Archive for the ‘Patients’ Category

Celebrating Elite National Quality Award, Again

Excellence Award from Vizient, Inc. for Quality Leadership Performance

Nebraska Medical Center is again honored to announce its recognition by Vizient, Inc., as a recipient of the 2017 Bernard A. Birnbaum, MD, Quality Leadership Award. The award recognizes Nebraska Medical Center for demonstrating superior quality and safety performance among more than 100 academic medical centers taking part in Vizient’s Quality and Accountability Study. Only twelve academic medical centers in the United States were recognized this year. Nebraska Medical Center is ranked eleventh and is the only health system in the region to earn this recognition.

“At Nebraska Medicine, the safety of our patients and the quality of care we provide to them comes above everything else,” says CEO Dan DeBehnke, MD, MBA. “To be recognized for something this important and for something we’re continually trying to improve upon validates the effort we’ve been making. Everyone who works here should be extremely proud of this honor, especially earning it for a second straight year.”


12 in the nation. Only 1 in Nebraska. National Leaders in Quality and Safety.*

This year, 107 academic medical centers and 161 community hospitals were included in the study. The study measured performance based on the Institute of Medicine’s six domains of care: safety, timeliness, effectiveness, efficiency, equity and patient centeredness. The composite scoring system uses patient-level performance data from a variety of sources, including the Vizient Clinical Data Base, the Vizient Core Measures Data Base, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, and the Centers for Disease Control and Prevention’s National Healthcare Safety Network.

Nebraska Medicine – Bellevue also earned a spot on the community hospitals list, checking in at twelfth.

“The entire Nebraska Medicine system strives to provide our patients with the highest quality, safest, most efficient and compassionate care available,” says Michael Ash, MD, chief transformation officer. “Earning this Vizient Quality Leadership Award alongside other elite national academic medical centers shows just how devoted everyone who works here is to providing serious medicine and extraordinary care every day.”

Here is the list of academic medical centers honored with the 2017 Bernard A. Birnbaum, MD, Quality Leadership Award:
Mayo Clinic Hospital – Rochester
NYU Langone Health
Froedtert & the Medical College of Wisconsin- Froedtert Hospital
Rush University Medical Center
Penn State Health Milton S. Hershey Medical Center
University of Utah Health
UCHealth University of Colorado Hospital
Lehigh Valley Health Network
University of Texas Medical Branch at Galveston
The University of Kansas Hospital
Nebraska Medicine
Oregon Health & Science University Hospital (OHSU)

Revolutionary Cancer Care that’s the Right Care for Your Patient

When you have a patient who has been diagnosed with cancer, you want to make sure he or she is not only receiving the best and most cutting-edge care, but also the right care. Roger Belohlavy is a case in point.

Belohlavy was critically ill. All treatments for his acute lymphoblastic leukemia had failed. Until he came to Nebraska Medicine. The therapy he received here is one of the most cutting-edge treatments now available to fight his type of cancer.

Belohlavy qualified for a clinical trial using an immunotherapy called CAR T-cell therapy. The treatment targets cancer cells by homing in on specific molecular changes seen primarily in those cells and then engineering a patient’s own immune cells to recognize and attack the cancer. The therapy saved Belohlavy’s life. Twenty-eight days after the infusion, Belohlavy was declared cancer-free.

The development of new cutting-edge cancer treatments like immunotherapy is just one of the many treatments the specialists and researchers at Nebraska Medicine are developing to win the battle against cancer. Personalized cancer therapies based on a person’s DNA also are play a growing role in diagnosis and treatment and Nebraska Medicine researchers and clinicians are at the forefront of these advances bringing the latest clinical trials and breakthroughs to our patients.

Nebraska Medicine provides the most comprehensive cancer care in the region using the most advanced and innovative treatments. It is one of only sixty nine National Cancer Institute (NCI)-designated cancer centers in the United States. NCI-designated Cancer Centers are recognized for their scientific excellence and commitment to cancer treatment and research that focuses on the development of more effective approaches to cancer prevention, diagnosis and therapy.

Patients come from across the state and around the world to see many of the internationally renowned cancer specialists at Nebraska Medicine, many of whom have dedicated training in specialty areas of cancer. This includes areas such as breast cancer, lymphoma and leukemia, multiple myeloma, ovarian and cervical cancer and thyroid cancer. This ensures our patients receive the most advanced and up-to-date care and treatment.

Nebraska Medicine is also making cancer care more personal and accessible than ever with cancer clinics available at Bellevue, Village Pointe and Nebraska Medical Center.

