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Title: Positioning Academic Pathology for the Future:


1
  • Positioning Academic Pathology for the Future
  • Research Challenges
  • Annual Meeting of APC
  • July 24, 2004

Stephen J. Galli
sgalli_at_stanford.edu
2
Research Challenges
  • Mission To improve the diagnosis, treatment
    and basic understanding of human disease by
    clinical service, education and research.
  • What is Pathology Research?
  • Funding and Other Resources
  • Recruitment/Retention/Mentoring
  • Goals for Pathology Research
  • From Stanford Deptartment of Pathology
    Strategic Planning Retreat, Sept. 8, 2001.

3
Pathology (pa-thol??-je ) n. pl. -gies
Websters II New College Dictionary (The
Websters You Need!), Houghton Mifflin Company,
Boston, 1995, pg. 805.
4
Pathology (pa-thol??-je ) n. pl. -gies
  • 1. The branch of medicine concerned with the
    study of the nature of disease and its causes,
    processes, development, and consequences.

Websters II New College Dictionary (The
Websters You Need!), Houghton Mifflin Company,
Boston, 1995, pg. 805.
5
Pathology (pa-thol??-je ) n. pl. -gies
  • 1. The branch of medicine concerned with the
    study of the nature of disease and its causes,
    processes, development, and consequences.
  • Anatomic or functional manifestations of disease
    pathol?ogist n.

Websters II New College Dictionary (The
Websters You Need!), Houghton Mifflin Company,
Boston, 1995, pg. 805.
6
Pathology (pa-thol??-je ) n. pl. -gies
  • The branch of medicine concerned with the study
    of the nature of disease and its causes,
    processes, development, and consequences.
  • Anatomic or functional manifestations of disease
    pathol?ogist n.

patho- or path- pref. N.Lat. lt Gk. ltpathos,
suffering. Disease suffering ltpathogengt
Websters II New College Dictionary (The
Websters You Need!), Houghton Mifflin Company,
Boston, 1995, pg. 805.
7
Spectrum of Research in Department of
Pathology(SoM/SU Service Centers run by
Pathology)
BASIC (Stanford Proteomics Integrated
Research Facility)
(Transgenic Mouse Core) TRANSLATIONAL
(Stanford Tissue Bank) (Histology Core)
CLINICAL
  • Stem cells
  • Cell cycle regulation
  • Oncogenes
  • Leukocyte homing
  • Protein evolution
  • RNAi (Genome defense mechanisms)
  • Immunotyping of lymphomas
  • Cyclosporin mechanism
  • Microarrays and cancer
  • Mouse models
  • Fly Models
  • (PD, AD)
  • Dx support for transplants
  • AIDS/CMV screening of blood supply
  • Flow cytometry for HIV other viral nucleic
    acids
  • Molecular/Genetic Pathology
  • Dendritic cell trials

8
Funding and Other Resources
  • Funding Sources
  • NIH (guarded forecast)
  • Biopharma/Industry (strings)
  • Practice Surplus (we hope!)
  • Other Resources
  • Facilities (aka space)
  • Faculty
  • Trainees (residents, clinical fellows,
  • postdocs, graduate students, etc.)
  • Non-faculty administrative technical staff

9
Recruitment/Retention/Mentoring
  • Define goals (especially type(s) of research
    relationship to other entities, e.g.,
    institutes or other IDPs)
  • Decide whether you will hire
    non-pathologists or non-MDs (and for which
    faculty tracks ?)
  • Attempt to optimize the total compensation
    package and research environment
  • Mentor monitor Roles compensation of
    faculty, trainees (e.g., PI, Co-I, collaborator,
    other, etc.)


