Volume 41 | December 2020
Surgical Notes
A Second Chance for Veteran Through Liver Transplant
"As an Air Force commander and 'human performance specialist,' Adam McLean uses his Ph.D. in performance psychology to coach others — soldiers, airmen, businesspeople — to succeed in high-stress situations.

And this year, he’d need a dose of his own medicine. It was late summer 2020, and Adam and Melissa McLean had started preparing for his end-of-life care.

Diagnosed with cirrhosis more than a year earlier, Adam’s liver scarring had progressed to late-stage liver failure. Doctors in Orlando told him there was nothing they could do. So Adam, a 52-year-old Air Force veteran, had gone home to — as the doctor put it — 'enjoy your family.'

Back home, the McLeans worked with a nurse to make Adam’s last few weeks comfortable. Frustrated with the devastating forecast, the nurse inquired as to whether they’d talked to a doctor at the Veterans Health Administration. The McLeans hadn’t considered it.

'I called the VA, and by the grace of God, saw a doctor there, and two days later we were admitted to the ICU,' Melissa recalled. Physicians at the VA determined Adam was indeed a candidate for a liver transplant. On September 12, they were transferred from Orlando to the Central Virginia VA Health Care System (CVHCS) in Richmond.

Nine days later, in an overnight surgery at VCU Medical Center, Adam was given a 'second chance on life' with a liver transplant..."

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Award for Outstanding Prehospital Educator
The ODEMSA Regional EMS Award for Outstanding Prehospital Educator was presented to J. Adam Alford of VCU Center for Trauma & Critical Care Education (CTCCE). Adam is an educator that is not only dedicated to his students but also the region and state. He has a way of explaining complex topics that are engaging, motivational, and entertaining.

His development of an EMT hybrid program is currently used for both the ODEMSA and VCU CTCCE hybrid EMT programs and has helped train and prepare nearly 100 students since its inception. His knowledge and abilities have been instrumental in facilitating the VCU Paramedic Program’s transition to the online environment during the ongoing pandemic, with minimal interruptions to the classroom experience.

Adam is a member of the ODEMSA Training and Education Committee and the National Association of EMS Educators Research Committee. He is currently leading a workgroup to develop a Regional Educator’s Summit scheduled for November 13th, which is planned to feature the region’s best instructors to share their best practices for teaching EMS courses. Adam teaches, but he is involved with the review of the information that his students receive and has been a peer reviewer for multiple EMS related texts.
Living Donor Kidney & Liver Donation
"Leah Luongo of Williamsburg, Virginia was barely through the living donor evaluation process at VCU Health when she had an idea. Maybe after donating a kidney to her husband, she could donate part of her liver to somebody else in need.

'I kind of half joked to my coordinator that since they were taking my right kidney, was there any way to just go ahead and do both at the same time?'

Leah had just learned that the spouse of a friend now needed a liver. 'I was kinda like, Well, I’m going to be in there anyway.'

VCU Health wasn’t performing living donor liver transplants at the time, so Leah missed her opportunity. But deep in the recesses of her mind, she knew she’d donate again.
Meanwhile, her husband, Bruce, had his kidney transplant. He and Leah both went back to work, and life returned to normal.

But then they checked their Facebook pages. Chandos Brown needed a liver..."

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Research Spotlight
In the United States, firearm-related violence has reached epidemic proportions and has become a major public health problem. Violently injured adults are not only victims in the present, but 40% will be violently re-injured and 20% will be killed within 5 years; these patients are also 88 times more likely to commit retaliatory violence once they leave the hospital (Cunningham et al., 2009). To help curb the rate of violence, violently injured patients are an essential target population to engage in violence prevention strategies. The overarching goal of violence prevention research is to understand what works for reducing violence and what psychosocial violence risk factors are malleable to intervention efforts.

