Archive for the ‘Medical Professionals’ Category

Lydiatt new vice chair of NCCN thyroid guidelines panel

by Mallory Car, UNMC public relations


William Lydiatt, M.D.

William Lydiatt, M.D., professor of otolaryngology-head and neck surgery in the UNMC College of Medicine, has been appointed vice chair of the National Comprehensive Cancer Network (NCCN) Thyroid Guidelines Panel.

A member of the head and neck committee since the 1990s, Dr. Lydiatt is excited to serve in a leadership position.

“This role provides an opportunity to make a real difference in the standards of care for treating thyroid cancers,” he said. “The chair and vice chair have an important role in guiding the committee, using best evidence to enhance and improve care nationally.”

NCCN, a not-for-profit alliance of 25 of the world’s leading cancer centers devoted to patient care, research and education, is dedicated to improving the quality, effectiveness, and efficiency of cancer care so that patients can live better lives. As one of the 13 original NCCN member institutions, Nebraska Medicine remains committed to the organization’s vision by serving as a leader in defining and advancing high-quality, high-value cancer care.

“As founding members of NCCN, our faculty members have been extensively involved in developing and updating yearly comprehensive guidelines for the diagnosis and treatment of more than 97 percent of cancers affecting patients in the United States,” said Peter F. Coccia, M.D., Ittner Professor and vice chair of pediatrics at UNMC and NCCN board and guidelines steering committee member. “Thyroid cancer accounts for 4 percent of all cancers and more than 1 percent of people will develop thyroid cancer in their lifetime. Bill’s appointment as vice chair of the thyroid guidelines panel recognizes him as a national expert in the diagnosis and management of thyroid cancer.”

“This is not only an outstanding recognition for Dr. Lydiatt and the expertise he has in thyroid cancer but also his talent in collaboration and building consensus with respected colleagues in premier cancer programs,” said Theresa Franco, cancer care service line executive director at Nebraska Medicine. “This brings prestige and value to our cancer program and advances the reputation of the Fred & Pamela Buffett Cancer Center.”

“To have this kind of influence in setting standards of care is such an honor,” said Ken Cowan, M.D., Ph.D., director of the Fred & Pamela Buffett Cancer Center. “This appointment reflects Dr. Lydiatt’s unwavering commitment to educating the world in best cancer care practices.”

Five cancer researchers recruited to Fred & Pamela Buffett Cancer Center


The Fred & Pamela Buffett Cancer Center at the University of Nebraska Medical Center and its clinical partner, Nebraska Medicine, has added five new translational cancer researchers to its staff in recent months.

The Fred & Pamela Buffett Cancer Center is Nebraska’s only National Cancer Institute-designated cancer center. It is affiliated with the University of Nebraska Medical Center and its clinical partner, Nebraska Medicine. Located at 45th Street and Dewey Avenue, the Fred & Pamela Buffett Cancer Center is scheduled to open in 2017.

The recruits hail from some of the nation’s top scientific and medical institutions. Collectively, they bring more than $5 million in cancer research funding to Nebraska. All have begun their work at the Fred & Pamela Buffett Cancer Center during the past four months.

“When we launched this ambitious project to build the world’s finest cancer center right here in Omaha, we believed that it would attract the very best minds in cancer research from around the world,” said Ken Cowan, M.D., Ph.D., director of the Fred & Pamela Buffett Cancer Center.

“These recruits exemplify that vision. We are building a place where pioneering scientific exploration will shape the future of cancer science and medicine – and these recruits are just the start.”

The $323 million Fred & Pamela Buffett Cancer Center – the largest construction project ever on the medical center campus – will create approximately 1,200 jobs at the medical center alone, plus thousands of others in construction and related industries. In total, the project will provide 4,657 new jobs to the metro area, infusing $537 million annually into the economy on an ongoing basis.

As translational cancer researchers, these new recruits conduct research that applies discoveries generated in the laboratory directly to patients’ bedsides.

