylor University Medical Center

station . The medical center is a two-block walk .

Healing Garden

FutureCancerHospital

Underground Parking Garage

Lot 25

Underground Parking

Garage 8

(Staff)(Patient/Visitorand Staff)(Patient/Visitor)

Parking Garage 4

WorthStreetTower

Collins Center

Underground Parking Garage 30



Lot 44

Lot 43

Lot 40Lot 41

Lot 42

Lot 13Lot 14

Lot 19

Lot 46

Lot 27Lot 28 (BIR

only)

Lot 9

Lot 26

Lot 9

Baylor Tom LandryFitness Center

BaylorSchool

of NursingBass

Hall

BaylorInstitute for

Rehabilitation(BIR)

Parking Garage 10

BaylorMedicalPavilion

ParkingGarage 6

ParkingGarage 5

Baylor Hamilton Heart & Vascular Hospital

Emergency Department

Barnett Tower

WadleyTower Baylor College

of Dentistry

Roberts Hospital

JonssonHospital

HoblitzelleHospital

Truett Hospital

Baylor Charles A. Sammons

Cancer Center

Was

hing

ton

Aven

ueW

ashi

ngto

n Av

enue

Junius Street

Nussbaumer Street

Floyd Street

Malcolm X Blvd.

Hall

Stre

etHa

ll St

reet

Floyd Street

Gaston Avenue

CBD Link–Fair Park Blvd.

Gaston Aveue

Junius Street

Worth Street

Crutcher Street

Victor Street

Paul

ine

Stre

et

Self Parking

Valet Parking

(Staff)

Heart and Lung Clinic

Transplant Clinic

Administration Offices

Baylor Liver and Pancreas

Disease Center

davidharper

Sticky Note

Ashleigh and Tommy:The word "the" appeared in the first sentence before "Baylor University Medical Center at Dallas . . ." so it was deleted.The second sentence noted that the freeway map is on the following page, when it is actually on page 32.

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Ave

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Nin

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Ende

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To I-30

Rosedale Street

Mistletoe Boulevard

Enderly Place

N. Enderly Place

W. Myrtle Street

W. Allen Avenue

Magnolia Avenue

CarterRehab and

FitnessCenter

Emergency Entry

ProfessionalPavilion

PavilionGarage

Self Parking Garage

Texas Oncology

Eighth Avenue

TerrellSchool

PhysicianParking Garage

MACC Building (Building D)

TC Terrell MD

Tower(Building C)

Martin Tower (Building A)

ValetAndrewsWomen’sHospital

Entrances

Vale

t

MoncriefTower

(BuildingB)

ProfessionalArts

Building

Baylor All Saints Medical Center at Fort Worth

Baylor All Saints Medical Center at Fort Worth is located south of downtown Fort Worth in the

hospital district and is accessible via the Fort Worth freeway system . A map on page 32 illustrates

freeway access to the medical center .

Valet parking is available at the main entrance off Magnolia Avenue (H) and between the

Professional Pavilion and Pavilion garage . The fee for valet parking is $5 . Patient drop-off and

pickup are located at both valet areas . Covered self parking is located off Enderly Place (H) .

davidharper

Sticky Note

Ashleigh and Tommy:The sentence about the location of the freeway map was changed to be consistent with the Baylor Dallas page.

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Downtown Dallas

I-35e

I-35e

I-30

Wooda

ll Rod

gers

Fwy.

Elm

Commerce

Live O

ak

Gaston

Malcolm

X

Hall

Lemmon

Haskell

Peak

Washington

US 75N. Central Expy.

Live O

ak

Gaston

Main

First

US 175

I-45

I-30

I-30

I-35e

Worth

Dallas N. Tollway

Haskell

Robert B. Cullen

Peak

Worth

Fitzhugh

Malcolm X

Carroll

LancasterI-30

Vickery

Pennsylvania

Rosedale

Magnolia

West Myrtle

Mistletoe

Baylor Fort Worth

Hwy. 121

Airport

Free

way

Comm

erce

Houston

I-30 West Freeway

I-35W

Sout

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ain

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th A

venu

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mm

it

Hwy. 287

Baylor Dallas

Baylor University Medical Center at Dallas

Baylor All Saints Medical Center at Fort Worth

Cancer research studies on the campus of Baylor University Medical Center at Dallas are conducted through Baylor Research Institute, Mary Crowley Medical Research Center, Texas Oncology, and US Oncology . Each reviews, approves, and conducts clinical trials independently .

Physicians are members of the medical staff at one of Baylor Health Care System’s subsidiary, community, or affiliated medical centers and are neither employees nor agents of those medical centers, Baylor University Medical Center at Dallas, Baylor All Saints Medical Center at Fort Worth or Baylor Health Care System .

If you wish to be taken off this mailing list please call 1 .800 .9BAYLOR . © 2011 Baylor Health Care System . All rights reserved . DH_ACHC_274_2011


3410 Worth Street, Suite 950 Dallas, Texas 75246

1400 Eighth Avenue, Fort Worth, Texas 76104

annette c. and harold c. simmons transplant …...cirrhosis, which replaces normal liver tissue with...

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