This knowledge can help improve the delivery of interventions to patients. Dr. Thomson, Director of Research at VCU's Injury and Violence Prevention Program (IVPP) and Assistant Professor in the Departments of Surgery and Psychology, has been awarded a 3-year $1.95 million R01 from the CDC to conduct a RCT to evaluate IVPP's violence intervention program, Bridging the Gap. Dr. Thomson also serves as a co-investigator on a second recently funded CDC grant awarded to Erin Austin at the Virginia Division of Surveillance and Investigation at the Virginia Department of Health (VDH). The study aims to evaluate and refine VDH's syndromal definition of nonfatal gun violence injury to help improve the timeliness of aggregate reporting of ED visits for nonfatal firearm injuries.

It is the first time in more than 20 years that Congress has appropriated money for gun violence research (Hellman, 2019). This is a big step in understanding what works for violence prevention and places VCU's IVPP as a national leader in gun violence prevention research.
Urology Alumni Feature
"Housestaff alumnus Randy Vince Jr., M.D., H’19, was in his second year of medical school when his beloved grandmother died of kidney cancer. As he learned more about her last days, he realized she could have been a candidate for a potentially life-saving surgery. Her physician never even suggested the procedure to his family.

Soon after, Vince made a decision that changed the trajectory of his career: to become the urologic oncologist that Black Americans like his grandmother needed.

'I decided I wanted to know how to perform the surgery she was not offered and be the best at doing it,' says Vince, who completed his urology residency on the MCV Campus in 2019. 'I wanted to help families in similar situations. It’s been well documented that people of color are not given the same standard treatments of care....'"

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Journal of the American College of Surgeons
Congratulations to Dr. Paula Ferrada for her appointment to the board of the Journal of the American College of Surgeons (JACS).

Created in 1905, JACS is a monthly peer-reviewed journal serving as the official journal of the American College of Surgeons. Within its pages you will find publications about research, investigations, and reviews in the surgical field.
FDA Inspection Success
The transplant team led by Dr. Chandra Bhati and Mary (Merv) Baldechi, completed their first FDA inspection/audit for Dr. Bhati’s portable organ care system for the liver sponsored by TransMedics. This is a routine inspection in response to the sponsor’s application to the FDA for approval of the system. This is good news for the research program as the FDA usually chooses high enrolling sites for these types of inspections and Dr. Bhati and team are near the top for enrollment with 31 patients accrued.  

We are pleased to say the FDA inspector had positive comments about our university and hospital. And we are happy to continue to provide a way to explore the most effective means to prevent, diagnose and treat our patients.

Well done, team!
Committee on Trauma Awards
Congratulations to General Surgery residents Drs. Hae Sung Kang (Research) and Dr. Yahya Alwatari (PGY3) for their accomplishments at the recent Committee on Trauma meeting.

Dr. Kang won the the Virginia State Resident Paper Competition for the Committee on Trauma in the basic science category and went on to win at the regional level as well, taking first place by receiving the highest score in all categories. 

He will be competing in the National ACS COT meeting in March. Special congratulations to Dr. Mangino and the Lab for their superb preparation and presentation as well.

Dr. Yahya won the Virginia State Resident Paper Competition for the Committee on Trauma in the Clinical Category and came in second place at the regional competition. Congratulations to Dr. Edgar Rodas and all the coauthors as well.
Society of Clinical Vascular Surgery
Congratulations to our General Surgery residents and team members in Vascular Surgery for their incredible representation at the 2020 Society of Clinical Vascular Surgery (SCVS).

The team collectively submitted 22 individual abstracts to the SCVS of which 20 were accepted. This is outstanding particularly given that no other General Surgery Program or School of Medicine in the country has had such a level of representation at this or most any other national surgery meeting.

Special shout out to Dr. Michael Amendola for his leadership!
Journal of Gastrointestinal Surgery
Congratulations to Guilherme Mazzini, MD, PhD (Assistant Clinical Professor, Bariatric & GI Surgery) for his recent publication in the Journal of Gastrointestinal Surgery.