The new recruits are:

Nick Woods, Ph.D.
• Recruited from H. Lee Moffitt Cancer Center in Tampa, Fla. Joined the Fred & Pamela Buffett Cancer Center on Oct. 1.
• Has a $400,000 National Institutes of Health (NIH)/National Cancer Institute (NCI) grant in breast cancer.
• A Fairfield, Neb., native and cancer survivor, Dr. Woods’ primary research interest is systems biology based analysis of protein-protein interactions networks associated with cancer signaling pathways to identify novel targets for cancer therapies. His future goals are to examine acute myeloid leukemia signaling pathways associated with Fanconi Anemia proteins.
• For more information on Dr. Woods, click here.

Michael Green, Ph.D.
• Recruited from Stanford University. Joined the Fred & Pamela Buffett Cancer Center on Nov. 1.
• Has a $195,000 grant funded by The Leukemia & Lymphoma Society.
• Dr. Green works to identify and understand the genetic alterations that give rise to lymphoma and allow it to evade the immune system. He is interested in the genetics of B-cell lymphoma, with the goal of using genetic profiling to understand disease biology and inform treatment decisions.
• For more information on Dr. Green, click here.

Amar Singh, Ph.D.
• Recruited from Vanderbilt University. Joined the Fred & Pamela Buffett Cancer Center on Oct. 1.
• Has a $1.65 million National Institutes of Health grant in colon cancer.
• Brought one other Ph.D. level researcher with him to Nebraska.
• Dr. Singh’s research focuses on understanding the role of the tight junction proteins, claudins, in the regulation of barrier function, colonic inflammation and neoplastic transformation and growth in correlation with the EGF receptor signaling.
• For more information on Dr. Singh, click here.

Punita Dhawan, Ph.D.
• Recruited from Vanderbilt University. Joined the Fred & Pamela Buffett Cancer Center on Oct. 1.
• Has a $950,000 Veteran’s Affairs Health Grant in colon cancer
• Recruited one additional Ph.D. postdoctoral fellow from Chicago.
• Dr. Dhawan focuses her research on claudins, metastasis, tumorigenesis, signal transduction and trafficking, and cell death and differentiation.
• For more information on Dr. Dhawan, click here.

Rebecca Oberley-Deegan, Ph.D.
• Recruited from National Jewish Hospital in Denver. Joined the Fred & Pamela Buffett Cancer Center on Aug. 1.
• Has a $1.65 million National Institutes of Health/National Cancer Institute grant in prostate cancer
• Dr. Oberley-Deegan’s research examines the role of oxidative stress and inflammation in the context of radiation and cancer biology. Her laboratory previously has shown that a catalytically active antioxidant can protect normal prostate tissues during radiation, but not prostate tumor tissues. The focus of her research is to determine the mechanisms by which antioxidants can protect normal tissues from radiation while simultaneously making the tumor vulnerable to radiation damage.
• For more information on Dr. Oberly-Deegan, click here.

Nebraska moves into top 10 of healthiest states in U.S.

Liz Kumru


Ali Khan, M.D.

Nebraska has moved into the top 10 among the healthiest states in the country.

In a report issued by the United Health Foundation earlier this month, Nebraska moved up one notch after ranking No. 11 last year. The five states surrounding Nebraska ranked between 18 and 36.

“We are heading in the right direction,” said Ali S. Khan, M.D., M.P.H., dean of the University of Nebraska Medical Center College of Public Health. “With a real concerted effort, we can reach No. 1 by 2020.”

Since joining UNMC in July, Dr. Khan has traveled across the state to talk about how to improve the state’s health indicators. He supports UNMC Chancellor Jeffrey P. Gold, M.D., and his strategic goal to work with all health systems and private and community partners to help make Nebraska the healthiest state in the union by 2020.

