Scholars@Duke
Jeffrey Keenan

Jeffrey Keenan

Associate Professor of Surgery
Surgery, Cardiovascular and Thoracic Surgery
jeffrey.keenan@duke.edu
2301 Erwin Rd, Durham, NC 27708

Selected Publications

Five-year experience of heart transplantation following donation after circulatory death.

Journal Article J Thorac Cardiovasc Surg · December 2025 OBJECTIVE: The United States' experience with heart transplantation following donation after circulatory death (DCD HT) has expanded since clinical adoption in 2019. We aimed to examine a large institution's outcomes associated with DCD HT versus HT follow ... Full text Link to item Cite

Application of plasma cell-free metagenomic next-generation sequencing for the identification of Aspergillus fumigatus donor-derived infections among solid organ transplant recipients.

Journal Article Med Mycol Case Rep · December 2025 A cluster of Aspergillus fumigatus donor-derived infections (DDI) was rapidly diagnosed using plasma metagenomic next-generation sequencing (mNGS) among solid organ transplant recipients. The heart recipient, experiencing marginal hemodynamics, underwent a ... Full text Link to item Cite

Outcomes among patients bridged to heart transplant with microaxial flow versus durable left ventricular assist device support.

Journal Article J Thorac Cardiovasc Surg · October 9, 2025 OBJECTIVE: To evaluate characteristics and outcomes of patients bridged to orthotopic heart transplantation with microaxial left ventricular assist device (ma-LVAD) versus durable LVAD (d-LVAD). METHODS: This was a single-center retrospective cohort study ... Full text Link to item Cite

Ensuring access to novel donor heart preservation modalities.

Journal Article J Heart Lung Transplant · September 2025 Despite improvements in managing earlier stage heart disease, the population of patients needing heart transplants continues to increase in the United States. Fortunately, novel methods of procuring and preserving donor hearts, including the use of ex-vivo ... Full text Link to item Cite

Out-of-Sequence Donor Heart Allocation: A United Network for Organ Sharing Registry Analysis.

Journal Article J Card Fail · August 7, 2025 BACKGROUND: Out-of-sequence (OOS) allocation is a mechanism by which donor organs are offered outside the standard match run, typically to expedite the placement of hard-to-match or time-sensitive allografts. Rising OOS rates are described in abdominal org ... Full text Link to item Cite

A High-Fidelity Porcine Model of Orthotopic Heart Transplantation Following Donation after Circulatory Death.

Journal Article J Vis Exp · June 6, 2025 The number of advanced heart failure patients who can receive a heart transplant is limited by a shortage of suitable organ donors. In efforts to expand the donor pool, alternative donation and procurement methods have been developed, including heart trans ... Full text Link to item Cite

Surgical Intervention for Outflow Graft Obstruction in Patients With Magnetically Levitated Centrifugal-Flow Left Ventricular Assist Devices.

Journal Article ASAIO J · June 1, 2025 Outflow graft obstruction (OGO) is an under-reported but severe complication after insertion of magnetically levitated centrifugal-flow left ventricular assist devices (LVADs). The optimal treatment and long-term outcomes have not been well-described. We r ... Full text Link to item Cite

Early U.S. Heart Transplant Experience With Normothermic Regional Perfusion Following Donation After Circulatory Death.

Journal Article JACC Heart Fail · December 2024 BACKGROUND: Heart transplantation following donation after circulatory death (DCD HT) has short-term survival outcomes comparable to donation after brain death and has led to a significant increase in transplantation volume. The U.S. experience with the no ... Full text Link to item Cite

Regional variation in donation after circulatory death heart allograft utilization.

Journal Article JTCVS Open · October 2024 OBJECTIVE: Randomized data support transplantation of hearts from donors after circulatory death. This may lead to a sizeable increase in the donor pool. Regional variations in donors after circulatory death heart use were examined to help elucidate barrie ... Full text Link to item Cite

Donor Heart Recovery and Preservation Modalities in 2024.

Journal Article JACC Heart Fail · March 2024 Historically, heart transplantation (HT) has relied on the use of traditional cold storage for donor heart preservation. This organ preservation modality has several limitations, including the risk for ischemic and cold-induced graft injuries that may cont ... Full text Link to item Cite

Techniques in Lung Transplantation

Chapter · January 1, 2023 Lung transplantation remains the gold standard therapy for patients suffering from end-stage lung disease, providing quality of life and prognostic benefits in otherwise severely debilitating, if not imminently fatal conditions. This chapter discusses some ... Full text Cite

Does deeper hypothermia reduce the risk of acute kidney injury after circulatory arrest for aortic arch surgery?