His paper, titled "Gastric Bypass Increases Circulating Bile Acids and Activates Hepatic Farnesoid X Receptor (FXR) but Requires Intact Peroxisome Proliferator Activator Receptor Alpha (PPARa) Signaling to Significantly Reduce Liver Fat Content" was co-authored by: Drs. Jad Khoraki, Matthew Browning, Jilin Wu, Huiping Zhou, Austin Wiles, Elvin Price, Luke Wolfe, Martin Mangino, and Guilherme Campos.

Well done, Dr. Mazzini and team!
Updates from Bariatric & GI Surgery
Congratulations to Dr. Guilherme Campos and team for successfully completing the first Endoscopic Sleeve Gastroplasty (ESG) in Richmond, Virginia.

ESG is a novel totally endoscopic treatment for obesity that adds to the armamentarium of the tools we have available. The procedure can be done in most patients in the outpatient setting or as a 23-hour stay. Peri-procedural complications are less than a standard Laparoscopic Sleeve Gastrectomy and weight loss results in selected series is 15% total body weight loss.

Thanks as well to the OR and purchasing teams involved in securing the endoscopes needed and for the support.
Dr. Kasirajan Dad-Jokes: Holiday Edition
What do you call a snowman with a six pack? An abdominal snowman!

How many potatoes does it take to make potato pancakes? A latke!

How can Santa deliver presents during a thunderstorm? His sleigh is flown by rain-deer!

What should you never eat on New Year's Eve? Fire Crackers!

What did the loaf of bread say to the other loaf of bread during Hanukkah? Happy challah days!
Employee Spotlight
Meet VCU Surgery's newest team member, Porter William Golob!

Porter was born on Tuesday November 24th in the early morning hours weighing 7 pounds and measuring 20 inches long. Both mom and baby are doing well!

You can find Porter sleeping (except for the hours between midnight and 3am), enjoying walks around his neighborhood, and playing with his big sister, Bryn.

Katie and Jared want to extend their sincerest gratitude to the many attendings, housestaff, nurses, care partners, dietary, transport staff and many others who provided care during her stay. Katie writes "[I am] so thankful to work among providers who created such an exceptional experience for us during this special time!"

Welcome to the world, Porter! And congratulations to Katie and Jared!
Monthly Wellness Note
The Society of Human Resource Management recently sent out an amazing article about the effects of COVID on working moms. The article itself is attached here but below are a few of the many suggestions that we as a team can incorporate into our work lives here at VCU (with personal emphasis on bolded items).

"A Helping Hand

Experts share the following tips on how companies can best help women (and men) who are working from home while also caring for their children:

  • Communicate openly and frequently with your employees. Listen to their needs and concerns and be as accommodating as possible.
  • Remind employees of your mental health benefits and bolster them if feasible.
  • Encourage workers to take their vacation or paid time off, and make sure managers understand the importance of allowing time away from work.
  • Promote the Families First Coronavirus Response Act, which requires certain employers to provide their workers with paid sick leave or expanded family and medical leave for reasons specifically related to COVID-19.
  • Set standards for work/life balance. For example, instruct managers and supervisors not to send nonurgent e-mails at all hours and don't expect immediate responses to questions that can wait.
  • Prioritize which employee projects are most important so workers know where to focus.
  • Explore paying for or subsidizing virtual or in-person tutoring services or babysitting.
  • Consider introducing job sharing or part-time work for positions where those options don't exist.
  • Reduce the number of meetings and carefully choose who must attend.
  • Record meetings or have someone take notes for those who can't attend.
  • Take employees' overall record into account in performance reviews, raises and bonuses. Right now, employees are navigating challenging circumstances."
Upcoming Events
Research Open Forum
Monthly, 2nd Mondays
4:00 - 5:00 PM

All are encouraged to attend!
Have a story to tell? Contact [email protected]
Department of Surgery | Virginia Commonwealth University | (804)828-7874 | [email protected]