The report, “America’s Health Rankings: A Call to Action for Individuals and their Communities,” analyzed the health of the nation holistically with in-depth data and analysis. Its focus is on behaviors, community and environment, policy and clinical care to provide a comprehensive picture of the nation’s health. Indicators are: low birth weight, smoking, obesity, drug deaths, physical inactivity and adolescent immunizations.

First, the good news – Nebraska ranks:
• First – High rate of high school graduation. In the past two years, high school graduation increased 12 percent from 82.9 percent to 93 percent for incoming ninth graders. Nebraska is tied with Vermont for the highest graduation rate in the nation.
• Second – High immunization coverage among children. In the past year, immunization coverage among children increased by 9 percent from 72.6 percent to 79 percent for children aged 19 to 35 months.
• Third – Low rate of drug deaths.
• 10th – In the past year, the number of children in poverty decreased by 27 percent from 19.6 percent to 14.3 percent.
• 24th – In the past year, preventable hospitalizations decreased by 13 percent from 63.8 to 55.8 per 1,000 Medicare beneficiaries.

Still, it isn’t all good news. In areas that need work, Nebraska ranks:
• 16th – In the past two years, the percentage of adults with diabetes increased 10 percent from 8.4 percent to 9.2 percent.
• 21st – Percentage of adults who are smokers (self-report smoking at least 100 cigarettes in their lifetime and currently smoke).
• 23rd – Public health funding.
• 27th – Percentage of adults who are obese.
• 44th – Percentage of adults who self-report drinking alcoholic beverages on at least one occasion in the last month: women – four or more drinks at one sitting; men – five or more drinks at one sitting.

This marks the 25th year that UHF has issued state rankings in partnership with the American Public Health Association and Partnership for Prevention.

America’s Health Rankings is the longest-running report of its kind. It provides analysis of national health on a state-by-state basis by evaluating a historical and comprehensive set of health, environmental and socioeconomic data to determine national health benchmarks and state rankings. The rankings employ a unique methodology that is developed and annually reviewed and overseen by a Scientific Advisory Committee of leading public health scholars.

The data in the report come from well-recognized outside sources, such as the Centers for Disease Control and Prevention, American Medical Association, FBI, Dartmouth Atlas Project, U.S. Department of Education, and the Census Bureau.

To view the rankings in full, go to

How the states rank

Here are the top 10 states, and the last:

1 – Hawaii

2 – Vermont

3 – Massachusetts

4 – Connecticut

5 – Utah

6 – Minnesota

7 – New Hampshire

8 – Colorado

9 – North Dakota

10 – Nebraska

States surrounding Nebraska and their rank:
• South Dakota – 18
• Iowa – 24
• Wyoming – 25
• Kansas – 27
• Missouri – 36

New Catheter System Navigates and Fixes Arterial Blockage

For approximately 18 million Americans, it’s a disease that affects nearly every step. Walking down the sidewalk or up a flight of stairs causes painful cramping in the hip, thigh or calf muscles. Left untreated, it’s the leading cause of amputation in patients over 50.


David Vogel, MD

“Those highest at risk for peripheral artery disease (PAD) are smokers,” said David Vogel, MD, a vascular surgeon at Nebraska Medicine. “However, diabetes is also an important risk factor, along with obesity and advanced age.”

PAD is a circulatory problem caused by the build up of plaque in the arteries of the legs. These blockages limit blood flow to the leg muscles, causing pain during activity. In the past, patients with PAD required bypass surgery, which meant several days in the hospital, followed by an extended recovery time of weeks to months.

Fortunately, new lumivascular technology is being used at Nebraska Medicine to treat patients with PAD. The Ocelot catheter system allows doctors to navigate inside long, blocked leg arteries for the first time. It’s used in combination with the Lightbox, a mobile imaging device that delivers optical coherence tomography imaging (OCT), which enables physicians to see from inside an artery during the procedure.