10
Goals for Pathology Research

11
By the end of May (83), Stanford
University Hospital became the only major medical
center in the US to decide to start testing blood
for evidence of AIDS infection Some said it was
a gimmick Ibid, pg. 308.
Ed Engleman, MD
The tall, lanky Englemanwho bore a striking
resemblance toChevy Chase
And the band played on Politics, people, and
the AIDS epidemic, Randy Shilts, Penguin Books,
New York, 1987, pg.307.
12
Arend Sidow, PhD
13
Biocomputation Project in Arend Sidows Lab
to Annotated Gene Trees
to Predictions of Structure and Function
and their Visualization
From Curated Alignments
Protein Phylogenies and Evolutionary Rates
  • The definitive database of eukaryotic protein
    evolution
  • Highly curated global alignments of orthologs and
    closely related paralogs
  • Evolutionary relationships of proteins and
    species
  • Inference of functional regions in proteins by
    quantification of constraints
  • Local rates of evolution within proteins
  • Distinction of structural from functional
    constraints
  • Estimates of the deleteriousness of human cSNPs
  • Tree-based multivariate analysis of
    physicochemical characteristics of each position
    in all alignments
  • Position-specific physicochemical constraints
  • Comparative analyses of noncoding DNA in
    mammalian genomes
  • Establishing location of functional elements
  • Estimates of constrains on functional elements

p53 bound to DNA. Color is strength of
physicochemical constraints inferred by ProPhylER
analysis. Blue most, red least constrained.
PNAS 2002. 992912-2917 Cell 2002.
11113-16.
14
Matt Bogyo, PhD
15
Activity Based Probes for Profiling of Protease
Function
In Vivo Imaging
Biochemical Profiling
Matthew Bogyo, Ph.D.
Cancer
Malaria
- Cancer Cell, 2004, 9912963-68 - Mol. Cell,
2004, 101 811-16 - Science, 2002, 298 2002-2006
- Chem. Biol., 2002, 91085-1094 - PNAS, 2001,
982967-2972
16
Jeff Axelrod, MD, PhD
17
Planar cell polarity signaling and oncogenic Wnt
signaling Jeffrey D. Axelrod M.D., Ph.D.
Generation of cellular asymmetry (Axelrod, 2001
Genes Dev 15 1182-1187)
Global control of orientation (Yang et al. 2002
Cell 108 675-688 Ma et al. 2003 Nature 421
543-547)
Planar cell polarity
Mathematical modeling (Amonlirdviman et al.,
submitted to Science)
An intercellular feedback loop (Tree et al. 2002
Cell 109 371-381)
18
Bingwei Lu, PhD
19
Neural Stem Cell Behavior and Neurodegenerative
Disease ModelingBingwei Lu, Ph.D.
Neural stem cell (NSC)
NSC
Wild type
tau
Expression of Alzheimers disease (AD)-associated
Tau gene leads to degeneration of Drosophila
eye Cell 2004. 116671-682

Different types of neurons
Self-renewing asymmetric division of Drosophila
NSCs Cell 1998. 95225-235 Nature 2001.
409522-525

Wild type
Pael-R
Expression of Parkinsons disease (PD)-associated
Pael-R gene in Drosophila brain causes loss of
dopamine neurons Neuron 2003. 37911-924