Our new multidisciplinary breast cancer clinic at Village Pointe streamlines appointments for the patient and brings a multidisciplinary team of breast cancer experts together to provide a comprehensive approach to cancer care based on a woman’s personal preferences. The clinic is also one of a few health care centers in the region offering cutting-edge 3-D mammography that can increase detection rates by 40 percent and reduce callback rates by 20 to 40 percent.

Opening this spring on the Nebraska Medical Center campus, is the Fred & Pamela Buffett Cancer Center. The Fred & Pamela Buffett Cancer Center will integrate high-tech clinical medicine with research to accelerate new therapies for patients. Scientists and clinicians will be working together in one building as a team to collaborate on the development of new cancer treatments.

“Our goal is to be a national leader in cancer research and clinical care and one of the leading cancer centers in the country,” says Ken Cowan, MD, PhD, director of the Fred & Pamela Buffett Cancer Center. “We’re not content with just being a part of these exciting developments in cancer care, we want to be pioneering and leading these new advances.”

Study aims to improve pancreatic cancer therapies

Image with caption: Pankaj Singh, Ph.D.

Pankaj Singh, Ph.D.

Pankaj Singh, Ph.D., professor in the Eppley Institute for Research in Cancer and Allied Diseases, is the corresponding author of a paper published this month in the journal “Cancer Cell.”Dr. Singh’s paper, “MUC1 and HIF-1alpha Signaling Crosstalk Induces Anabolic Glucose Metabolism to Impart Gemcitabine Resistance to Pancreatic Cancer,” is visible on the journal’s website until Aug. 29.

This is the first study published in the journal that originated from UNMC. “Cancer Cell” is a top-tier journal in the field of cancer research with a 27-impact factor.

Pancreatic cancer strikes more than 53,000 people in the U.S. each year. The one-year survival rate of people with pancreatic cancer who do not have surgery is 29 percent and the five-year survival rate is 7 percent.

Poor survival in pancreatic cancer is due in part to modest response to the existing therapies. Current therapies include mimetics of nucleosides, which get modified and make DNA.

One such mimetic is gemcitabine, which has been used as a therapy, alone or in combination with other drugs, for decades. Studies from Dr. Singh’s lab establish a novel, widely-prevalent mechanism describing how cancer cells respond poorly to therapy by developing resistance.

Resistance to gemcitabine is mediated by a protein called Hypoxia-Inducible Factor1 (HIF1) alpha that changes how cancer cells take up nutrients and increase the levels of nucleosides in cancer cells. Such increased levels of nucleosides dilute the therapy levels in cancer cells and tumors respond poorly.

The recent study in “Cancer Cell” demonstrates that combining gemcitabine with other therapeutic treatments, specifically digoxin or Leflunomide, will decrease resistance to therapy in pancreatic cancer patients. Additionally, imaging for sugar uptake by tumors also demonstrates that pancreatic tumors with high sugar uptake respond poorly to chemotherapies and perhaps would benefit from the novel combination therapies tested in the manuscript in pre-clinical models.

In addition, the manuscript was selected as the issue highlight and received a special commentary from Chi Van Dang, M.D., Ph.D., an eminent scientist in the field of cancer biology.

“The published studies were truly inter- and intra-institutional collaborative studies and would not have been feasible without contributions from each of the basic and clinical investigators who are coauthors on the paper,” Dr. Singh said. “I really appreciate the supportive research environment at the Fred & Pamela Buffett Cancer Center, especially the Specialized Program of Research Excellence (SPORE) leadership by Dr. Tony Hollingsworth and overall support by Dr. Ken Cowan.”

The research also highlights the role of MUC1 mucin protein in causing therapy resistance in pancreatic tumors. An array of technological platforms, such as mass spectrometry-based steady-state metabolomics and kinetic flux metabolomics of stable isotopes, patient-derived xenografts, and CRISPR techniques, which are routine in the lab, were utilized in these studies.

This research was supported by a grant through the American Association for Cancer Research (AACR) and the Pancreatic Cancer Action Network (PanCAN) as well as multiple National Cancer Institute grants.

Remarkable Recovery: Local boy thriving after triple organ transplant

Alex Leach had never had food or even tried water in his life. But now, after a triple organ transplant, Alex’s life is brand new. But as you’ll see in this story from WDAY, his zest for life will never change.