Ocelot Catheter System 

“It basically works by sending out a light source – in this case, a low power, red laser,” explained Dr. Vogel. “The light then reflects off the plaque and artery, giving us an image. With that image, we can steer the catheter through the plaque to the open artery on the other side of the blockage. It’s much safer than trying to blindly push a wire and catheter across a blockage, which can lead to perforation of the artery.”

In July 2013, doctors at Nebraska Medicine – Nebraska Medical Center began using this technology. It’s the only hospital in Nebraska, Iowa, Kansas and South Dakota currently treating PAD patients with the Ocelot catheter system. The next closest providers are in Chicago, St. Louis and Columbia, Mo.

“Dr. Vogel is one of 20 people in the United States working with the latest lumivascular technology,” said Michael Moulton, MD, chief of the division of cardiothoracic surgery at Nebraska Medicine. “There’s no one else in the entire region doing this type of treatment. Patients with PAD would do extremely well seeing Dr. Vogel.”

Dozens of patients have undergone the procedure at Nebraska Medicine, including Billy Baney, who’s worked at Union Pacific Railroad for over 20 years.

Billy-BaneyBilly Baney
“I build railroad tracks, so I do a lot of walking. Up and down the tracks. I need my legs to do my job.”

In late 2013, Baney came to Dr. Vogel, looking for a second opinion, after doctors at another area hospital told him he’d need bypass surgery.

“I left there shaking. Got into my car and said, ‘I can’t believe this,’” remembered Baney. “When I found Dr. Vogel, he told me that we could avoid major surgery.”

In February 2014, Dr. Vogel used the Ocelot catheter system to navigate through Baney’s blocked arteries. By April, Baney was building train tracks again.

“Dr. Vogel is really good at what he does,” said Baney. “I can’t thank him enough for helping me get back on my feet and back to work.”

Symptoms of PAD:
•Painful cramping in the hip, thigh or calf muscles after walking or climbing stairs
•Leg numbness or weakness
•Coldness in the lower leg or foot
•Sores on the toes, feet or legs that will not heal
•Skin on your leg turns pale or bluish when leg is elevated
•Your foot turns a dusky red when you stand or sit
•The hair on your foot stops growing
•Your toenails stop growing
•You get frequent toenail infections

Preventing PAD:
•If you smoke, your risk of getting PAD increases four times
•Controlling high blood pressure, high cholesterol and diabetes will decrease your risk
•Maintaining a healthy weight and getting regular exercise will improve your overall health

To schedule an appointment with Dr. Vogel, call (800) 922-0000.


New Heart Procedure Helps Mitral Regurgitation Patients


For 78-year-old Viola Foley, nothing brings a bigger smile to her face than talking about family, country music or Nebraska Medicine.

“I tell everyone that the nicest doctors in the world work here,” she says. “They saved my life more than once.”

After raising nine children in Springfield, Neb., Foley underwent a liver transplant at Nebraska Medicine – Nebraska Medical Center and battled breast cancer twice.

“I was diagnosed with breast cancer six years before my liver transplant, then again four years later. It’s amazing how far I’ve come.”

Once Foley passed the 10-year mark for her transplant, she started having serious breathing problems. Walking across the living room was almost impossible. In September, she made an appointment with Nebraska Medicine cardiologist Thomas Porter, MD.

“Dr. Porter did an echocardiogram,” remembers Foley. “He discovered that my heart and liver were working against each other. One of my heart valves wasn’t opening and shutting the right way.”

In September, Foley was diagnosed with mitral regurgitation (MR), a condition that affects four million people in the United States. The heart’s mitral valve leaflets don’t close tightly, causing blood to flow backwards from the heart’s left ventricle into the left atrium. It makes the heart work harder at pushing blood through the body, leading to shortness of breath, fatigue and worsening heart failure. For many patients, open-heart mitral valve surgery is generally recommended, but for Foley, surgery wasn’t an option.

