• Highly regarded and renowned in his field of work, Higgins is one of the leading authorities in heart and lung transplantation, minimally invasive cardiac surgery, and mechanical circulatory support. (medscape.com)
  • She now focuses on research connected with mechanical circulatory support, cardiac and lung transplantation, and heart valve disease. (rbht.nhs.uk)
  • You have some patients where it's going to be very difficult to survive no matter what you do," said Entwistle, Jefferson's surgical director of heart transplantation and mechanical circulatory support. (inquirer.com)
  • The virtual ISHLT Academies continued in February 2022 with a LIVE Core Competencies course that featured expert-led education in Basic Science and Translational Research in heart and lung transplantation. (ishlt.org)
  • In 2001, he was named chief of pediatric and congenital cardiac surgery at the Arkansas Children's Hospital in Little Rock, Arkansas. (wikipedia.org)
  • Jonathan M. Chen, MD, is the Co-Director of the Cardiac Center and holds the Mortimer J. Buckley Jr., MD, Endowed Chair in Cardiac Surgery at Children's Hospital of Philadelphia. (chop.edu)
  • Dr. Chen is the Co-Director of the Cardiac Center and holds the Mortimer J. Buckley Jr., MD, Endowed Chair in Cardiac Surgery at Children's Hospital of Philadelphia. (chop.edu)
  • Dr. Chen served as the Chief of Congenital Cardiac Surgery, Co-Director of the Heart Center, Professor of Surgery at the University of Washington School of Medicine, and holder of the Sam and Althea Stroum Endowed Chair in Pediatric Cardiovascular Surgery. (chop.edu)
  • Dr. Chen holds important leadership positions in cardiac surgery organizations and currently serves on the editorial board of the Journal of Thoracic and Cardiovascular Surgery. (chop.edu)
  • He is distinguished as a world class researcher and is acknowledged both nationally and internationally for his research in the areas of heart and lung transplantation and disparities in outcomes in cardiac surgery. (medscape.com)
  • A randomized trial comparing lung-volume- reduction surgery with medical therapy for severe emphysema. (medigraphic.com)
  • After performing cardiac surgery for over ten years and lung transplantation for over twenty years, he made the choice to focus his practice primarily on esophageal surgery. (uthscsa.edu)
  • He is nationally recognized as an expert in performing complex pulmonary and esophageal surgery to include resection of lung and esophageal cancers, redoing previously failed anti-reflux procedures, repairing large diaphragmatic hernias, performing esophageal reconstructions including colon interpositions, and treating end-stage achalasia. (uthscsa.edu)
  • Thoracic surgery is distinct from cardiac surgery at UCLA, and focuses on surgical treatment of the lungs, pleura, diaphragm, and esophagus. (uclahealth.org)
  • Go inside the OR with Dr. Parsia Vagefi, chief of the Division of Surgical Transplantation, to experience a kidney transplant surgery. (utsouthwestern.edu)
  • The theatre department at Harefield Hospital can offer qualified theatre staff an unparalleled opportunity to gain experience in adult cardiothoracic surgery, including transplantation. (rbht.nhs.uk)
  • All aspects of adult cardiac and thoracic surgery are performed and a heart/lung transplantation programme is fully established. (rbht.nhs.uk)
  • Non-cardiac Surgery after Heart Transplantation -- 13. (osu.cz)
  • Kidney Transplantation -- Part VII: Eye, Ear, and Throat Surgery -- 35. (osu.cz)
  • How long does a heart transplantation surgery take? (medicalartsshop.com)
  • A heart-lung bypass machine keeps oxygen-rich blood pumping through the body during the surgery. (medlineplus.gov)
  • Off-pump heart surgery is open-heart surgery on a beating heart without using a heart-lung bypass machine. (medlineplus.gov)
  • This type of heart surgery may or may not use a heart-lung bypass machine. (medlineplus.gov)
  • UCLA is one of the few centers nationally to offer patients the option of surgical pleurectomy and decortication, which spares the lung and offers a significant mortality advantage over extrapleural pneumonectomy. (uclahealth.org)
  • Significant progress has been achieved in improving one-year mortality after heart transplantation. (lidsen.com)
  • Because no data suggest that the presence of cardiac cirrhosis worsens mortality or morbidity rates, direct treatment at the underlying source of elevated right-sided heart pressure and hepatic venous congestion. (medscape.com)
  • Infection is an ever-present threat to the well-being of the lung transplant recipient and is a leading cause of both early and late mortality. (ersjournals.com)
