School Notes: School of Medicine
September/October 2007

Transplant program transformed

Yale's section of Organ Transplantation and Immunology recently received a transplant of its own. Sukru Emre, former director of the adult and pediatric liver transplant programs at Mount Sinai Medical Center, in New York, was named section chief. Emre's appointment was made as Yale makes a $12.5 million investment in its transplant section. His mission is to revive a largely inactive liver transplant program while strengthening Yale's kidney and pancreatic transplant sections.

A native of Turkey and a world-renowned transplant surgeon, Emre is recognized for his innovative solutions to clinical problems. He has dealt successfully with the shortage of organ donors though split liver transplants, in which sections of a single liver are used for two patients. Emre's long-term goal is to increase the number of liver transplants at Yale from four or five a year to between 80 and 100; double the number of kidney transplants to 150; and bring the number of pancreatic transplants up to 20.

The clock is ticking on Lyme Disease

Medical school researchers have identified a chink in the lifecycle of the tick-borne bacterium that causes Lyme disease, suggesting a way to stop ticks from carrying the disease. Ticks pick up the bacterium as larvae when they suck blood from mice.  As the tick bites the mouse, it injects a protein that suppresses the mouse's immune response. Erol Fikrig, professor of medicine, epidemiology, and microbial pathogenesis, and colleagues discovered that the bacterium, B. burgdorferi, uses this protein to move from mouse to tick. When the researchers blocked the protein, either by preventing ticks from producing it or by inducing the mice to block it, the bacterium couldn't survive. The findings, published in the inaugural issue of Cell Host & Microbe, in July, could help prevent infections in humans by targeting the bacterium at this early stage in its lifecycle. For more on this story, see "Findings."

From the hospital wards to the halls of Congress

John Barrasso, an orthopedic surgeon who received his medical degree from Georgetown in 1978 and did his residency at Yale medical school, is the new Republican U.S. senator from Wyoming. He was named in June to replace the late Sen. Craig Thomas.

Barrasso, 54, was previously a rodeo physician for the Professional Rodeo Cowboy's Association and a volunteer team physician for Casper College as well as several local high schools. He also served as chief of staff of the Wyoming Medical Center, as president of the National Association of Physician Broadcasters, and as a member of the American Medical Association Council of Ethics and Judicial Affairs. Barrasso, who was twice elected to the Wyoming state senate, believes in "limited government, lower taxes, less spending, traditional values, local control, and a strong defense." His priorities as a U.S. senator include supporting rural health care, promoting energy independence and the agriculture industry, and abolishing the so-called death tax.

Rested doctors make for healthier patients

When medical residents work fewer hours, fewer patients are transferred to intensive care and there aren't as many medication mishaps, according to a Yale School of Medicine study in the Annals of Internal Medicine. The study also found that when residents work shorter shifts, more patients are discharged to their homes or rehabilitation centers rather than to nursing homes. (See Noted, July/August.)

In 2003, the Accreditation Council for Graduate Medical Education implemented regulations limiting residents to 80 hours a week. The rules were intended to reduce errors caused by fatigue, but there was concern that transferring patient care more often could increase errors. Dr. Leora Horwitz, postdoctoral fellow in internal medicine, and colleagues looked at data for patients discharged one year before and one year after these work-hour regulations were instituted. "We found no evidence of adverse unintended consequences after the institution of work-hour regulation," said Horwitz. Besides reducing residents' fatigue, she said, the positive result could be due to the increased clinical involvement of more senior physicians to compensate for the turnover of residents.