“She currently has a life threatening blood disorder that prohibits her from having any open surgical procedures,” says Michael Moulton, MD, chief of cardiothoracic surgery at Nebraska Medicine. “Her only shot was to have the MitraClip procedure, which was recently approved by the U.S. Food and Drug Administration.”


The MitraClip Clip Delivery System (MitraClip CDS) is a new option for patients diagnosed with MR, who have too high a risk for surgery. The procedure consists of implant catheters and the MitraClip device, which is a permanent implant that attaches to the mitral valve leaflets, reducing the leakiness of the valve.

On October 1, Foley became the first patient to undergo the procedure at Nebraska Medicine. With the help of a catheter, Nebraska Medicine chief of interventional cardiology, Gregory Pavlides, MD, inserted the MitraClip device through a blood vessel in Foley’s groin, guiding it to her heart. The surgical team could watch in real time on the echo machine if the mitral regurgitation was appropriately reduced. Once the MitraClip device was in place, the catheter was removed.

“This procedure requires a lot of skill from interventional cardiology, imaging cardiology and anesthesia,” explains Dr. Pavlides. “Not many places in the area have the infrastructure to offer the MitraClip procedure as well as we can; based on our experience with the mitral valve and our superb imaging and cath lab skills.”

Foley’s procedure took approximately one hour and 30 minutes. She spent a little over three days in the hospital before going home. Since then, she’s regained her strength, is able to walk up and down the stairs and feed her pets without feeling fatigued. She’s excited for the next chapter in her life, which includes watching her great-grandson attend the University of Nebraska Medical Center with the hopes of becoming a cardiologist.

“I am forever grateful,” says Foley. “I wouldn’t be here today if I didn’t have this option. I’m really proud to be the first patient at Nebraska Medicine to have the MitraClip procedure. Couldn’t have asked for a better crew or a better place.”

Nebraska Medicine anticipates performing the procedure on 2-4 patients per month. To connect with a member of the Heart Center team regarding the MitraClip, call (402) 559-8888 or visit their website.


UNMC flow cytometer among world’s finest

by Kalani Simpson, UNMC public relations

Philip Hexley, Ph.D.

Philip Hexley, Ph.D., research core facility director at the flow cytometry research facility, likens flow cytometry to a grocery check-out scanner. But instead of scanning bar codes for information, it uses lasers to read cells.

A close-up of the flow cell in the new Fortessa X50 flow cytometer, a key fluidics component for single cell analysis. 

Researchers can use the technology to analyze physical and chemical properties of single cells in suspension — up to 35,000 of them per second.

“As you can imagine, this is incredibly valuable data, allowing us to get statistically significant cell numbers with robust and quantitative data,” Dr. Hexley said.

For more photos of the flow cytometer, click here.

And perhaps the world’s best instrument for doing so resides on the first floor of the Durham Research Center.

Top-line flow cytometers have the capability to capture up to 18 different pieces of information about a single cell. But UNMC’s new Fortessa X50 flow cytometer, which arrived late this last summer, uses up to nine lasers and can acquire up to 30 different pieces of information.

“Our researchers really have a fantastic opportunity to get data at a level which is not possible at any other institution,” Dr. Hexley said.

There is one other instrument on the planet — at the National Institutes of Health — with comparable capabilities, although it does not have as many lasers, making it less flexible in its capabilities.

UNMC’s one-of-a-kind new cytometer is not yet available anywhere. It is the latest in production from BD Biosciences, which, Dr. Hexley said, hopes to release this model on the commercial market sometime in the summer of 2015.

Meanwhile, UNMC is getting a state-of-the-art sneak preview, beta-testing it. This model will likely cost about $1.3 million, but because of the collaborative partnership, UNMC got it for about half that.

“We got a great deal,” Dr. Hexley said. “But BD got a good deal as well.” UNMC is helping BD further develop the hardware and software as beta testing goes on.

“It’s truly mind-blowing to have access to this technology,” Dr. Hexley said.