Conference Eur J Cardiothorac Surg · July 30, 2021 OBJECTIVES: The impact of hypothermic circulatory arrest (HCA) temperature on postoperative acute kidney injury (AKI) has not been evaluated. This study examined the association between circulatory arrest temperatures and AKI in patients undergoing proxima ... Full text Link to item Cite

Adjuvant Chemotherapy Improves Survival Following Resection of Locally Advanced Rectal Cancer with Pathologic Complete Response.

Conference J Gastrointest Surg · August 2019 BACKGROUND: Controversy exists over the use of adjuvant chemotherapy for locally advanced (stages II-III) rectal cancer (LARC) patients who demonstrate pathologic complete response (pCR) following neoadjuvant chemoradiation. We conducted a retrospective an ... Full text Link to item Cite

Successful aneurysm resection and coronary artery revascularization following saphenous vein graft aneurysm rupture.

Journal Article Eur J Cardiothorac Surg · March 1, 2019 Saphenous vein graft aneurysms after coronary artery bypass grafting (CABG) have been rarely reported. Their incidence and natural history are poorly defined. Herein, we present a patient who presented acutely with contained rupture of a large saphenous ve ... Full text Link to item Cite

Risk Prediction Model for Major Adverse Outcome in Proximal Thoracic Aortic Surgery.

Journal Article Ann Thorac Surg · March 2019 BACKGROUND: Proximal thoracic aortic surgery utilizing hypothermic circulatory arrest carries risks of mortality and major morbidity; however, these risks are not the same for every patient. The goal of the current study was to establish a risk prediction ... Full text Link to item Cite

Vascular Complications and Use of a Distal Perfusion Cannula in Femorally Cannulated Patients on Extracorporeal Membrane Oxygenation.

Journal Article ASAIO J · 2018 Femoral arterial cannulation in adult venoarterial (VA) extracorporeal membrane oxygenation (ECMO) predisposes patients to ipsilateral limb ischemia. Placement of a distal perfusion catheter (DPC) is one of few techniques available to prevent or manage thi ... Full text Link to item Cite

Outcomes of Reoperation After Acute Type A Aortic Dissection: Implications for Index Repair Strategy.

Conference J Am Heart Assoc · October 3, 2017 BACKGROUND: The optimal surgical approach for management of acute type A aortic dissection remains controversial. This study aimed to assess outcomes of reoperation after acute type A dissection repair to help guide decision making around index operative s ... Full text Link to item Cite

Imaging Surveillance After Proximal Aortic Operations: Is it Necessary?

Journal Article Ann Thorac Surg · March 2017 BACKGROUND: Current guidelines for imaging surveillance after proximal aortic repair are not evidence based. This study sought to characterize the incidence and causes of reintervention after proximal aortic operations to provide data to guide the frequenc ... Full text Link to item Cite

Mitochondrial quality-control dysregulation in conditional HO-1-/- mice.

Journal Article JCI Insight · February 9, 2017 The heme oxygenase-1 (Hmox1; HO-1) pathway was tested for defense of mitochondrial quality control in cardiomyocyte-specific Hmox1 KO mice (HO-1[CM]-/-) exposed to oxidative stress (100% O2). After 48 hours of exposure, these mice showed persistent cardiac ... Full text Link to item Cite

Does moderate hypothermia really carry less bleeding risk than deep hypothermia for circulatory arrest? A propensity-matched comparison in hemiarch replacement.

Journal Article J Thorac Cardiovasc Surg · December 2016 BACKGROUND: Moderate (MHCA) versus deep (DHCA) hypothermia for circulatory arrest in aortic arch surgery has been purported to reduce coagulopathy and bleeding complications, although there are limited data supporting this claim. This study aimed to compar ... Full text Link to item Cite

Neurophysiological Intraoperative Monitoring During Aortic Arch Surgery.

Journal Article Semin Cardiothorac Vasc Anesth · December 2016 Circulatory management during replacement of the aortic arch is complex and involves a period of circulatory arrest to provide a bloodless field during arch vessel anastomosis. To guard against ischemic brain injury, tissue metabolic demand is reduced by s ... Full text Link to item Cite

Complementary roles of open and hybrid approaches to thoracoabdominal aortic aneurysm repair.