20
Jon Pollack, MD, PhD
21
Analyzing gene copy number expression in
cancer to improve understanding, Dx and Rx of
the diseases
Jonathan Pollack, MD, PhD
- Nat Genet, 1999, 23 41-46 - PNAS, 2002,
9912963-68 - PNAS, 2004, 101 811-16 - NEJM,
2004, 3501605-16
22
Matt van de Rijn, MD, PhD
23
High throughput studies of mRNA and protein
expression in human tumors Matt van de Rijn,
M.D., Ph.D.
Modern Pathology, 2001 7686-694. The Lancet,
2002 3591301-7. American Journal of Pathology,
2002 1611557-65. American Journal of
Pathology, 2002 1611991-6. American Journal of
Pathology, 2003 1631449-56. American Journal of
Surgical Pathology, 2003 2758-64 American
Journal of Pathology, 2003 1632383-95. Molecular
Biology of the Cell, 2004 15649-656 Diagnostic
Molecular Pathology, 2004, in press. American
Journal of Surgical Pathology, 2004, in
press. American Journal of Pathology, 2004, in
press.
24
Iris Schrijver, MD
25
Iris Schrijver, M.D. __ PATIENT
SPECIFIC CARE____ __ Mutation analysis
Genotype to phenotype New diagnostic tools
  • Research interests Genotype-phenotype
    correlations in
  • Cystic fibrosis, hearing loss, FV deficiency,
    prothrombin mutations, mitochondrial disorders.
  • EXAMPLE Cystic fibrosis (CF)
  • Non-Caucasians gt 50 of the local population
  • Mutations undetected due to panels with few
    mutations
  • Frequency of mutations in non-Caucasians unknown
  • Focus on identification of novel mutations in
    Asians
  • (Schrijver, et al., AJMG - in press), and
    Hispanics
  • (Schrijver, et al., JMD - revising).
  • APEX-based DNA diagnostic microarrays (three
  • provisional patents for CF, hearing loss,
    HNPCC). For CF

gt mRNA/protein effects gt Genotype-phenotype
correlations
gt Comprehensive, affordable diagnosis
prognosis and treatment targeted to the unique
patient family-specific genetic counseling
26
  • Andy Fire, PhD

27
Genome Defense Mechanisms Andrew Z. Fire,
Ph.D. How do cells identify certain genetic
information as "unwanted"? How does "unwanted"
status lead to silencing? Can we apply genome
defense mechanisms to develop therapeutic tools?
 Do genome defense mechanisms have specific
roles in nomal and disease states?
One Prominent Set of Defense Mechanisms RNAi
28
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29
Research Recognition of Pathology Faculty
  • California Scientist-of-the-Year ( many more)
    (Irv Weissman)
  • Crawfoord Prize (Eugene Butcher)
  • Genetics Soc. of America Medal, Myenburg, NAS Mol
    Biol, Wiley, Passano, Aventis Heineken
    Prizes/Awards (Andy Fire)
  • Most Outstanding Investigator in VA (Larry Eng,
    Gene Butcher)
  • Benjamin Castleman Award (Roger Warnke)
  • National Academy of Sciences, USA
  • (Jerry Crabtree, Andy Fire, Irv Weissman)
  • Accademia Nazionale dei Lincei, Italy (Steve
    Galli)
  • Investigator, HHMI (Jerry Crabtree)
  • Pluto Club (Association of University
    Pathologists) (9)
  • Association of American Physicians
  • (Eugene Butcher, Mike Cleary, Ed Engleman,
    Steve Galli)
  •   Was 2, until Irvs position was voluntarily
    relinquished

30
From Program for Annual Meeting of ASCP,
October, 7-10, 2004, San Antonio, Texas
31
The potential of this technology is enormous
(especially for research), but cost other
issues (e.g., sensitivity, specificity, etc.)
must be addressed before it will become useful
for standard diagnostic testing.
  • From
  • Program
  • for
  • 2004
  • ASCP
  • Meeting

32
The Evolution of Diagnostic Pathology (Cont.)

33
Anatomic Pathology Profile
  • Steady increases in numbers of surgical
    pathology/cytopathology cases
  • National/international reputation for diagnostic
    excellence 30 of surgical pathology cases
    sent from outside of SUMC (Ron Dorfman, Dick
    Kempson)
  • Highly regarded ACGME-accredited clinical
    fellowships (CP, DP, HP, NP MGP), as well as
    popular fellowships in surgical pathology
    immunopathology
  • Outstanding translational/clinical research
    (e.g., immunophenotyping of lymphomas
    transcriptional profiling/classification of
    neoplasms)