Robotic Thyroid Surgery Doesn’t Leave a Visible Scar

We’re One of a Few Academic Medical Centers Offering Robotic Thyroidectomies

Katie O’Callaghan was working the checkout line at her parents’ grocery store in Hastings, Nebraska, when a customer noticed a lump on O’Callaghan’s neck. The 24 year old, who was four months pregnant with her first child, brought it up at her next OB/GYN appointment. A biopsy later revealed she had thyroid cancer.

Estelle Chang, MD.

Estelle Chang, MD

“I couldn’t believe it,” says O’Callaghan. “Being pregnant with my first child was intimidating enough, let alone discovering I had cancer.”

Wanting a second opinion, O’Callaghan was referred to Estelle Chang, MD, an otolaryngology head and neck surgeon at Nebraska Medicine, who completed a six-month Advanced Robotic Head and Neck Endocrine Surgery Fellowship at Severance Hospital of the Yonsei University Health System in Seoul, South Korea. During her fellowship, Dr. Chang studied the latest, minimally invasive, thyroid and parathyroid surgery techniques.

“Traditionally, thyroidectomy has been performed using a 4 to 8 centimeter incision in the front of the neck, which can leave a visible scar,” explains Dr. Chang. “Robotic thyroidectomy is a minimally invasive surgical technique that is used to remove all or part of a thyroid gland without leaving a visible scar. This is the future and we should be at the forefront.”

At Nebraska Medicine, three robotic thyroidectomy approaches are offered for patients:

  • Underarm
  • Facelift (behind the earlobe)
    • If the patient wants a complete facelift at the end of the procedure, that’s a possibility
  • Through the mouth

    Katie O’Callaghan was shocked to learn at 24 years old, she had thyroid cancer.

    Katie O’Callaghan was shocked to learn at 24 years old, she had thyroid cancer.

“We can tailor to the patient, depending on the size of the tumor and the patient’s physical characteristics,” explains Dr. Chang. “This type of surgery is a great option for Caucasians who tan easily, African-Americans and Asians. They all tend to have a difficult time with scarring.”

Not wanting a scar on her neck, O’Callaghan opted for Dr. Chang to perform the facelift approach. For the safety of the baby, surgery was put on hold until after O’Callaghan gave birth to her son. On May 22, O’Callaghan became the first patient to undergo a robotic thyroidectomy at Nebraska Medicine. Dr. Chang made the incision behind O’Callaghan’s earlobe and surgery took approximately three hours. O’Callaghan was kept overnight for observation and released the next day.

“I knew I was in good hands at Nebraska Medicine,” says O’Callaghan. “Currently, I have no cancer in my body and I feel great. By looking at me, you’d never know I had thyroid surgery. I’m really happy with the outcome.”

Thyroid nodules are very common and occur in approximately 30 percent of all people in the United States. By the age of 60, more than half of women will have a thyroid nodule. The vast majority of the nodules are benign, with about 5 to 10 percent being cancerous. Symptoms of thyroid cancer can involve swollen lymph nodes in the neck, difficulty swallowing or breathing – but most patients don’t experience any symptoms.

“While thyroid cancer can be seen in people of any background, age or gender, most cases occur in women, people less than 55 years old, and those with Caucasian or Asian backgrounds,” says Nebraska Medicine surgical oncologist Abbey Fingeret, MD. “Fortunately, in most cases, it can be completely cured with surgery.”

Abbey Fingeret, MD

Abbey Fingeret, MD

Dr. Fingeret is currently the only endocrine surgery fellowship-trained surgeon in the state of Nebraska. She completed her fellowship at Harvard University and Massachusetts General Hospital, performing more than 500 thyroid operations. Dr. Fingeret also finished a three-month Advanced Robotic Endocrine Surgery Fellowship in South Korea. This summer, she looks to perform her first robotic thyroidectomy at Nebraska Medicine.

“I truly believe in the mission of Nebraska Medicine,” says Dr. Fingeret. “We are here to offer state-of-the-art care, where the patient always comes first. It’s my honor and privilege to be part of this exceptional team of ancillary staff, clinicians and researchers.”

“Nebraska Medicine treats all aspects of thyroid ailments and endocrine-related disorders,” adds Harris Frankel, MD, chief medical officer. “We have a large and experienced multidisciplinary team, which includes physicians from ENT, Endocrinology, General Surgery and Cancer Services. When you walk in the door, you can be seen by an endocrinologist and thyroid surgeon on the same day.”

We are one of a few academic medical centers in the country offering robotic thyroidectomies. Patients with multiple medical problems who shouldn’t be under anesthesia for extended periods of time are not ideal candidates. Robotic surgery can also be used to remove other benign masses of the neck, such as lipomas and thyroglossal duct cysts.

