Overview
As a practicing cardiothoracic anesthesiologist, I have contributed to the better understanding of the management and of perioperative thrombosis (particularly HIT). This has been as a Duke site PI for the Rare Thrombotic Diseases Consortium led by Dr T.L Ortel and a clinical collaborator with the basic and translational science approach to HIT led by Dr G Arepally. I have also championed novel approaches to dealing with perioperative HIT such as plasmaperesis.
Similarly, I have been a local leader in establishing management of transfusion approaches to major cardiac surgery including the novel introduction of autologous plateletpheresis to limit exposure to allogeneic platelet transfusions in this highly transfused population, identifying the transfusion requirements during thoracic aortic reconstruction and promoting use of a lower dose of rFVIIa use in this population, changing established clinical practice.
My research interests focus on perioperative transfusion and hematology concerns. Recently, Dr Kor (Mayo Clinic) and I received a multiple PI R-01 award to evaluate point-of-care/bedside washing of packed red blood cells to reduce perioperative lung injury. This novel repurposing of commonly available “cell-saver” technology is, for most surgical cases, the only practical means of delivering a washed product, and promises to be a critical advancement in perioperative transfusion medicine. I also have a longstanding interest in the rejuvenation of RBCs to normalize oxygen delivery capacity of transfused RBCs. Such a development will be of tremendous importance to transfusion practice, particularly for highly transfused populations and with current threats to blood banking inventory.
In summary, I have dedicated my research career to improving the outcome of patients undergoing cardiothoracic surgery, understanding perioperative coagulopathy, and optimizing transfusion practice.
Current Appointments & Affiliations
Recent Publications
Impact of Point-of-care allogeneic red blood cell washing on markers of transfusion-related respiratory complications: A phase II randomized clinical trial.
Journal Article Anesthesiology · April 14, 2025 BACKGROUND: Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) are leading causes of transfusion-related morbidity and mortality. Soluble factors in red blood cell (RBC) supernatant may increase risk for th ... Full text Link to item CitePerioperative Bleeding Risk in Lung Transplantation After Previous Cardiothoracic Surgery.
Journal Article Clin Transplant · April 2025 INTRODUCTION: Previous cardiothoracic surgery (CTS) is associated with a significant risk of perioperative bleeding in lung transplantation (LT). The types of prior surgery have not been well-defined. We aimed to quantify the risk of perioperative bleeding ... Full text Link to item CiteThrombin generation after prothrombin complex concentrate or plasma transfusion during cardiac surgery.
Journal Article J Thromb Thrombolysis · February 2025 Thrombin generation (TG) is reduced after cardiac surgery using cardiopulmonary bypass (CPB), contributing to coagulopathy and bleeding. Plasma transfusion or four-factor prothrombin complex concentrate (PCC) are commonly used to treat coagulopathic bleedi ... Full text Link to item CiteRecent Grants
Integrated Training in Anesthesiology Research
Inst. Training Prgm or CMEMentor · Awarded by National Institutes of Health · 1996 - 2026Hematology & Transfusion Medicine (T32)
Inst. Training Prgm or CMEPreceptor · Awarded by National Institutes of Health · 1975 - 2026Cerus/BARDA CLI 00125 ReCePI study
Clinical TrialPrincipal Investigator · Awarded by Cerus Corporation · 2019 - 2024View All Grants