34
Clinical Pathology Profile
  • Large increases in number complexity of tests
  • Consolidated Lab Admin and LPCH SHC Labs
  • Substantial financial benefits to hospitals
  • Productivity Top 20 of all UHC Columbia HCA
    Hospitals
  • Improved cost/test (down 27.7 since FY98)
    while gross revenue for the hospitals increased
    from 122 to 176 million (30)
  • Generated increased cumulative net
    margin/savings for the hospitals of 60.6
    million from FY98 to FY03
  • New outreach business added 12.9 million net
    revenue from FY99-03, with 5.1 million in FY03
    alone (75 of contribution margin to the
    hospitals)
  • Outside agencies rank quality among highest in
    U.S.
  • CAP, JCAHO, AABB, FDA and California State
  • From S. Galli/S. Lu 2003 report to SHC (11-5)
    LPCH (12-11) Medical Boards

35
Stanford Blood Center Profile (2003)
Mission To support research and teaching
programs in transfusion medicine, and provide
blood products and related services of the
highest quality to the Stanford community
  • 19.6 million budget (excluding grants)
  • 190 Employees (160 operational 30 academic)
  • 4 faculty, 1 CE
  • 24 K square feet over three sites (will move main
    operations from Welch Rd. to Hillview Ave.)
  • 134,000 transfusable blood products (plus
    research products) in 2003 ( 40 increase
    2000-2003)
  • Histocompatibility/genetic testing (supports
    growing programs in BM solid organ
    transplantation)
  • Clinical advances (first AIDS screening in world
    , first CMV screening, first dendritic cell
    clinical trial)
  • See And the band played on Politics, people,
    and the AIDS epidemic, Randy Shilts, Penguin
    Books, New York, 1987, pp.307-9, 346-7 410-11.

36
Education in the Department of Pathology
  • Medical students (All)
  • Post sophomore fellows (2)
  • Graduate students (23)
  • Housestaff (residents clinical fellows)(29)
  • Post-doctoral fellows (61)
  • Medical Technologists
  • Clinical Colleagues

37
Education Medical/Graduate/Undergraduate
Students
  • Human Health Disease (12 hours/week, 3
    quarters/year)
  • Sophomore medical students
  • Pathology, Pharmacology, Physiology
    Microbiology
  • Three Immunology and Biology courses cross-listed
    in other departments
  • Advanced Immunology (2 courses)
  • Immunology for Medical Students
  • Three graduate and medical student electives
  • Molecular Mechanisms of Disease
  • Early Clinical Experience in Pathology
  • DNA Repair and Mutagenesis
  • One undergraduate sophomore seminar
  • Final Analysis The Autopsy As a Tool of Medical
    Inquiry

38
Education - Housestaff
AP or CP only 24 months structured
training 12 months flexible training (Up
to 3 years of research training) Combined
AP/CP 18 months structured AP training 18
months structured CP training 12 months
flexible training ACGME-Accredited Clinical
Fellowships Cytopathology (new 2004),
Dermatopathology, Hematopathology, Molecular
Genetic Pathology (new 2003) and
Neuropathology Department provides funding
backstop (e.g., until KO-8 Award) for these
programs trainees are encouraged to consider any
suitable laboratory at Stanford (SoM, SoE, HS,
etc.) for their research training.
39
This years pathology residents (7),
clinical fellows (9) post-sophomore student
fellows (2)
40
Community Outreach by Pathology Faculty
Dr. Vogel Takes a Brain to School On March
25, 2004, Hannes Vogel, Director of
Neuropathology, spent 2 hours with the 5th
graders at Gideon Hausner Jewish Day School. I
really enjoyed seeing a real brain. It felt
nothing like I predicted. My love of anatomy has
doubled.
41
Faculty/Staff by Lines (CEs, MCL,
UTL)/Rank/Location