Patient Shares Emotional Story of Her Quest for a Kidney

Below is a Blog Written by Kimberly Pilar, Kidney Transplant Patient

I was first diagnosed with kidney failure in January 2004 when I was just 20 years old. I was in my third year of college at the University of South Dakota in Vermillion. Everything changed that day. I was no longer a normal college student. Before I knew it, I was sent back home to Sioux City, Iowa, and was admitted to the hospital. From there, I learned my kidney function was at just 7 percent. I started peritoneal dialysis right away. I was told I needed a kidney transplant to regain a normal life. I was speechless. No one in our family had a history of kidney failure. The search began for a donor.

Kimberly and her cousin, Theresa (in pink), who donated her kidney to her.

Kimberly and her cousin, Theresa (in pink), who donated her kidney to her.

I received my first kidney transplant at Nebraska Medicine. My cousin, Theresa – who was only 25 at the time – offered to give me one of her kidneys. It is an incredible gift and the words “thank you” just seem so small. On Nov. 2, 2004 (Election Day), we underwent our surgeries. I was completely terrified of all the things that could happen. Not Theresa (Or not that she would show me.). She was my rock that day. I looked at her strength and tried to gather my own. For her. For her sacrifice.

Our surgeries were a great success. Theresa and Kenny (the kidney) gave me my life back. I no longer needed to do peritoneal dialysis. Recovery took some time but it was worth the pain.

In 2009, we were devastated when Theresa was diagnosed with breast cancer at just 29 years old. I watched this vibrant, beautiful woman become frail and sick. It was heartbreaking. She fought hard for three years but lost her battle with cancer June 4, 2012. Even today, talking about her brings tears to my eyes. It breaks my heart every day that I couldn’t save the woman who saved me. All I could do was be there for her every day and show her how much I loved her. That also made the gift she gave me even more special. I was able to give life to a piece of her.

So you can imagine my heartbreak when I began losing her gift. I was getting fevers every night for about a week. Only at night. During the day I felt fine, so I waited a week to call my transplant coordinator. She suggested I come to Omaha. It was Halloween night, 2014. I went through several tests and was later admitted to the hospital. I spent our 10-year “kidney-versary” in the hospital trying to save Theresa’s kidney. They couldn’t find a reason for the fevers and decreased kidney function. I went home for about a week before going back to Nebraska Medicine. This time it was three weeks of tests. They finally figured out after an endoscopy and colonoscopy that I had somehow contracted a virus called CMV. It is a very dangerous virus and my counts were off the charts. The virus attacked my transplanted kidney and began to kill it off. They started me on hemodialysis in hopes to rejuvenate my kidney. We spent a couple months hoping it would bounce back but it didn’t. They said I would need another kidney transplant. My heart broke that my piece of Theresa was dying and needed to be replaced.

For two and a half years, I waited. Bag packed just in case I got the call. I had visited another transplant center in Des Moines, Iowa, and was told it would be hard to match me with a donor due to high antibodies in my system. They told me I was looking for a needle in a haystack and that search could be 5 to 10 years. We were all devastated. Theresa’s sister started a Facebook page looking for donors called “Kidney 4 Kimmy.” I had a great response from the Facebook page. People from all over the country were reading my story. If just one person decided to register as an organ donor, I consider the page a success.

Kimberly is seen here with her brothers.

Kimberly is seen here with her brothers.

On June 28, 2017 I received the call I was waiting for at 11:20 p.m. I ran downstairs to my roommate and woke her up while still on the phone with Nebraska Medicine. I could barely speak. Was this really happening? I had to have my roommate call my parents – as I was crying. My parents drove to my house, picked me up and by midnight, we were on our way to Omaha. We arrived about 1:45 a.m. and were taken right into a room. I went through some blood work for final cross-matching and X-rays. Some doctors and nurses came in to talk us through what was going to happen in the next few hours. They needed to make sure the donor kidney was viable for transplantation and everything matched me.

At about 10:15 a.m., the transplant surgeon, Arika Hoffman, MD, said everything looked great and we were ready for surgery. By 10:30 a.m., we were being taken to Pre-op. It seemed like a whirlwind. Next thing I remember was waking up in my room with a new kidney. I am so very thankful to the entire team at Nebraska Medicine. The surgeons, nephrologists, nurses, care techs – everyone was so amazing and supportive over my five-day stay.

I remember looking at my mom the day we left and crying on her shoulder. I still couldn’t comprehend what had just happened. I had waited for this moment for over two and a half years and it was now over. All that was left was to heal and praise God for the gift I was given.