For more on flow cytometry opportunities at UNMC, go here or contact Dr. Hexley.

Setting the standard in Ebola care

by Elizabeth Kumru, UNMC public relations

From left, UNMC Chancellor Jeffrey P. Gold, M.D, Shelley Schwedhelm, Angela Hewlett, M.D., Phil Smith, M.D., Ali Khan, M.D., M.P.H., John Lowe, Ph.D., and Nebraska Medicine President Brad Britigan, M.D.
The successful treatment of two men who had Ebola has turned UNMC and Nebraska Medicine into the go-to institution of the world for advice on care and protocols.

“Nebraska has set the gold standards for Ebola care,” said Philip Smith, M.D., professor of Internal Medicine, Division of Infectious Disease, and medical director of the Biocontainment Unit. “We embody everything that went right.”

“Not every institution in the U.S. had this vision and could step up and do the cutting-edge research, education and patient care to protect our citizens. That’s what an academic medical center does.”

UNMC Chancellor Jeffrey P. Gold, M.D.

Dr. Smith was part of a five-person panel of experts who spoke to more than 60 UNMC students and faculty members at a 90-minute “Ebola Explained” discussion last week.

Watch the presentation here. (A UNMC login is needed to view the discussion.)

The medical center received extensive global media attention – via television, print and social media – over the two-month period, said UNMC Chancellor Jeffrey P. Gold, M.D.

“We were in the top 10 tweets and were number three for a while – only exceeded by the National Football League,” he said before showing a video of news reports that highlighted UNMC’s heroic response.

Dr. Gold praised Dr. Smith’s foresight in building the unit.

“Not every institution in the U.S. had this vision and could step up and do the cutting-edge research, education and patient care to protect our citizens. That’s what an academic medical center does.”

Bradley Britigan, M.D., dean of the UNMC College of Medicine and president of Nebraska Medicine, served as moderator for the panel of experts that included:

•Ali Khan, M.D., M.P.H., dean, UNMC College of Public Health and former director of the Office of Public Health Preparedness and Response at the Centers for Disease Control and Prevention;
•Dr. Smith;
•Angela Hewlett, M.D., assistant professor of internal medicine-infectious diseases, and associate medical director of the Biocontainment Unit;
•John Lowe, Ph.D., assistant professor, environmental, agricultural and occupational health; associate director of research, Biocontainment Unit, director of Public Health Training and Exercise Programs, Center for Preparedness Education;
•Shelly Schwedhelm, director of the emergency department’s trauma and emergency preparedness at Nebraska Medicine.

Although some team members or family members had been shunned because they were working in the Biocontainment Unit, many experienced support and gratitude from the community. And nothing is more complimentary than imitation.

So, two experts were pleased to see three elementary school children dressed in a kid’s adaptation of the yellow biocontainment suit for Halloween.

You know you’ve reached a certain coolness factor when that happens.

Second Ebola patient released

by John Keenan, UNMC public relations

From left, Phil Smith, M.D., medical director of the Biocontainment Unit at Nebraska Medicine-Nebraska Medical Center and professor of internal medicine/infectious diseases at UNMC, Ashoka Mukpo, and Andre Kalil, M.D., professor of internal medicine/infectious diseases at UNMC. (Photo courtesy Taylor Wilson, Nebraska Medicine)

UNMC’s second Ebola patient, Ashoka Mukpo, was released from the Biocontainment Unit Wednesday after multiple tests confirmed by the Centers for Disease Control and Prevention (CDC) that he was free of Ebola.

Although Mukpo did not attend Wednesday’s new conference, UNMC Chancellor Jeffrey P. Gold, M.D., read a prepared statement in which Mukpo called it a “joyful day.”

“After enduring weeks where it was unclear whether I would survive, I’m walking out of the hospital on my own power, free from Ebola,” the statement said. “This blessing is in no small measure a result of the world-class care I received at the Nebraska Medical Center.

See a video interview with Ashoka Mukpo here.