SHC Dan Arber, MD Ellen Jo Baron, PhD David
Bingham, MD David Cassarino, MD, PhD James
Faix, MD Magali Fontaine, MD, PhD Sharon
Geaghan, MD Tracy George, MD Lawrence Tim
Goodnough, MD Neeraja Kambham, MD Richard
Kempson, MD James Malone, MD Yaso Natkunam,
MD, PhD Kent Nowels, MD Bruce Patterson, MD
Iris Schrijver, MD Uma Sundram, MD, PhD Megan
Troxell, MD, PhD Maurene Viele, M.D. Robert
West, MD, PhD James Zehnder, MD
  • Stone Complex
  • Jeff Axelrod, MD, PhD
  • Gerald Berry, MD
  • Matthew Bogyo, PhD
  • Michael Cleary, MD
  • Andrew Fire, PhD
  • Heinz Furthmayr, MD
  • Stephen J. Galli, MD
  • Michael Hendrickson, MD
  • John Higgins, MD
  • Peter Jackson, PhD
  • Sabine Kohler, MD
  • Christina Kong, MD
  • Joe Lipsick, MD
  • Teri Longacre, MD
  • Don Regula, MD
  • Richard Sibley, MD
  • Arend Sidow, PhD
  • Howard Sussman, MD

PAVAHCS Eugene Butcher, MD Luis Fajardo, MD
Jon Kosek, MD Bingwei Lu, PhD Robert Rouse,
MD Raymond Sobel, MD
Blood Center Ed Engleman, MD Steven Foung,
MD Susan Galel, MD F. Carl Grumet, MD Dorothy
Nguyen, MD
CCSR Sara Michie, MD Jon Pollack, MD, PhD
Beckman Gerald Crabtree, MD Irv Weissman,
MD KEY TO FACULTY RANK Assistant Professor
5/8 Associate Professor 4/14 Full Professor
16/6
LPCH Athena Cherry, PhD Tina Cowan, PhD
Melanie Manning, MD
42
Faculty/CEs Locations after Hillview Move
16/55 SUMC faculty/CEs (29) will have
main office off-site

David Bingham, MD David Cassarino, MD,
PhD Magali Fontaine, MD, PhD Lawrence Tim
Goodnough, M.D. Neeraja Kambham, MDRichard
Kempson, MD James Malone, MD Yaso Natkunam, MD,
PhD Kent Nowels, MD Uma Sundram, MD, PhD Megan
Troxell, MD, PhD Maurene Viele, MD Robert West,
MD, PhD
  • Stone Complex SHC
  • Jeff Axelrod, MD, PhD
  • Gerald Berry, MD
  • Matthew Bogyo, PhD
  • Michael Cleary, MD
  • Andrew Fire, PhD
  • Heinz Furthmayr, MD
  • Stephen J. Galli, MD
  • Michael Hendrickson, MD
  • John Higgins, MD
  • Peter Jackson, PhD
  • Sabine Kohler, MD
  • Christina Kong, MD
  • Joe Lipsick, MD
  • Teri Longacre, MD
  • Don Regula, MD
  • Richard Sibley, MD
  • Arend Sidow, PhD
  • Howard Sussman, MD

PAVAHCS Eugene Butcher, MD Luis Fajardo, MD Jon
Kosek, MD Bingwei Lu, PhD Robert Rouse,
MD Raymond Sobel, MD
Hillview North (Blood Center) Ed Engleman,
MD Steven Foung, MD Susan Galel, MD F. Carl
Grumet, MD Dorothy Nguyen, MD
Hillview South (SHC Labs) Dan Arber, MD Ellen Jo
Baron, PhD James Faix, MD Sharon Geaghan,
MD Tracy George, MD Bruce Patterson, MD Iris
Schrijver, MD James Zehnder, MD Athena Cherry,
PhD Tina Cowan, PhD Melanie Manning, MD
CCSR Sara Michie, MD Jon Pollack, MD, PhD
Beckman Gerald Crabtree, MD Irv Weissman, MD
43
SHC Dan Arber, MD
Faculty w/ 2ndary/Courtesy Appointments
Stone Complex Jeff Axelrod, MD, PhD Gerald Berry,
MD
15/53 ( 28) of faculty w/ 2ndary