I did not know my donor. I will never be able to know him/her. I will never be able to hug them and thank them for the gift they have given me. I hope to one day meet their family and thank them for the amazing life they allowed me to have thanks to their lost loved one.

I want to thank my parents, brothers and their families, my entire extended family and friends for all the love, support, and prayers offered to me over the last 13 years.

To Nebraska Medicine, I couldn’t imagine having my second transplant anywhere else and am so happy to call you family. Dr. Hoffman and fellow surgeons, Dr. Clifford Miles and staff, you are truly amazing and my lifesavers. I will never be able to thank you enough. Every nurse and care tech on the Solid Organ Transplant Unit was truly incredible. I couldn’t have made the progress I did without you all.

Thank you, thank you, thank you.

Kimberly Pilar

Kidney Transplant Recipient

Effective Parkinson’s Management Requires Comprehensive Care by Multidisciplinary Team

Danish-Bhatti.jpg

Danish Bhatti, MD

The needs of Parkinson’s patients are very diverse and become even more complex as the disease progresses.

“If we can get to them early on, we can initiate changes that are so important in making meaningful impact,” says Danish Bhatti, MD, neurologist and co-director of the Parkinson’s Disease Clinic at Nebraska Medicine, along with John Bertoni, MD, PhD.

The Parkinson’s Disease Clinic is a multidisciplinary clinic designed to provide comprehensive care by a team of specialists trained and experienced in treating Parkinson’s patients including physical therapists, speech therapists, occupational therapists, nutritionists, social workers and case managers.

Parkinson’s disease is the second most common neurodegenerative disease after Alzheimer’s disease and usually occurs in individuals after age 60. The disease typically advances slowly and affects movement, muscle control and balance. People with Parkinson’s may develop a tremor, slow movement, loss of balance, stiffness of the limbs, speech problems and difficulty swallowing.

“When the disease reaches a moderate stage, the movement problems become more pronounced, medication benefits may become less predictable and non-motor symptoms begin to worsen, such as swallowing difficulty, low blood pressure, sleep problems, mood and memory issues,” notes Dr. Bhatti. “This disease really takes a comprehensive, multi-disciplinary team to handle. We are here to collaborate with a patient’s primary care doctor and be involved in a patient’s care as much or as little as needed.”

“Proper diagnosis is the first step to begin proper treatment,” says Dr. Bhatti. “Unfortunately, Parkinson’s disease is sometimes misdiagnosed. Approximately 70 percent of Parkinson’s patients have tremors, which can be confused with one of many different tremor disorders. Because the other 30 percent of patients may not have tremors severely or at all, the diagnosis is even more difficult for these patients.”

Most people with Parkinson’s can get significant control of their symptoms with medications and a combination of other therapies, including: occupational therapy, speech therapy, nutrition counseling, support groups and regular exercise.

Beginning a regular exercise program early in the disease process can provide significant benefits to Parkinson’s patients and is important to continue as the disease progresses, says Dr. Bhatti. “People who are independent after 10 years are the ones who were very physically active early in the disease,” he says. “The more active you are, the less likely you are to have severe symptoms.”

Nebraska Medicine offers several exercise programs taught by certified instructors that are geared specifically for Parkinson’s patients and are recognized nationally. These include PWR! Parkinson Wellness Recovery® and the Lee Silverman Voice Treatment (LSVT) BIG® therapy program. PWR! helps patients with Parkinson’s disease improve function and slows motor deterioration by retraining sensory, motor and cognitive functions through intensive exercise and patient empowerment.

The LSVT BIG therapy program is a speech treatment program for individuals with Parkinson’s and other neurological conditions that can help improve vocal loudness, intonation and voice quality. Recent research studies have documented the effectiveness of this therapy in improving common problems such as disordered articulation, diminished facial expression and impaired swallowing.

“While we don’t have a cure for Parkinson’s, we continue to make progress in treatment,” says Dr. Bhatti. “There are newer forms of symptomatic therapy and new delivery methods, which are dramatically improving the control of symptoms.”

Some of these treatments are aimed at previously untreatable symptoms, such as medication for low blood pressure and hallucinations designed specifically for Parkinson’s patients. In addition, traditional medications like levodopa, can now be delivered through a stomach tube with a pump to provide more continuous and even control of symptoms.

Nebraska Medicine also offers other very effective therapies for Parkinson’s disease including chemodenervation with botulinum toxin and deep brain stimulation surgery. Deep brain stimulation uses mild electric impulses to stimulate the brain and block the signals that cause Parkinson’s symptoms such as tremors. It involves implanting a wire in one of several areas of the brain.