“When Dr. Smith and his team first received me, I was in a difficult situation and was quite sick. The professionalism and confidence of the team instantly reassured me that I was in good hands. The nursing staff was incredibly calm and handled my symptoms in a manner that clearly reflected strong training and preparedness.”

Mukpo also said the nursing staff had introduced him to “something called a ‘Runza.'”

For the complete text of Mukpo’s statement, click here.

Phil Smith, M.D., medical director of the Biocontainment Unit at Nebraska Medicine-Nebraska Medical Center and professor of internal medicine/infectious diseases at UNMC, praised the health care team, noting that Nebraska Medicine and UNMC staff continue to volunteer to work at the unit.

He praised the efforts of Shelly Schwedhelm, director of Emergency Department, Trauma and Emergency Preparedness at Nebraska Medicine, in assembling a group that has now helped two patients overcome the Ebola virus.

“Shelly has done a tremendous job of selecting and recruiting the best we have, and we have more people volunteering than we can use,” Dr. Smith said.

Schwedhelm and Angela Hewlett, M.D., associate medical director of the Biocontainment Unit and assistant professor of internal medicine/infectious diseases at UNMC, joined Dr. Smith at the press conference.

Dr. Gold said that U.S. government agencies had reached out to UNMC and Nebraska Medicine for assistance and input into ways to stop the spread of the virus both in the U.S. and Africa, and ways to educate both health care facilities and the general public in the United States.

Dr. Smith said that, until the Biocontainment Unit was asked to care for another Ebola patient, “we will use this time to try to share our knowledge as best we can with the rest of the world.”

Pediatric Liver Transplant Program Provides Depth of Experience and Expertise

dr-mercerNebraska Medicine has been a leader in both adult and pediatric liver transplants since the program was founded in 1985. The program averages approximately 80 adult liver transplants and 20 to 25 pediatric transplants annually.

“We are one of the oldest and busiest programs in the country with a very skilled and experienced team of physicians, nurses, educators and other support staff,” says Wendy Grant, MD, transplant surgeon at Nebraska Medicine. “This team works together very closely to make this a positive experience not only for the child, but for the whole family.”

Transplant surgeons at Nebraska Medicine have many years of experience and are backed by a large pool of pediatric specialists including pediatric hepatologists, intestinal failure specialists and liver/kidney infectious disease specialists. “We have the dedication and all the resources needed to follow these patients for the rest of their lives,” says Dr. Grant. “It’s very a patient-focused and family-friendly environment. These patients become part of our family.”

Other transplant surgeons include David Mercer, MD, PhD, Luciano Vargas, MD and Alan Langnas, DO, director of the Liver Transplant Program.

“Our depth of experience also allows us to take on cases that are some of the most complex and technically challenging,” says Dr. Grant.

The most common problem that may necessitate a liver transplant in children is biliary atresia. Biliary atresia usually presents in infants at about two to three months old and will result in a jaundiced appearance. “The child should undergo a physical, blood tests and ultrasound as soon as possible,” says Dr. Grant.

If the condition is diagnosed early enough, surgery to repair the blocked bile ducts may be successful. “If the liver becomes scarred, a transplant will be needed,” notes Dr. Grant. “Some children will need a liver transplant within the first year of life.”

Another less common indication for liver transplant is a cancer called hepatoblastoma. First line treatment for hepatobalastoma includes chemotherapy and surgical resection of the liver. If the tumor is not resectable, a transplant is a viable option, says Dr. Grant.

Nebraska Medicine Liver Transplant Program also has the advantage of being supported by one of the leading intestinal rehabilitation programs in the country. “We can often reverse their intestinal and liver disease so they won’t need a transplant at all,” notes Dr. Grant. “In those who present with advanced liver disease, we are very aggressive in trying to get them off TPN so they can avoid an intestinal transplant.”