Ellen Jo Baron, PhD Med
PAVAHCS Eugene Butcher, MD Luis Fajardo, MD Jon
Kosek, MD Bingwei Lu, PhD Robert Rouse,
MD Raymond Sobel, MD
Matthew Bogyo, PhD MI pending
David Bingham, MD David Cassarino, MD, PhD James
Faix, MD Magali Fontaine, MD, PhD
Michael Cleary, MD Ped
Andrew Fire, PhD Gen
Heinz Furthmayr, MD
Sharon Geaghan, MD Ped
Stephen J. Galli, MD MI
Tracy George, MD
Michael Hendrickson, MD John Higgins, MD
L. Tim Goodnough, MD Med
Neeraja Kambham, MDRichard Kempson, MD James
Malone, MD Yaso Natkunam, MD, PhD Kent Nowels, MD
Blood Center
Peter Jackson, PhD MI
Ed Engelman, MD Med
Sabine Kohler, MD Derm
Steven Foung, MD Susan Galel, MD F. Carl Grumet,
MD Dorothy Nguyen, MD
Christina Kong, MD
Joe Lipsick, MD Gen
Bruce Patterson, MD Med
Teri Longacre, MD Don Regula, MD Richard Sibley,
MD
Iris Schrijver, MD Uma Sundram, MD, PhD Megan
Troxell, MD, PhD Maurene Viele, MD Robert West,
MD, PhD
CCSR
Sarah Michie, MD Jon Pollack, MD, PhD
Arend Sidow, PhD Gen
Howard Sussman, MD Matt van de Rijn, MD, PhD
James Zehnder, MD Med
Beckman Gerald Crabtree, MD DB Irv Weissman, MD
DB also NeuroS Biol. Sci. (HS)
LPCH Athena Cherry, PhD
Hannes Vogel, MD Ped
Tina Cowan, PhD Ped
  • Teresa Wang, PhD
  • Roger Warnke, MD

Melanie Manning, MD
44
Department of Pathology Summary
  • Outstanding faculty, trainees staff in basic
    science, translational clinical fields
  • Strong record in interdisciplinary research,
    clinical service, education citizenship
  • Provides important clinical research services
    to SUMC/SU Diagnostic services (including
    outreach programs in AP CP) transfusion
    medicine Stanford Blood Center and Transgenic
    Mouse, Tissue Bank, Histology (soon) Proteomics
    Cores
  • Contributor to many interdisciplinary programs
    (e.g., SCCI,Cancer Biology IDP, Ca Biol Prog
    Ped)
  • Currently in the black, and with significant
    potential to increase further revenues and
    contribution margin
  • Pathology is not listed in USNWR

45
Anatomic Clinical Pathology Clinical Service
Issues
  • Need for additional faculty/CEs Increasing test
    volume and complexity, but historical
    approach, in department, of limiting number of
    clinical faculty)
  • Faculty non-faculty staffing recruitment/
    retention Highly unfavorable market forces
    especially for non-faculty staff
  • Laboratory information systems Currently, there
    are 8 systems! replacement in progress
  • Improve further service operations Challenges
    of split leadership structure for
    hospital-owned labs
  • Improve Pathology Service/Laboratory/Blood
    Center involvement in strategic planning To
    accommodate current needs while enabling
    effective execution of SHC/LPCH strategic plans

46
Goals Defined at Strategic Planning Retreat
  • Research Sustain excellence Begin Annual
    Research Retreats Enhance/Establish New Cores
    Support Interdisciplinary Programs (e.g., Cancer
    Biology IDP) Establish Awards Committee
  • Patient Care Increase faculty/CEs in targeted
    areas, especially in CP Work with SHC/LPCH to
    expand lab outreach program Relocate Blood
    Center expand operations
  • Education Increase academically-oriented
    trainees (CP only track/pre-K08 research
    support) Increase diversity Establish new
    ACGME fellowships (Cytopathology Mol/Genetic
    Pathology)
  • Citizenship As above (underlined sections)
    Start Community Outreach Program
  • September 8, 2001 or added subsequently ()