“The device is like a pacemaker for the brain. We are the leading medical center in the whole region that performs this procedure and have had great results,” says Dr. Bhatti.

Nebraska Medicine is also involved in several groundbreaking studies that are intended to slow the progression of Parkinson’s disease. “I believe we are on the verge of finding such therapy,” says Dr. Bhatti. “We encourage patients to seize opportunities to participate in clinical trials.”

Nationwide, approximately 60,000 Americans are diagnosed with Parkinson’s disease each year. The incidence of Parkinson’s disease in Nebraska and across the Midwest is higher than most states. According to the Nebraska Parkinson’s Disease Registry, in 2014 alone, 576 new cases were registered with Parkinson’s disease at the average age of 73 years and more than 13,000 patients have been registered since data collection started.

While the cause of Parkinson’s is still unknown, there is evidence connecting the disease to genetics, lifestyle and environmental factors such as exposure to pesticide chemicals, and head trauma.

“Ultimately, our goal is to do everything possible to provide great care to Parkinson’s patients in a multidisciplinary model,” says Dr. Bhatti. “This is one in which primary care physicians, therapists and movement disorder neurologists are all on one team – fighting with the patient and standing by their side.”

One of the Largest Living-Donor Kidney Transplant Chains

Nine Donors and Nine Recipients Meet Face-to-face for the First Time

All 12 of the donors and recipients attended the June 8 press conference.

All 18 donors and recipients attended the June 8 press conference.

Fourteen weeks after being part of the largest internal living-donor kidney transplant chain in Nebraska history, 18 people from different cities, states and backgrounds met face-to-face for the first time. The week of Feb. 27, nine patients received kidneys at Nebraska Medicine — Nebraska Medical Center from nine living donors. Previously, the largest internal living-donor kidney transplant chain here was a three-way exchange in July 2016.

This 18-person chain marks one of the largest single center kidney transplant chains involving a pediatric recipient in the United States. It’s also one of the largest single center kidney transplant chains performed in the U.S. in which none of the recipients were on hemodialysis (where a machine filters the patient’s blood outside their body). A 52-year-old Omaha woman, who wanted to donate her kidney in memory of a friend, started the chain.

Arika Hoffman, MD, became emotional while discussing the rare event.

Arika Hoffman, MD, transplant surgeon, became emotional while discussing the rare event.

“Without her, this never would have happened,” explains Arika Hoffman, MD, transplant surgeon. “One selfless act of an anonymous donor impacted the lives of 18 people.”

That woman is Sue Venteicher, a wife, mother and grandmother, who worked as a phlebotomist at Nebraska Medicine in 1988, before making the switch to Children’s Hospital & Medical Center.

“We can always do something for somebody else. It’s not the things you have – it’s the things you do for other people. Donating my kidney has been a wonderful experience,” says Venteicher. “When I worked at Nebraska Medicine, I always thought, ‘I could give my kidney to somebody.’ But at the time, I was busy having babies, so the idea went on the back burner.”

After raising her seven children, the opportunity to donate a kidney presented itself. Michael Peters was a former patient that Venteicher cared for at Children’s. He received a heart transplant as an infant and now needed a kidney transplant. Venteicher was tested – but unfortunately, wasn’t a good match. Peters received a kidney from a different donor in the summer of 2016. Shortly after, the transplant failed and his health problems worsened. Peters died in January at the age of 20. One month later, Venteicher donated her kidney to an anonymous recipient at Nebraska Medicine in honor of Peters.

Once the transplant team knew Venteicher was willing to start a kidney transplant chain, the planning process began in October 2016 and took about five months. Patient names were matched and rearranged several times on a large board in the transplant offices. The transplant team referred to this board as the Board of Hope – as it gave people a chance to receive living-donor transplants that otherwise would not.

The woman who started the chain, Sue Venteicher, was presented a unique "Tree of Life" necklace by

The woman who started the chain, Sue Venteicher, was presented a unique “Tree of Life” necklace by transplant surgeon Alexander Maskin, MD.

A kidney chain is an approach to living-donor transplantation in which an anonymous donor comes forward to donate a kidney to someone they do not know, starting a chain of events where patients with incompatible donors swap kidneys for a compatible one. Kidney transplants from living donors last much longer and tend to do better postoperatively. If individuals are open to doing a chain, the transplant team actively looks for exchanges.

“We have an obligation to get as many people transplanted as possible – especially with the scarce resource of deceased kidney donors. Exchanges and chains are the way to do that,” explains Dr. Hoffman. “The most exciting part about this chain was that it included recipients who were very difficult to match.”