For those children needing a liver transplant, living donor transplantation is an option. Nebraska Medicine has an active living donor liver transplant program. Donors do not necessarily have to be a relative. Donors go through a rigorous screening process. Matching is done based on size and blood type. This program allows children more opportunity for transplant and decreases the risk that a child would die while waiting for a transplant.

For patients who receive a liver transplant, the outlook is good. The five-year survival rate is 80 percent or more. “Surgery and immunosuppressant drugs have greatly improved over the years,” says Dr. Grant. “We have many patients who have been living with their transplants for 20 to 25 years. Most patients go on to live a normal life aside from the immunosuppressant drugs they must take daily.”

Advances in Brain Tumor Treatment Continue to Progress

Not only is brain cancer very rare, affecting less than 1 percent of the population, brain tumors can be both difficult to diagnose and to treat.

There are more than 120 different types of brain tumors that can have varying symptoms ranging from a headache to memory loss or seizures, depending on the tumor’s location in the brain. These symptoms often mimic other neurological conditions.

Brain tumors also have one of the least favorable outcomes. But Nicole Shonka, MD, neuro-onocolgist at Nebraska Medicine, says that is starting to change. While advancements in the treatment of brain cancers have been slow, there has been progress in small steps and Dr. Shonka is confident new advancements are just around the corner.

Nicole Shonka, MD

Dr. Shonka is the only fellowship-trained neuro-oncologist in the state specializing in brain tumors. An assistant professor in oncology/hematology at the University of Nebraska Medical Center (UNMC), she joined the staff in 2010. Dr. Shonka received her medical degree from UNMC where she also completed her residency and general oncology fellowship. She completed an additional neuro-oncology fellowship at MD Anderson Cancer Center, one of the top cancer centers in the nation and a highly respected neuro-oncology fellowship – one of a few programs in the country. The program draws from a large population base that allows doctors to see up to 3,000 primary brain tumors a year. “Completing my training there allowed me to see many more brain tumors, including the rarer ones,” notes Dr. Shonka.

This is important, notes Dr. Shonka, “As there are many nuances in this field that you may not be aware of unless you have that additional training.”

Treatment for brain tumors typically involves surgery followed by radiation therapy and/or chemotherapy. Pseudo-progression and radiation necrosis are two conditions that can develop during cancer treatment that can be misinterpreted by the untrained eye and change the treatment regimen.

“Glioblastomas (the most common type of malignant brain tumor in adults) often develop pseudo-progression the first several months after treatment,” explains Dr. Shonka. “Pseudo-progression could easily be misinterpreted by someone unfamiliar with these cancers as evidence that the treatment is ineffective.”

Some patients may also develop radiation necrosis, which can appear to be additional tumor growth, she says.

Chemotherapy has been a big area of advancement for brain tumors. “In the past 10 years, we have developed better chemotherapies for treating brain cancers which have helped improve survival rates for nearly all brain cancer patients,” says Dr. Shonka.

Other advances lie in the realm of personalized medicine, in which cancer treatment is based on a person’s unique genetic makeup. In brain cancers, this includes the discovery of molecular markers which can provide both prognostic and predictive data. Scientists have also discovered variances in the molecular features of glioblastomas that have allowed them to classify them differently. This is spurring the development of personalized therapies based on these classifications.

“We are currently studying certain enzymes which can help predict a patient’s response to therapy or provide us information about their prognosis,” says Dr. Shonka. “This will help us determine what therapies to use and how aggressively to treat a patient.”

Dr. Shonka says she expects research to reach a new level at Nebraska Medicine with the creation of the new Fred & Pamela Buffett Cancer Center, which is expected to be open in 2017.

“With the new cancer center, we will all be housed in greater proximity which I believe will foster more collaboration among clinicians and researchers and should help to expedite moving new advances from basic sciences research to the bedside,” she says.

“This is an exciting time to be a neuro-oncologist and I’m increasingly optimistic about the future for patients with brain tumors,” says Dr. Shonka.