Angel Wings on Orlando Medical News

Angel Wings

By: LYNNE JETER

Posted: Monday, January 3, 2011 1:40 pm

Dr. Michael Angelis

Orlando Surgeon Michael Angelis Surpasses Milestone of 500 Transplants at Florida Hospital

When Michael Angelis, MD, was a student at Jefferson Medical College in Philadelphia with a background in microbiology and immunology, he was drawn to surgery as a specialty. (See related story below.)

“When I saw my first liver transplant, I knew right away that’s what I wanted to do,” said Angelis, chief surgical director of transplant services and surgical director of renal transplant services at Florida Hospital, whose clinical specialties include kidney, liver and pancreas transplantation. “What I saw clinically in the patients and operation itself really made me want to go into that field. A transplant represents one of the more technical, complicated surgeries, and brings with it the whole aspect of helping people for whom there are no alternatives. It’s so gratifying to see the recipients transform after a transplant.”

Florida Hospital’s Transplant Team:

· Robert A. Metzger, MD, Chief Medical Director of Transplant Services, a career nephrologist and transplant physician who helped establish the Florida Hospital transplant program in 1973.

· Michael Angelis, MD, Chief Surgical Director of Transplant Services and Surgical Director of Renal Transplant Services, who has been the lead surgeon in more than 500 transplants since joining Florida Hospital in 2003.

· Bobby Nibhanupudy, MD, Surgical Director of Pancreas Transplant Services.

· L. Thomas Chin, MD, Surgical Director of Liver Transplant Services.

· Nikolaos T. Pyrsopoulos MD, PhD, Chief of Hepatology and Medical Director of Liver Transplantation Services.

· Uday Desai, MD, Medical Director of Pancreas Transplant Services.

· Dmitriy A. Nikitin, MD, Multi-Organ Abdominal Transplant Surgeon.

· Trushar B. Patel, MD, Hepatology and Transplant Hepatology.

· Badar Muneer, MD, Hepatology and Transplant Hepatology.

· Barbara Czerska, MD, Medical Director of Advanced Heart Failure, Cardiac Transplant and Mechanical Circulatory Assist Device Programs.

In mid-October, Angelis performed his 500th transplant since joining Florida Hospital in 2003. Afterward, he took vacation time to visit family in Connecticut and Canada.

“I was ready for a break,” said Angelis, who had been the lead surgeon on transplant cases averaging one every four days over the seven-year stretch, with kidneys representing the vast majority of transplanted organs.

By fall, the year had already been a busy one for the Florida Hospital Transplant Center, punctuated by a record-setting weekend during the summer.

On the last weekend in June, Angelis and three transplant physicians—Thomas Chin, MD, Bobby Nibhanupudy, MD, and Dmitriy Nikitin, MD—set a record in Orlando when the Florida Hospital team performed eight transplant procedures—five kidney transplants, three liver transplants and the organ recoveries of two hearts, four livers, four sets of kidneys, and a pancreas—within a 37-hour period. To accomplish such a daunting task, Angelis, Chin, Nibhanupudy and Nikitin retreated to their offices between the transplant surgeries to take brief naps in sleeping bags.

“What we accomplished that weekend,” said Angelis, “is a reflection of the whole team—transplant coordinators, transplant nurse practitioners, anesthesiologists, clinical psychosocial services, floor and intensive care nurses, dieticians, nephrologists, hepatologists, pharmacists, pathologists and more. It took a tremendous amount of work, coordination and commitment. That weekend alone required about 80 nurses and transplant staff. A number of people who were not even on call came in to help out during this record setting process.”

Reaching the 500 transplants mark at Florida Hospital, Angelis noted, is an excellent example of “how individual accomplishments couldn’t be done without the support of the whole team.”

By mid-December, Angelis had completed 10 more local transplants. Before coming to the Florida Hospital Transplant Center from Tufts New England Medical Center in Boston, where he served as director of pancreas transplantation, and before that, Jackson Memorial Hospital in Miami, where he completed an American

Society of Transplant Surgeons-approved fellowship in multi-organ transplantation, Angelis had performed another 200 transplants as the lead surgeon, and had assisted on hundreds more transplant surgeries.