“Many hours were spent at the Board of Hope, plotting, planning and finding potential matches,” says Vicki Hunter, Kidney/Pancreas Transplant manager. “We had to make sure everyone was healthy enough to participate. If a single person dropped out, the entire chain would fall apart.”

The morning of Feb. 27, Venteicher walked into the Nebraska Medical Center to start the chain. Two transplants were performed each day on Feb. 27 and 28, March 1 and 2, with the final transplant happening on March 3. Transplant surgeon Alexander Maskin, MD, performed the donor surgeries (known as a donor nephrectomy) and Dr. Hoffman transplanted them into the recipients. The chain included five patients who had not yet started dialysis, four who had a difficult time finding a match, and one person who was transplanted off the wait list. None of the recipients knew who gave them a kidney – until now.

On June 8, the 18 people involved in the chain finally met.

“This is our labor of love,” says Hunter. “It wouldn’t be possible without the living donors putting complete trust in the transplant team and saying ‘yes’ to the option of a chain. The donors didn’t know who they would ultimately give a kidney to, but they knew the end result was their intended recipient being transplanted.”

6-12 Kidney Chain wide of presser

Nebraska Medicine – Nebraska Medical Center is home to one of the most reputable and well-known organ transplant programs in the country. Since 1970, the organization has performed more than 1,000 living-donor kidney transplants. Nebraska Medicine transplants more patients on peritoneal dialysis (where the lining of the abdomen filters blood inside the body) than any other program in the world. It also performs more deceased donor kidney transplants on individuals who are nearing – but not yet started on dialysis – than any other program in the country.

Each year, the number of patients needing kidney transplantation increases while the number of deceased donors has remained about the same. If you’d like more information about becoming a living kidney donor, visit www.nebraskamed.com/kidneydonor.

For more on the celebration, watch our video below.

6-12 Kidney Chain Graphic JPG

Bariatric Surgery: A Growing Solution for Obesity

Obesity is a national health issue in this country with more than one third of all U.S. adults considered to be overweight. Bariatric surgery has become a growing solution for obese individuals.

“For many obese individuals, surgery provides the most effective long-term solution for weight loss when other methods have failed,” says Vishal Kothari, MD, bariatric surgeon at Nebraska Medicine’s Bariatrics Center. The Bariatrics Center is the most comprehensive program in the region offering medical weight loss, placement of a weight loss balloon, bariatric surgery and a meal replacement plan all in one location. The program is designed and directed by physicians who are fellowship-trained in medical weight management and bariatric surgery and are supported by a multidisciplinary team of specialists.

Vishal-Kothari-General-Surgery.jpg
Vishal Kothari, MD

“Approximately 80 to 90 percent of our patients have kept their weight off after five years,” says Dr. Kothari. “On average, people can expect to lose 60 to 70 percent of excess body weight, which can be 100 pounds or more.” Like any weight loss plan, patients have to make lifestyle changes to make it work including exercise and adopting healthy eating habits.

“One of the key aspects of the program that makes it different from many others is that we take a holistic approach to our care and follow our patients for life,” says Dr. Kothari. “After surgery, we follow them closely for the first 18 months and then annually to help keep them healthy and motivated. We work closely with their primary care doctor to check weight and nutrition, recommend labs and address any issues such as nutritional deficits, medical issues and any excess weight gain so we can help our patients stay on track.”

We also understand that a successful transition to lifelong healthy living requires more than just losing the weight and may require the support of other specialists, notes Dr. Kothari. As a result, the Bariatrics Center also includes medical nutritionists, an exercise specialist and a clinical psychologist to support a patient’s medical, physical and mental health throughout the process.

In addition to weight loss and improved quality of life, there are other reasons a patient and his or her physician may want to think about weight loss surgery. “Increasing evidence shows that it can help reduce a person’s risk for a number of serious diseases like diabetes, heart disease, arthritis and cancer,” notes Dr. Kothari.

Depending on the type of surgery and the amount of weight loss, bariatric surgery has been shown to improve or resolve diabetes in 50 to 85 percent of patients; reduce sleep apnea by 90 percent; lower high blood pressure by 60 percent; decrease joint pain by 60 to 70 percent; and drop high cholesterol by 60 percent. Bariatric surgery patients also have been shown to live longer than their obese counterparts.

A person may be considered for surgery with a BMI over 35 with other obesity-related health conditions, or a BMI over 40 and has tried various weight loss plans with no results.

