Medical Student Research Fellowship for Summer 2007

Mentor: David Markham, MD
Department: Cardiology - Heart Failure / Transplantation
Room number: HA9.133, St Paul University Hospital
Mail Code: 9047
Phone number: (214) 645-7500
E-mail: david.markham@utsouthwestern.edu
Project title: Evaluation of the Efficacy of Treatment Protocols for Panel Reactive Antibody (PRA) Reduction in HLA Sensitized Pre-transplant Patients Bridged with Mechanical Support Devices

Human subjects IRB approved project number (where applicable): 062006-037 (renewing)

Project Type

Patient-based research

Brief Description of Project:

Patients are often bridged to cardiac transplantation by using left ventricular assist devices. However, these patients with assist devices are at increased risk for the development of anti-HLA antibodies. Positive panel reactive antibodies, also termed HLA sensitization or positive PRA, increases the likelihood of having a positive cross match at the time of transplantation, thus prolonging transplant wait times. Sensitization has also been shown to increase rates of rejection and vasculopathy in the post-transplant period. To reduce sensitization, many transplant centers utilize different immunomodulatory therapies; however the utility and efficacy of these therapies are unknown. This is an increasingly difficult and important question in transplant medicine, where more data could be very important.
To further evaluate the utility and efficacy of these therapies (cyclophosphamide, IVIG, plasmapheresis, etc.), we are conducting a retrospective evaluation of the UT Southwestern and Baylor Medical Center experience. We will evaluate and collect retrospective data on demographics, PRAs, treatment types, and post transplant outcomes at both centers. All patients who have had an LVAD are eligible. The student will be exposed to data collection, database maintenance, statistical analysis, and abstract writing under guidance by a cardiology fellow (Dr. Parag Patel) and cardiology attending (Dr. David Markham). There will also be potential for guidance with manuscript development depending on study results. Further, the student will have the opportunity to round with the heart failure transplant team at University Hospital in order to gain further understanding with regard to the clinical implications / importance of this study.

Previous Research Activities or Publications with Medical Students:
N/A