  • Individuals with Fontan circulation are at risk of late mortality from both cardiac and noncardiac causes. (bvsalud.org)
  • Kavita Sharma, Syed Yawer Husain, Pragnya Das, Mohammad Hussain, and Mansoor Ali Syed Despite substantial clinical advances over the past decades, inflammatory lung diseases are a major cause of morbidity and mortality and have become one of the major public health issues across the world. (ebrary.net)
  • INTRODUCTION: Primary graft dysfunction (PGD) is a leading cause of 30-day mortality following heart transplantation, and early intervention in PGD may correlate to improved survival. (lu.se)
  • Cardiac arrhythmias and sudden cardiac death are important late complications of this syndrome. (medscape.com)
  • Conclusions: Cardiac transplant recipients, when treated for gout, are at high risk of therapeutic complications. (monash.edu)
  • Heart problems are the most frequent significant complications after transplantation. (ucdavis.edu)
  • Second, synthetic liver function may be affected, leading to bleeding complications associated with transplantation. (medscape.com)
  • This article will review the major medical complications, excluding allograft rejection, which may be encountered in the lung transplant recipient. (ersjournals.com)
  • While offering a vital therapeutic option for patients with advanced lung disease, LTx remains fraught with complications that threaten both the quality and duration of the recipient's life. (ersjournals.com)
  • In addition toallograft rejection (a topic covered elsewhere in this series), a multitude of medical complications mark the post-transplantation course. (ersjournals.com)
  • Until now, there is no known treatment besides supportive care with ankle foot splints and treatment of respiratory failure with nocturnal home ventilation [7,8] and cardiac failure which are complications of the illness. (fortuneonline.org)
  • However, according to serious complications reported for skeletal myoblast cells transplantation, giving ethical approval for using this cell type in human research requires strict commitment to precise methods (such as inclusion criteria, patient follow-up methods, and prophylactic treatments). (ac.ir)
  • His clinical research has primarily been directed toward surgical issues in complex congenital heart care and cardiac transplantation (focusing on advances with operative techniques, outcomes research and transplantation for congenital heart disease), with a particular emphasis on the development of mechanical ventricular assist devices for children, as well as stem-cell based valved conduits for pediatric application. (chop.edu)
  • In those with cardiac arrest or cardiogenic shock, it appears to improve survival and good outcomes. (wikipedia.org)
  • Background: Outcomes of patients with a prior diagnosis of peri-partum cardiomyopathy (PPCM) undergoing heart transplantation are not well described but may be worse than for women who undergo transplantation for other etiologies. (houstonmethodist.org)
  • The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) Fontan Committee has developed recommended thresholds for advanced heart failure referral to guide primary cardiologists. (bvsalud.org)
  • A cardiologist, cardiothoracic surgeon, trained nursing staff, and pharmacist well trained with titration and side effects of immunosuppressants can significantly improve heart transplantation outcomes. (medicalartsshop.com)
  • Munagala M, Phancao A. Cardiac Allograft Vasculopathy: A Review of Risk Factors and Pathogenesis. (lidsen.com)
  • Long term survival of heart transplant recipients is limited by chronic rejection, cardiac allograft vasculopathy (CAV), and malignancy. (lidsen.com)
  • Freedom from cardiac allograft vasculopathy was similar or higher in the PPCM Group compared with the other groups. (houstonmethodist.org)
  • Survival and freedom from cardiac allograft vasculopathy in patients who receive a transplant for PPCM are no worse than in women who require a transplant for other indications, regardless of parity. (houstonmethodist.org)
  • Donation after Circulatory Death (DCD) organs are being increasingly used for renal, liver and lung transplantation. (whiterose.ac.uk)
  • These recommendations are divided into 4 categories of clinical Fontan circulatory dysfunction including (1) cardiac/systemic ventricular dysfunction, (2) Fontan pathway dysfunction, (3) lymphatic dysfunction, and (4) extracardiac dysfunction. (bvsalud.org)
  • Overview of Arrhythmogenic Cardiomyopathies Although any dilated or hypertrophic cardiomyopathy (see Overview of Cardiomyopathies) can produce cardiac and systemic factors that predispose to a number of different arrhythmias, including. (merckmanuals.com)