The most commonly performed bariatric surgeries at the Bariatric Center include laparoscopic adjustable gastric band, laparoscopic sleeve gastrectomy and laparoscopic roux-y-gastric bypass. All of the surgeries are performed laparoscopically, which means they involve making several small incisions that are closed with only a few stitches, resulting in fewer complications and a much quicker recovery time for patients.

The Bariatrics Center at Nebraska Medicine also offers a newer, noninvasive bariatric procedure that can be performed endoscopically and is an alternative to traditional bariatric surgery. Orbera® gastric balloon is a reversible, nonsurgical weight loss procedure providing obese patients with another option to achieve significant weight loss when regular methods of diet and exercise have not worked, and traditional bariatric surgery isn’t a fit for them, says Dr. Kothari. “The procedure is very safe, can be performed as an outpatient and requires minimal recovery time,” he says.

“The health and quality of life benefits these patients receive from bariatric surgery and other weight loss methods are tremendous,” says Dr. Kothari. “They are more mobile, feel better about themselves, have less depression and have better family, social and work lives.”

The Bariatrics Center at Nebraska Medicine is nationally accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), a combined program of the American College of Surgeons (ACS) and American Society for Metabolic and Bariatric Surgery (ASMBS). The designation recognizes surgical programs with a demonstrated track record of favorable outcomes in bariatric surgery. Clinical research shows that the most experienced and comprehensive bariatric surgery programs have much lower rates of complication.

Nebraska Medicine Announces Availability of Breakthrough New Treatment for Patients with Peripheral Artery Disease

Nebraska Medicine is among the first in the United States to offer a new treatment recently cleared by the U.S. Food and Drug Administration (FDA) to provide relief for patients suffering from the painful symptoms of peripheral artery disease, or PAD – a condition caused by a build-up of plaque that blocks blood flow in the arteries of legs or feet.

The device, Avinger’s Pantheris™ lumivascular atherectomy system, is an innovative image-guided therapy that, for the first time ever, allows physicians to see and remove plaque simultaneously during atherectomy – a minimally invasive procedure that involves cutting plaque away from the artery and clearing it out to restore blood flow.

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Nebraska Medicine vascular surgeon David Vogel, MD,
is now able to see and remove plaque simultaneously.

Because the Pantheris device incorporates real-time optical coherence tomography (OCT) imaging on a therapeutic catheter – like having a small camera on the tip of the device – physicians are able to remove this plaque more precisely than ever before, with less risk of damage to the artery walls which can result in aggressive scarring that greatly increases the risk of restenosis, or re-narrowing of the artery. In the past, physicians have had to rely solely on X-ray as well as touch and feel to guide their tools while they try to treat complicated arterial disease.

For patients, this safe and more-precise treatment may potentially reduce the need for follow-up procedures and stents.

“Peripheral artery disease greatly impacts quality of life, with patients experiencing cramping, numbness, discoloration and pain,” said David Vogel, MD, a vascular surgeon at Nebraska Medicine. “The Pantheris technology is on the front lines. Nebraska Medicine is the only hospital in the region using it. We’re helping lead the way.”

Clinical results confirm that the technology is safe and effective: a 130-patient study showed a target lesion revascularization rate of just 8 percent, and not a single event of vessel perforation, clinically significant dissection or late aneurysm resulted from Pantheris. In addition, this radiation-free technology may help minimize radiation exposure to clinicians and patients by decreasing use of fluoroscopy.

Peripheral artery disease affects nearly 20 million adults in the U.S. and over 200 million people globally. PAD is caused by a build-up of plaque in the arteries that blocks blood flow to the legs and feet. Often dismissed as normal signs of aging, symptoms of PAD include painful cramping, numbness or discoloration in the legs or feet. PAD can become so severe and difficult to address with traditional treatments that patients and physicians often resort to undergoing invasive bypass surgeries, which can result in even higher health risks and lengthy, painful recoveries. In severe cases, patients often face amputation, the worst-case scenario associated with PAD.

Atherectomy is a minimally invasive treatment for PAD in which a catheter-based device is used to remove plaque from a blood vessel. Lumivascular technology utilized in the Pantheris system allows physicians, for the first time ever, to see from inside the artery during a directional atherectomy procedure by using an imaging modality called optical coherence tomography, or OCT. In the past, physicians have had to rely solely on X-ray as well as touch and feel to guide their tools while they try to treat complicated arterial disease. With the lumivascular approach, physicians can more accurately navigate their devices and treat PAD lesions, thanks to the OCT images they see from inside the artery.

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