47
Faculty/Staff (CEs, MCL, UTL) New since Jan.,
1999

SHC Dan Arber, MD Ellen Jo Baron, PhD David
Cassarino, MD, PhD James Faix, MD Magali
Fontaine, MD, PhD Tracy George, MD Lawrence
Tim Goodnough, MD Neeraja Kambham, MD James
Malone, MD (0.5 FTE) Yaso Natkunam, MD, PhD
Bruce Patterson, MD Iris Schrijver, MD Uma
Sundram, MD, PhD Megan Troxell, MD, PhD
Maurene Viele, MD (0.5 FTE) Robert West, MD,
PhD
  • Stone Complex
  • Matthew Bogyo, PhD
  • Andrew Fire, PhD
  • Stephen J. Galli, MD
  • John Higgins, MD
  • Christina Kong, MD
  • NEW ( Pathologists)
  • CEs 7 ( 6)
  • MCL 15 ( 12)
  • UTL 5 ( 2)

PAVAHCS Bingwei Lu, PhD
Blood Center Dorothy Nguyen, MD
CCSR Jon Pollack, MD, PhD
Beckman KEY TO CURRENT RANK of NEW
FACULTY Assistant Professors 11 Associate
Professors 4 Full Professors
5
LPCH Tina Cowan, PhD Melanie Manning, MD
(0.5 FTE)
48
Stanford Blood Center (SBC)Historical Perspective
  • 1980 1990 2000 2003
  • Whole blood 6,600 27,700 37,700 51,
    000
  • donations
  • Products 18,900 77,100 95,400 134,00
    0
  • Infectious
  • disease
  • markers 3 8 11 11

49
Comparative Blood Pricing Bay Area Blood
CentersJune, 2004
  • Stanford BCP
    American Red Cross
  • LRBC 186 199 - 209
    240
  • Platelet
  • Apheresis 550 574 - 660
    497
  • Based on survey of local hospitals including
    Good Samaritan, OConnor, CPMC, SF General, St
    Marys

50
Palo Alto WeeklyHealth Notes June 9, 2004
  • Stanfords (kidney) transplant program was rated
    statistically No. 1 this year in its one-year
    survival outcomes. The 125 adult patients who
    underwent kidney transplantation . . . had a
    one-year kidney survival of 99 percent.
  • A key element in avoiding graft rejection is the
    quality of pre-transplant compatibility testing,
    all of which is performed by the Stanford Blood
    Centers Histocompatibility Laboratory.

51
Liver, Kidney and Pancreas Transplant Services
Strategic PlanFebruary 20, 2004
  • Although the program is poised for
    incremental growth, it is possible for the
    program to double in volume in the next two to
    three years . . .

52
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53
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54
Stanford Molecular Pathology Laboratory
55
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56
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57
Department of Pathology _at_ Stanford
  • Interdisciplinary by definition
  • Interdepartmental by need choice (to
    achieve its 4 missions)
  • Creates the future in research and clinical
    practice
  • Provides SUMC, and regional, national
    international clients, with clinical services of
    high quality

58
Increasing need for SBC Support(based on SHC
clinical projections)
  • 25 increase in Histocompatibility testing
    over the next 5 years to support transplant
    programs
  • 5 increase in blood production per year over
    the next 5 years to support transplant, cancer
    and cardio-vascular surgery programs
  • _________________________________________
  • In one 14 day period in Feb. 2004, the
    Stanford Transplant Program performed 13 liver
    transplants requiring over 1,000 total blood
    products (red cells, platelets and plasma).
  • This represents 3 days of blood collection and
    production for the Stanford Blood Center.