  • Forty-three (19%) had pre-transplant gout, 19 recurring post-transplantation. (monash.edu)
  • A Society that Includes Basic Science, the Failing Heart and Advanced Lung Disease. (ishlt.org)
  • Held the day before the start of ISHLT2022, these academies offered a unique opportunity to learn from the world's leading experts in advanced heart and lung disease. (ishlt.org)
  • Although neurocognitive impairment is relatively common among patients with advanced lung disease, little is known regarding changes in neurocognition following lung transplantation. (nih.gov)
  • With diabetes, cardiac disease, and head injury ruled out, we learned that this passenger had high blood pressure and had last taken her blood pressure medication during her layover in Miami. (blogs.com)
  • They determined nearly half of patients enrolled in a PH registry had pulmonary hypertension because of lung disease. (childrenshospital.org)
  • Their findings reflect growing recognition of PH in diverse developmental lung diseases and how improving the phenotyping of a child's DNA sequence, based on these disease-specific characterizations, could improve PH care and research. (childrenshospital.org)
  • 60 years and have normal cardiac and pulmonary function and no history of coronary artery disease or other heart disorders. (msdmanuals.com)
  • More importantly, the small molecular properties of hydrogen enable it can rapidly reaches the alveoli, suggest a unique advantage for lung disease [18]. (researchgate.net)
  • In the clinical arena, our team of clinician scientists has pushed the boundaries of understanding the relationship between lung mechanics, disease pathology, and patient anatomy. (uclahealth.org)
  • In the future, we hope to expand on these new discoveries with larger, multi-center clinical trials that will evaluate novel lung-protective ventilation strategies for patients with significant lung disease. (uclahealth.org)
  • Cardiac transplantation is the definitive treatment for end-stage heart disease. (whiterose.ac.uk)
  • We have a limited understanding of Post cardiac arrest myocardial depression due to the lack of a good physiological model of the disease. (whiterose.ac.uk)
  • Contraindications to transplantation include significant un-correctible coronary artery disease and/or poor cardiac pump function. (ucdavis.edu)
  • If liver disease is too advanced, kidney transplantation alone is not an option. (ucdavis.edu)
  • Dr. Jackson went on to complete the advanced heart failure and transplantation fellowship at the University of North Carolina-Chapel Hill before returning to MUSC as an assistant professor of medicine in the Division of Cardiology.Dr. Jackson is board certified in advanced heart failure and transplant cardiology, cardiovascular disease, echocardiography, and internal medicine. (wellness.com)
  • Dr. Jackson's clinical interests include heart failure, left ventricular assist devices, cardiac transplantation, echocardiography, and cardiac catheterization, and his research interests include the intersection of sleep apnea and cardiovascular disease. (wellness.com)
  • Cardiac transplant is a widely accepted therapy for select patients with end stage cardiovascular disease. (lidsen.com)
  • A minority of persons with long-standing T cruzi infection develop the serious cardiac and gastrointestinal problems that characterize chronic symptomatic Chagas disease. (medscape.com)
  • The post- lung transplant recovery of patients with PH and right ventricular (RV) dysfunction has not been well-detailed, prompting persistent questions about their stay in the hospital during a transplant procedure, as well as their cardiac function after transplantation. (childrenshospital.org)
  • and other researchers found that all transplant PH patients who also had RV dysfunction were shown to have improved right ventricular function following transplantation - justifying the consideration of a lung transplant for pediatric patients with end-stage PH and RV dysfunction. (childrenshospital.org)
  • Objective: To develop a model of in-vivo cardiac arrest and resuscitation in order to characterize the biology of the associated myocardial dysfunction and test potential therapeutic strategies. (whiterose.ac.uk)
  • Hepatic morphology in cardiac dysfunction: a clinicopathologic study of 1000 subjects at autopsy. (medscape.com)
  • Ventricular dysfunction, atrioventricular valve regurgitation, and arrhythmia may directly impact cardiac performance and can progress with time. (bvsalud.org)
  • Cardiac transplantation can be considered for end-stage cardiomyopathy. (medscape.com)