Journal Article J Vasc Surg · November 2016 OBJECTIVE: Thoracoabdominal aortic aneurysm (TAAA) repair remains a significant challenge with considerable perioperative morbidity and mortality. A hybrid approach utilizing visceral debranching with endovascular aneurysm exclusion has been used to treat ... Full text Link to item Cite

Surgical Resection of the Primary Tumor in Stage IV Colorectal Cancer Without Metastasectomy is Associated With Improved Overall Survival Compared With Chemotherapy/Radiation Therapy Alone.

Journal Article Dis Colon Rectum · April 2016 BACKGROUND: Controversy exists over whether resection of the primary tumor in stage IV colorectal cancer with inoperable metastases improves patient outcomes. OBJECTIVE: The purpose of this study was to evaluate whether resection of the primary tumor witho ... Full text Link to item Cite

Use of human fibrinogen concentrate during proximal aortic reconstruction with deep hypothermic circulatory arrest.

Journal Article J Thorac Cardiovasc Surg · February 2016 OBJECTIVE: Human fibrinogen concentrate (HFC) is approved by the Food and Drug Administration for use at 70 mg/kg to treat congenital afibrinogenemia. We sought to determine whether this dose of HFC increases fibrinogen levels in the setting of high-risk b ... Full text Link to item Cite

Evolving practice pattern changes and outcomes in the era of hybrid aortic arch repair.

Journal Article J Vasc Surg · February 2016 OBJECTIVE: The role of hybrid repair in the management of aortic arch pathology, and long-term outcomes with these techniques, remains uncertain. We report a decade of experience with hybrid arch repair (HAR) and assess institutional practice patterns with ... Full text Link to item Cite

Electroencephalography During Hemiarch Replacement With Moderate Hypothermic Circulatory Arrest.

Journal Article Ann Thorac Surg · February 2016 BACKGROUND: This study aimed to characterize intraoperative electroencephalography (EEG) during moderate hypothermic circulatory arrest (MHCA) with selective antegrade cerebral perfusion (SACP), which has not been described previously. METHODS: This was a ... Full text Link to item Cite

Feeding jejunostomy tube placement during resection of gastric cancers.

Journal Article J Surg Res · January 2016 BACKGROUND: Feeding tube placement is common among patients undergoing gastrectomy, and national guidelines currently recommend consideration of a feeding jejunostomy tube (FJT) for all patients undergoing resection for gastric cancer. However, data are li ... Full text Link to item Cite

Early Experience with a Novel Cannulation Strategy for Left Ventricular Decompression during Nonpostcardiotomy Venoarterial ECMO.

Journal Article ASAIO J · 2016 Advances in technology for the delivery of venoarterial extracorporeal membrane oxygenation (VA-ECMO) have allowed for its expanded utilization in the treatment of patients with advanced cardiogenic shock, particularly through the use of peripheral cannula ... Full text Link to item Cite

Optimal timing of tracheostomy after trauma without associated head injury.

Journal Article J Surg Res · October 2015 BACKGROUND: Controversy exists over optimal timing of tracheostomy in patients with respiratory failure after blunt trauma. The study aimed to determine whether the timing of tracheostomy affects mortality in this population. METHODS: The 2008-2011 Nationa ... Full text Link to item Cite

Leukopenia is associated with worse but not prohibitive outcomes following emergent abdominal surgery.

Journal Article J Trauma Acute Care Surg · September 2015 BACKGROUND: There are little data currently available to guide surgical decision making regarding emergent surgical interventions in leukopenic patients. The purpose of this study was to investigate the impact of leukopenia among patients undergoing emerge ... Full text Link to item Cite

Long-Term Survival After Bovine Pericardial Versus Porcine Stented Bioprosthetic Aortic Valve Replacement: Does Valve Choice Matter?

Journal Article Ann Thorac Surg · August 2015 BACKGROUND: Bioprosthetic options are increasingly used for surgical aortic valve replacement (AVR). However, current decision making regarding bioprosthetic valve choice is not data-driven given incomplete information on comparative long-term outcomes aft ... Full text Link to item Cite

Inequalities in the use of helmets by race and payer status among pediatric cyclists.

Journal Article Surgery · August 2015 BACKGROUND: Despite nationwide campaigns to increase the use of helmets among pediatric cyclists, many children continue to be injured while riding without a helmet. To determine where programs and policies intended to promote helmet use should be directed ... Full text Link to item Cite

Improving Outcomes in Colorectal Surgery by Sequential Implementation of Multiple Standardized Care Programs.