“We also do organ recoveries from deceased people and then do the transplant,” said Angelis, “so we get to see the full spectrum, from the family donating their loved one’s organs to the recipients having a second chance at life. It’s very rewarding.”

Last year, more than 28,000 lives were saved because of organ donors, according to nonprofit United Network of Organ Sharing (UNOS), the contractor for the national Organ Procurement Transplantation Network, which also reported a lengthy waiting list: nearly 100,000 children and adults await organ transplantation.

When Angelis arrived at Florida Hospital in 2003, the transplant center had one surgeon certified to transplant one organ—the kidney—and handled some 100 cases annually. Today, the transplant team has four surgeons, is certified to transplant four organs—kidney, liver, pancreas, and heart—and manages some 250 cases annually.

“Because of this growth, Florida Hospital’s transplant program has risen to become ranked 18th in the nation for all organ transplants,” said Angelis, noting that the transplant team ended 2010 with more than 80 liver transplants, and would probably perform nearly 100 liver transplants in 2011. “Our outcomes are above expectations in general. Specifically, we have one of the best outcomes in terms of our one-year patient graft survival for liver transplants. My goal is to have the best liver transplant program in the state. What’s ironic is that people—the medical community and the general population—in Central Florida don’t realize there’s a liver transplant program here, much less one of the nation’s best … right in their own backyard.”

More than 3,000 patients have received organ transplants at Florida Hospital since the program began nearly 40 years ago, making the Florida Hospital Transplant Center one of the busiest of its kind in the nation. The kidney transplant program was established in 1973; the liver transplant program was added in mid-2007.

“You still see people being reviewed and turned down in other parts of the state,” said Angelis. “Soon after we opened the liver transplant program three and a half years ago, doctors seemed to say, ‘well, we don’t want to send patients there because the program is new.’ Well, we’re not new anymore. Volume-wise, we’re one of the largest liver transplant programs in the country. We have great outcomes.”

Related Story

Leaving a Void

At the 16th annual Florida Hospital Foundation Gala featuring Grammy-winning country artist Josh Turner on Nov. 4, transplant team members congratulated Lawrence McBride, MD, on saving the life of a 25-year-old patient.

McBride, surgical director of advanced heart failure, cardiac transplant and circulatory assist device programs, had been recruited to Florida Hospital earlier in the year to initiate the surgical side of the new heart transplant program.

“The guy (patient) walked out of the hospital, which I thought was incredible, so if Dr. McBride hadn’t been there, this 25-year-old kid would be dead,” said Angelis, chief surgical director of transplant services and surgical director of renal transplant services at Florida Hospital.

Sadly, McBride died suddenly the day before Thanksgiving from sudden cardiac arrest while running on a treadmill. He was 61, adhered to a strict regimen of healthy eating, and outwardly appeared in excellent physical health.

“This was the last person anyone expected this to happen to,” said Keith Naunheim, MD, a longtime friend of McBride, and chief of cardiothoracic surgery at Saint Louis University's School of Medicine, where McBride earned a degree in 1975 and later served as the school’s primary heart transplant surgeon. Because typically one in five heart attack victims have no prior symptoms, “this is, unfortunately, proof that genetics trumps everything.”

McBride’s death left a void much deeper than simply a highly skilled transplant surgeon missing from Florida Hospital’s transplant team and the premature departure of a medical professional who was internationally recognized for his lectures on mechanical circulatory assist devices and cardiac transplantation.

“There’s a whole emotional part of losing a guy like Dr. McBride,” said Angelis, noting that McBride was a bone and tissue donor even though his organs couldn’t be donated. “And he was gifted ... as a surgeon qualified in both heart and lung transplants.”

Last year, the nonprofit United Network of Organ Sharing (UNOS), the contractor for the national Organ Procurement Transplantation Network, gave Florida Hospital’s heart transplantation program the green light. The implementation of its lung transplantation program will be slightly delayed as a result of McBride’s death. Hospital administrators were already in the process of recruiting a second surgeon to assist with heart and lung transplants. Now McBride, who was listed as the surgical director on the UNOS application for lung transplantation that had not yet been submitted, will need to be replaced.

“Dr. McBride’s absence,” said Angelis, “is a great loss personally and professionally. We will bring the lung transplantation program online as soon as possible. He wouldn’t want to see it delayed.”