  • Cardiac arrythmia and cardiomyopathy [4,5,6] with congestive heart failure can present in males between ages 20-40 years and explains why BMD have a shorter lifespan. (fortuneonline.org)
  • They should be monitored for cardiac arrythmia and dilated or hypertrophic cardiomyopathy which are potentially treatable [5,6]. (fortuneonline.org)
  • Darren Berman, MD, has been named director of congenital interventional catheterization, leading CHLA's Cardiac Catheterization Lab, which includes two suites and a host of advanced technologies, including ultra-low radiation capabilities and rotational angiography with 3D imaging of the heart and vessels. (medscape.com)
  • Prior to joining CHLA, Berman served as co-director of cardiac catheterization and interventional therapy at Nationwide Children's Hospital in Columbus, Ohio. (medscape.com)
  • Emboli can affect the brain (causing a stroke), the lungs (causing respiratory distress) and/or other organs and body parts. (hopkinsmedicine.org)
  • Cardiac transplantation relies on organs procured from Brain Dead Donors (DBD). (whiterose.ac.uk)
  • The Harefield retrieval team are committed to optimising donor organs for transplantation and utilise the Organ Care System (OCS) to assist with this. (rbht.nhs.uk)
  • Nearly all patients with cardiac sarcoidosis have involvement of other organs (typically the lungs), but cardiac sarcoidosis may rarely occur in isolation. (merckmanuals.com)
  • By providing temporary heart, kidney, or liver support as a bridge-to-transplantation, these biological devices may allow patients to recover end-organ function and await allograft transplantation in a more stable clinical state, thus improving their chances of survival. (cdc.gov)
  • These devices are usually used to assist the left ventricle as interim (bridge-to-transplantation) or long-term (destination) treatment in patients who are not candidates for transplantation. (msdmanuals.com)
  • She trained in cardiology with a subspecialty interest in non-interventional cardiology, echocardiography and cardiac imaging at Papworth, Royal Brompton and St Thomas's hospitals. (rbht.nhs.uk)
  • Smith A, Molloy E, Miletin J, Curley A, Balfe J, Orla F, EL-Khuffash A, 'Longitudinal assessment of cardiac function in infants with Down's syndrome using novel echocardiography techniques-project protocol. (tcd.ie)
  • Echocardiography has become the most useful tool in the diagnosis of cardiac sarcoma, allowing the doctor to see the exact size and location of the tumor. (hopkinsmedicine.org)
  • Patients are more likely to die waiting for a human donor heart than in the first 2 years after transplantation. (cdc.gov)
  • Our analysis aimed to determine the feasibility of measuring cardiac biomarkers from the donor heart in the early phase for use as a predictor of PGD. (lu.se)
  • CONCLUSION: By measuring CK-MB from the coronary effluent in the donor heart, it may be possible to identify patients at increased risk for severe PGD after heart transplantation. (lu.se)
  • Further, the introduction of cyclosporine as the primary immunosuppressive agent for cardiac transplant recipients has resulted in excellent survival rates (85% 1-year survival at most centers) and has decreased illness associated with infection and rejection. (cdc.gov)
  • Objective: To study the clinical impact of gout treatment following cardiac transplantation.MethodsWe performed an audit of all cardiac transplant recipients of the Alfred Hospital before August 1998 who lived in Victoria. (monash.edu)
  • Infection rates among lung transplant recipients appear to be higher than those encountered in other solid organ transplant populations, likely related to the unique exposure of the lung allograft to the external environment and to the greater magnitude of immunosuppression employed 1 , 2 . (ersjournals.com)
  • Increasing clinical experience worldwide has shown that rejection and infection can be managed successfully in most patients who receive human cardiac allografts. (cdc.gov)
  • Alternatives to allograft donors, such as baboon or pig xenografts, require serious investigation if clinical transplantation is ever to meet the current demand and continue the explosive growth pattern it has established over the past quarter century. (cdc.gov)
  • These pump systems more recently have allowed the use of cardiac grafts retrieved from donors after cardiac arrest. (msdmanuals.com)
  • Hearts from DCD donors have not been utilized as there is a fear that they will have sustained irreversible myocardial injury post cardiac arrest. (whiterose.ac.uk)