Journal Article J Am Coll Surg · August 2015 BACKGROUND: The purpose of this study was to examine the impact of the sequential implementation of the enhanced recovery program (ERP) and surgical site infection bundle (SSIB) on short-term outcomes in colorectal surgery (CRS) to determine if the presenc ... Full text Open Access Link to item Cite

Factor VIIa for Annulus Rupture After Transcatheter Aortic Valve Replacement.

Journal Article Ann Thorac Surg · July 2015 Over the last decade, transcatheter aortic valve replacement (TAVR) has emerged as an effective treatment for inoperable and selected high surgical-risk patients with aortic stenosis. However, management of procedural complications with TAVR represents a m ... Full text Link to item Cite

Comparison of aortic annulus size by transesophageal echocardiography and computed tomography angiography with direct surgical measurement.

Journal Article Am J Cardiol · June 1, 2015 This study sought to compare the accuracy of 2-dimensional transesophageal echocardiography (TEE) and computed tomography angiography (CTA) for noninvasive aortic annular sizing as required for transcatheter aortic valve implantation (TAVI). Direct intraop ... Full text Link to item Cite

Management of 1- to 2-cm Carcinoid Tumors of the Appendix: Using the National Cancer Data Base to Address Controversies in General Surgery.

Journal Article J Am Coll Surg · May 2015 BACKGROUND: The management of 1- to 2-cm appendiceal carcinoid tumors remains controversial. Here we use the National Cancer Data Base (NCDB) to compare long-term outcomes for patients treated via resection of the primary tumor alone vs right hemicolectomy ... Full text Link to item Cite

Impact of specific postoperative complications on the outcomes of emergency general surgery patients.

Journal Article J Trauma Acute Care Surg · May 2015 BACKGROUND: The relative contribution of specific postoperative complications on mortality after emergency operations has not been previously described. Identifying specific contributors to postoperative mortality following acute care surgery will allow fo ... Full text Link to item Cite

Laparoscopic versus open low anterior resection for rectal cancer: results from the national cancer data base.

Journal Article J Gastrointest Surg · January 2015 BACKGROUND: While the use of laparoscopy has increased among patients undergoing colorectal surgery, there is ongoing debate regarding the oncologic equivalence of laparoscopy compared to open low anterior resection (LAR) for rectal cancer. METHODS: The 20 ... Full text Link to item Cite

Thoracic endovascular aortic repair for chronic DeBakey IIIb aortic dissection.

Journal Article Ann Thorac Surg · December 2014 BACKGROUND: Thoracic endovascular aortic repair (TEVAR) for chronic DeBakey IIIb dissection with associated descending aneurysm remains controversial. This study examines long-term results of TEVAR for this disorder including examination of anatomic featur ... Full text Link to item Cite

The preventive surgical site infection bundle in colorectal surgery: an effective approach to surgical site infection reduction and health care cost savings.

Journal Article JAMA Surg · October 2014 IMPORTANCE: Surgical site infections (SSIs) in colorectal surgery are associated with increased morbidity and health care costs. OBJECTIVE: To determine the effect of a preventive SSI bundle (hereafter bundle) on SSI rates and costs in colorectal surgery. ... Full text Link to item Cite

The effect of neoadjuvant radiation therapy on perioperative outcomes among patients undergoing resection of retroperitoneal sarcomas.

Journal Article Surg Oncol · September 2014 BACKGROUND: Neoadjuvant radiation therapy (RT) has several theoretical benefits in the treatment of retroperitoneal sarcoma (RPS), but concerns remain about treatment toxicity and perioperative morbidity. There are limited data regarding its effect on peri ... Full text Link to item Cite

Trials of nonoperative management exceeding 3 days are associated with increased morbidity in patients undergoing surgery for uncomplicated adhesive small bowel obstruction.

Journal Article J Trauma Acute Care Surg · June 2014 BACKGROUND: Controversy exists over how long trials of nonoperative management should be pursued in patients with uncomplicated adhesive small bowel obstructions (ASBOs) before deciding to proceed with surgery. The purpose of this study was to determine th ... Full text Link to item Cite

Central Cannulation as a Viable Alternative to Peripheral Cannulation in Extracorporeal Membrane Oxygenation.

Journal Article Semin Thorac Cardiovasc Surg Arterial cannulation for veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) is most commonly established via the aorta, axillary, or femoral vessels, yet their inherent complications are not well characterized. The purpose of this study was to c ... Full text Link to item Cite