Anesthesiology & Pain Medicine >> Research >> Focus Areas >> Outcomes >> The Influence of Inhaled Nitric Oxide...
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Research Focus Areas:

The Influence of Inhaled Nitric Oxide on Attenuating Hepatic Sinusoidal Leukocyte-Endothelial Interactions in Patients Undergoing Orthopic Liver Transplantation

Principal Investigators

J.D. Lang, Jr, M.D.


The purpose of this prospective study is to further document the efficacy and safety of inhaled nitric oxide (NO) in decreasing damage to the liver during liver transplantation. Hepatic ischemia-reperfusion (no blood flow and then reestablishing blood) leads to significant systemic inflammatory response (an infection-like response). This response involves numerous complex reactions that ultimately contribute to liver injury. The consequences of these actions may lead to acute graft dysfunction (the new donor liver to malfunction at the time of or shortly after surgery)/ failure or transient graft dysfunction (temporary malfunction of the new donor liver), but may also be responsible for other organs to fail, such as lung and kidney. Recent studies in children and adults document the effectiveness with inhaled NO. Inhaled NO has shown effectiveness in improving a number of clinical syndromes associated with high pressures in the lungs such as: (1) adult respiratory syndrome, (2) chronic obstructive pulmonary disease, (3) mitral valve disease, (4) cardiac and lung transplantation, (5) persistent pulmonary hypertension of the newborn, and (6) congenital heart disease. Surprisingly, the potential anti-inflammatory (decreased inflammation) properties of administering NO before the liver is transplanted has remained unexplored clinically, while a considerable number of well-designed liver surgery animal studies have demonstrated benefit.

Research Projects

A Nursing Study of Gut Function in Menstruating Women
M. M. Heitkemper, Ph.D., M. E. Jarrett, Ph.D., P. G. Richebé, M.D., Ph.D.
Abdominal Symptom Phenotypes: Pathways to New Biomarkers
M. M. Heitkemper, Ph.D., R. Shulman, M.D., P. G. Richebé, M.D, Ph.D., et al.
Closed Claims Project
K. Domino, M.D., MPH, K. Posner, Ph.D., F.W. Cheney, M.D., L. Lee, M.D.
Computerized Glucose Control in Critically Ill Patients
M. Horibe, M.D., J.D. Lang, M.D., B. G. Nair, Ph.D.
Determination of Risk Factors for Ischemic Optic Neuropathy After Spine Surgery
Lorri A. Lee, M.D.K., Domino, MD,MPH, K. Posner, PhD, et al.
Extubation Failure in Patients with Difficult Airways Study
M. M. Treggiari, M.D., Ph.D., M.P.H.
lst Tier Drugs + Theophylline In Pediatric Severe Asthma
J. Zimmerman, M.D., D. Jardine, M.D.
Pharmacokinetics of Intrathecal Drug Infusions
C.M. Bernards, MD, S. Flack, MBChB
Real-Time Electronic Alerts to Improve Antibiotic and Temperature Management in Surgical Patients
B. G. Nair, Ph.D., H. A. Schwid, M.D.
Resource Over Utilization due to Serious Alcohol Related Injuries (CR)
J. Jarvik, M.D., M.P.H., B.S. Roudsari, Ph.D., M.S. Vavilala, M.D., B. Bresnahan, Ph.D
SIDS and the Inner Ear: A Follow up study of Hearing, Vestibular Function and Respiratory Control
D. Rubens, M.D.
The Association Between Innate Immunity Genes and Outcome Following Sepsis in Children
J. H. Kim, M.D., G. P. Jarvik, M.D., D. Jardine, M.D.
The Gas Study: Comparing Neurodevelopment Outcome and Apnea in Infants
M.E, McCann, M.D., A. Lynn, M.D.
The Influence of Inhaled Nitric Oxide on Attenuating Hepatic Sinusoidal Leukocyte-Endothelial Interactions in Patients Undergoing Orthopic Liver Transplantation
J.D. Lang, Jr, M.D.
Use of Transthoracic Ultrasound to Triage Patients in Preanesthesia Clinic
E. Wako, M.D., G. Van Norman, M.D., G.A. Rooke, MD., Ph.D.