  • Bone mineral density measurements by dual-energy X-ray absorptiometry (DEXA) of axial and appendicular bone should be performed on all patients prior to transplantation. (medscape.com)
  • Quantifying infective endocarditis risk in patients with predisposing cardiac conditions. (smw.ch)
  • Lung transplantation, like cardiac revascularization procedures, appears to be associated with cognitive decline in a subset of older patients, which could impact daily functioning posttransplant. (nih.gov)
  • The goal is to translate these findings into potential lung-protective interventions that can be evaluated for effectiveness to help patients with these devastating diseases. (uclahealth.org)
  • In cardiac sarcoidosis, the conducting system and/or myocardium are typically involved in patients with clinically apparent cardiac sarcoidosis, but valvular, papillary muscle, and pericardial involvement may also occur. (merckmanuals.com)
  • About 25% of patients with systemic sarcoidosis have cardiac involvement identifiable using imaging techniques, but cardiac involvement is symptomatic in only about 20% of these (5% of all patients with sarcoidosis). (merckmanuals.com)
  • The predilection of cardiac sarcoid involvement of the interventricular septum causes atrioventricular (AV) conduction system blocks in many patients with cardiac sarcoidosis. (merckmanuals.com)
  • Most patients with cardiac sarcoidosis are asymptomatic, but the associated bradyarrhythmias and tachyarrhythmias may cause palpitations, syncope, and sometimes cardiac arrest or sudden death. (merckmanuals.com)
  • A significant number of deaths resulting from systemic sarcoidosis are due to sudden cardiac death, including in many patients who have had no previous indication of cardiac involvement. (merckmanuals.com)
  • However, a study examining the reversibility of cardiac cirrhosis in patients undergoing heart transplant showed that synthetic function significantly improved within 3 months after transplant. (medscape.com)
  • A sensible exercise program is appropriate for most patients with cardiac cirrhosis after medical control of their underlying heart failure. (medscape.com)
  • Transplantation of patients with underlying cystic fibrosis (CF), whose native airways and sinuses are chronically infected with virulent bacterial pathogens, initially raised unique concerns about the potential excessive risk of postoperative infections. (ersjournals.com)
  • Two recent series from North American centres with extensive experience in transplantation of CF patients have documented 1-yr survival rates of 50% versus 83% and 67% versus 96% among CF patients with and without B. cepacia , respectively 7 , 8 . (ersjournals.com)
  • In this cohort of small bowel/multivisceral transplantation patients, there was a high incidence of DSA. (lww.com)
  • To compare the effects of two physical therapy exercise in-hospital programs in pulmonary function and functional capacity of patients in the postoperative period of heart transplantation. (rbccv.org.br)
  • Cardiac rehabilitation (CR) for patients with LVAD or HT has been proposed to improve exercise capacity, skeletal muscle function and quality of life. (eacpr.org)
  • Fecal microbiota transplantation, also known as FMT, is a new way to replenish 'good' bacteria in some cancer patients . (medlineplus.gov)
  • The reemergence of xenotransplantation as a therapeutic option for the hundreds of thousands of people dying each year of heart, kidney, lung, and liver failure has raised ethical, social, and scientific questions. (cdc.gov)
  • Surgical advances, in conjunction with more effective immunosuppressive strategies, have propelled the field of lung transplantation forward and have made intermediate-term survival an achievable goal. (ersjournals.com)
  • In advanced stages of HF (functional classes III and IV), heart transplantation (HT) becomes a treatment able to restore hemodynamic function, improve quality of life and survival. (rbccv.org.br)
  • In the basic science arena, our team, in close collaboration with leading research scientists, is studying the mechanism of ventilator-acquired lung injury in the setting of severe lung pathology. (uclahealth.org)
  • Criteria for the initiation of ECMO vary by institution, but generally include acute severe cardiac or pulmonary failure that is potentially reversible and unresponsive to conventional management. (wikipedia.org)
  • The current radical treatment of severe HF is cardiac transplantation. (ebrary.net)
  • Dr Rahman Haley's doctoral thesis focused on cardiac imaging techniques in women and was completed at Royal Brompton Hospital in the nuclear cardiology and cardiovascular magnetic resonance departments in 2001. (rbht.nhs.uk)