59
I really enjoyed seeing a real brain. It felt
nothing like I predicted. My love of anatomy has
doubled.
60
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61
Department of Pathology _at_ StanfordPhilosophy
Goals
  • Emphasize the importance, and interconnection, of
    all 4 components of our mission
  • Communicate with/listen to colleagues, staff
    trainees
  • Define positions/roles ( establish/monitor
    programs, cores) based on missions
  • Recruit/retain the best qualified individuals for
    these specific positions/roles programs
  • Conduct open searches without artificial screens
    (e.g., being a pathologist or an MD)
  • Create/maintain an environment in which talented
    and committed people can succeed celebrate
    reward success
  • Promote honesty, equity, diversity respect
  • Have fun, recognize our good fortune

62
Stanford Department of Pathology
  • Mission To improve the diagnosis, treatment
    and basic understanding of human disease by
    clinical service, education and research.
  • Research Advance basic, translational
    clinical research in pathology and related
    fields
  • Patient Care Provide pathology diagnostic
    services blood products of the highest quality
  • Education Teach medical graduate students,
    residents fellows, and foster the development
    of leaders in pathology and related fields
  • Citizenship Contribute to the success of
    Stanford University Medical Center and Stanford
    University, and to the well being of all those
    people and communities we serve.
  • From Dept. of Pathology strategic planning
    retreat, Sept. 8, 2001.

63
Stanford Department of Pathology
  • Mission To improve the diagnosis, treatment
    and basic understanding of human disease by
    clinical service, education and research.
  • Research Advance basic, translational
    clinical research in pathology and related
    fields
  • Patient Care Provide pathology diagnostic
    services blood products of the highest quality
  • Education Teach medical graduate students,
    residents fellows, and foster the development
    of leaders in pathology and related fields
  • Citizenship Contribute to the success of
    Stanford University Medical Center and Stanford
    University, and to the well being of all those
    people and communities we serve.
  • From Dept. of Pathology strategic planning
    retreat, Sept. 8, 2001.

64
PATHOLOGY DEPT. LEADERSHIP GROUP Chair Steve
Galli Associate Chairs Research, Mike Cleary
Faculty Affairs, Steven Foung Education, Don
Regula Laboratory Services, Richard Sibley
DFA, Rob Krochak
  • Stanford Blood Center
  • Director Edgar Engleman
  • Manager Vince Yalon
  • Associate Director for Clinical Services
    Susan Galel
  • Assoc. Director Steven Foung
  • Director, HLA/Tissue Typing Lab F. Carl
    Grumet
  • (4 Faculty, 1 CE)
  • PAVAHCS Pathology
  • Chief Luis Fajardo
  • (AP CP) (6 Fac., 3 CEs)
  • Research (17 Faculty)
  • Conducted in Stone Complex, CCSR, Beckman,
    PAVAHCS, Stanford Blood Center
  • Cores
  • Transgenic Mouse Mike Cleary
  • Tissue Bank Jonathan Pollack
  • Histology Hannes Vogel
  • Proteomics/Mass Spec
  • Matt Bogyo Peter Jackson
  • Pathology Service (SHC/LPCH/Outreach)
  • Service Chief Chair (Service AP CP
    Components)
  • Autopsy Service Don Regula (names listed
    Service Director/s only faculty on that
    service)
  • Neuropathology Service Hannes Vogel
  • Surgical Pathology (including subspecialties
  • Cytopathology) Mike Hendrickson R. Sibley
  • Clinical Pathology (including Transfusion
    Medicine)
  • Medical Director Richard Sibley
  • Co-Director (Pediatric Testing) Sharon Geaghan
  • Chemistry/Immunology Jim Faix
  • Hematology/BM Dan Arber Residency
    Program
  • Microbiology Ellen Jo Baron Jim
    Faix, S. Galli
  • Virology Bruce Patterson
    Teri Longacre
  • Coagulation Jim Zehnder
  • Molecular Pathology Iris Schrijver J.
    Zehnder
  • Cytogenetics Tena Cherry
  • Clinical Biochemical Genetics Tina Cowan
  • Transfusion Maurene Viele (int.)/ L. Tim
    Goodnough
  • Faculty/CEs with Clinical Roles _at_SHC/LPCH
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