  • One recent case report illustrated the use of TIPSS procedure in a patient with cardiac cirrhosis after heart transplant that resulted in a successful outcome. (medscape.com)
  • Today, heart transplantation has become a relatively routine and commonplace procedure. (medicalartsshop.com)
  • During the procedure, the patient is aided by a heart-lung machine for blood circulation throughout the body. (medicalartsshop.com)
  • Extracorporeal membrane oxygenation ( ECMO ), also known as extracorporeal life support ( ECLS ), is an extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life. (wikipedia.org)
  • Death resulted from respiratory or cardiac failure at a mean age of 42 with the age range of 23-63 years [6]. (fortuneonline.org)
  • To facilitate access to the left hilum during off-pump bilateral lung transplantation we used the Xpose 4 (TM) apical suction device (Guidant Corp., Indianapolis, IN), an off-pump coronary bypass device to luxate the heart out of the pericardium. (rug.nl)
  • There, he became the surgical director of pediatric cardiac and lung transplantation. (wikipedia.org)
  • TBX4 mutations and deletions are associated with abnormal distal lung development, persistent pulmonary hypertension of a newborn, and pediatric pulmonary hypertension , as well as multiple congenital anomalies and developmental disabilities . (childrenshospital.org)
  • Although considerable advances have been made in the field of cardiac xenotransplantation since its first clinical application by Hardy in 1964 (1) , it remains uncertain whether xenotransplantation as destination therapy can be successfully applied to humans. (cdc.gov)
  • One of the major medical advances of the twentieth century is the development of cardiac transplantation. (whiterose.ac.uk)
  • Conclusions: Cardiac arrest and reperfusion lead to calcium cardiac memory, which support cardiomyocyte contractility in the face of post arrest myofilament calcium sensitivity. (whiterose.ac.uk)
  • Generally, it is used either post-cardiopulmonary bypass or in late-stage treatment of a person with profound heart and/or lung failure, although it is now seeing use as a treatment for cardiac arrest in certain centers, allowing treatment of the underlying cause of arrest while circulation and oxygenation are supported. (wikipedia.org)
  • An implantable cardioverter defibrillator (ICD) to help prevent sudden cardiac arrest . (medlineplus.gov)
  • Wanless IR, Liu JJ, Butany J. Role of thrombosis in the pathogenesis of congestive hepatic fibrosis (cardiac cirrhosis). (medscape.com)
  • Congestion may be assessed by lung ultrasound as well as, hepatic, portal vein and venous renal congestion (VEXUS Score) along with trans-mitral inflow and E/e' ratio to estimate LV filling pressures. (springeropen.com)
  • Cardiac sarcoma is a rare type of primary malignant (cancerous) tumor that occurs in the heart. (hopkinsmedicine.org)
  • The symptoms of cardiac sarcoma may resemble other cardiac or medical conditions. (hopkinsmedicine.org)
  • The methods for diagnosing cardiac sarcoma vary, to some degree, based on the symptoms present. (hopkinsmedicine.org)
  • While cardiac sarcoma may cause changes in the heart's rhythm, EKG changes may indicate other heart problems. (hopkinsmedicine.org)
  • Therefore, other diagnostic tools are needed to make a definitive diagnosis of cardiac sarcoma or any other type of heart tumor. (hopkinsmedicine.org)
  • Wildevuur CR, Benfield JR. A review of 23 human lung transplantations by 20 surgeons. (medigraphic.com)
  • UCLA's thoracic surgeons perform a high percentage of lung resections either by video-assisted thoracoscopy (VATS) or with the assistance of a da Vinci surgical robot. (uclahealth.org)
  • When UCLA thoracic surgeons perform segmental lung resection, our real-time bronchoscopy guides their final placement of staples across the correct segmental bronchus. (uclahealth.org)
  • The Division of Surgical Transplantation is an exciting and growing division with leading surgeons, clinicians, and professionals working together to improve patient care. (utsouthwestern.edu)
  • Originally described in association with a large VSD, Eisenmenger syndrome can also manifest with a patent ductus arteriosus (PDA) or, less frequently, with other congenital cardiac anomalies, such as atrioventricular septal defects (AVSDs) and atrial septal defects (ASDs). (medscape.com)
  • He developed a wide range of expertise as noted by his service during his tenure including Surgical Director of Cardiac Transplantation, Surgical Director of Lung Transplantation and Associate Program Director of the Residency Program. (uthscsa.edu)