Nancy Ascher

Last updated
Nancy L. Ascher
NationalityAmerican
Alma mater University of Michigan
OccupationSurgeon
Known forHolly Smith Award for Exceptional Service
SpouseJohn Roberts

Nancy L. Ascher is an American surgeon, and the first woman to perform a liver transplant. Ascher specializes in transplant surgery, focusing on end-stage kidney disease, kidney transplantation, non-alcoholic fatty liver disease and liver transplantation. [1]

Contents

Biography

Ascher is from Detroit, Michigan and is the third child of four. Her mother was a teacher and her father was a doctor who both placed a strong emphasis on serving the community. Consequently, as a young child, she had originally aspired to become a nun, but as her background is Jewish, she instead pursued studies in medicine. [2]

Ascher completed her undergraduate and medical education at the University of Michigan. Ascher was one of only 20 women in a cohort of 220 students and was one of two women to pursue surgery. When she applied to medical school, she was asked to have an additional interview with a psychiatrist who asked inappropriate questions about her sex life. [3]

In an interview, she recalled how one Professor of Obstetrics and Gynecology showed pictures of naked women during his class, during which the female students stood up and left.

She then went on to complete a general surgery residency and clinical transplantation fellowship at the University of Minnesota.

Ascher joined the faculty of the Department of Surgery at the University of Minnesota in 1982 and was named Clinical Director of the Liver Transplant Program. In 1988 she was recruited by the University of California, San Francisco (UCSF) Department of Surgery to build a liver transplantation program. In 1991, she was appointed Chief of Transplantation, an expanded role that included liver, kidney and pancreas transplants.

In 1993, Ascher was appointed Vice-Chair of the UCSF Department of Surgery, and in 1999 was appointed Department Chair where she served until September 2016. Ascher has continued to work with the UCSF. [4]

She has been a member of the Presidential Task Force on Organ Transplantation, the Surgeon General's Task Force on Increasing Donor Organs and the Secretary of Health and Human Services Advisory Committee on Open Transplantation. [5] [6] [7] She was also invited to join the WHO Task Force on Donation and Transplantation of Human Organs and Tissues, [8] which she joined as a member in 2018. [9]

Awards

Ascher is the recipient of the Holly Smith Award for Exceptional Service for 2020. She was described by the award committee as a 'lighthouse of possibility' and that 'watching Nancy perform the most demanding of surgical operations is a never-ending source of inspiration.' [10]

Select publications

Media

Ascher and her pioneering work in organ transplantation was the focus of the third episode of Netflix’s docuseries ‘The Surgeon’s Cut' which was released in December 2020. The episode focusses on the case of Maria, a patient with a nonalcoholic steatohepatitis and her 22 year old daughter Adriana. Ascher performed the removal in parts of Adriana's liver while her husband re-implanted the donor liver into Maria. [3]

Personal life

Ascher is married to fellow surgeon John Roberts - who was originally her student - and with whom she performed the first-ever live adult-to-child liver transplant that occurred at the University of California, San Francisco, in 1993.

She has two children; during both pregnancies, she went into labor while operating. [2] Ascher gave a kidney to her sister, who died three years after the operation.

Ascher has noted that her desire to work in medicine stemmed from a love of horror films - which showed her how to overcome her fears within her job. Ascher was heavily influenced in her early career by the feminist movement.

Related Research Articles

<span class="mw-page-title-main">Organ transplantation</span> Medical procedure in which an organ is removed from one body and placed in the body of a recipient

Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.

<span class="mw-page-title-main">Hepatocellular carcinoma</span> Medical condition

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer in adults and is currently the most common cause of death in people with cirrhosis. HCC is the third leading cause of cancer-related deaths worldwide.

<span class="mw-page-title-main">Liver transplantation</span> Type of organ transplantation

Liver transplantation or hepatic transplantation is the replacement of a diseased liver with the healthy liver from another person (allograft). Liver transplantation is a treatment option for end-stage liver disease and acute liver failure, although availability of donor organs is a major limitation. The most common technique is orthotopic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic position as the original liver. The surgical procedure is complex, requiring careful harvest of the donor organ and meticulous implantation into the recipient. Liver transplantation is highly regulated, and only performed at designated transplant medical centers by highly trained transplant physicians and supporting medical team. The duration of the surgery ranges from 4 to 18 hours depending on outcome. Favorable outcomes require careful screening for eligible recipient, as well as a well-calibrated live or cadaveric donor match.

<span class="mw-page-title-main">Everolimus</span> Chemical compound

Everolimus, sold under the brand name Afinitor among others, is a medication used as an immunosuppressant to prevent rejection of organ transplants and as a targeted therapy in the treatment of renal cell cancer and other tumours.

<span class="mw-page-title-main">Kidney transplantation</span> Medical procedure

Kidney transplant or renal transplant is the organ transplant of a kidney into a patient with end-stage kidney disease (ESRD). Kidney transplant is typically classified as deceased-donor or living-donor transplantation depending on the source of the donor organ. Living-donor kidney transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient.

Autotransplantation is the transplantation of organs, tissues, or even particular proteins from one part of the body to another in the same person.

Organ procurement is a surgical procedure that removes organs or tissues for reuse, typically for organ transplantation.

<span class="mw-page-title-main">Liver cancer</span> Medical condition

Liver cancer is cancer that starts in the liver. Liver cancer can be primary or secondary. Liver metastasis is more common than that which starts in the liver. Liver cancer is increasing globally.

<span class="mw-page-title-main">National Organ Transplant Act of 1984</span>

The National Organ Transplant Act (NOTA) of 1984 is an Act of the United States Congress that created the framework for the organ transplant system in the country. The act provided clarity on the property rights of human organs obtained from deceased individuals and established a public-private partnership known as Organ Procurement and Transplantation Network (OPTN). The OPTN was given the authority to oversee the national distribution of organs.

Surgical Outcomes Analysis & Research, SOAR, is a research laboratory of the Department of Surgery at Boston University School of Medicine and Boston Medical Center with expertise in outcomes research. SOAR investigates surgical diseases and perioperative outcomes. The group focuses on pancreatic cancer, other gastrointestinal and hepatobiliary malignancies, vascular disease, and transplant surgery. SOAR's goal is to examine quality, delivery, and financing of care in order to have an immediate impact on patient care and system improvements. The group members utilize national health services and administrative databases, as well as institutional databases, to investigate and to address factors contributing to disease outcomes and healthcare disparities.

In transplantation medicine, the Milan criteria are set of criteria applied in consideration of patients with cirrhosis and hepatocellular carcinoma (HCC) for liver transplantation with intent to cure their disease. Their significance derives from a landmark 1996 study in 48 patients by Mazzaferro et al which showed that selecting cases for transplantation according to specific strict criteria led to improved overall and disease-free survival at a four-year time point. These same criteria have since been adopted by the Organ Procurement and Transplantation Network (OPTN) in the evaluation of patients for potential transplantation.The threshold Milan criteria are as follows:

<span class="mw-page-title-main">Arvinder Singh Soin</span> Indian hepatologists

Dr. Arvinder Singh Soin is the Chief Hepatobiliary and Liver Transplant Surgeon & Chairman of the Institute of Liver Transplantation and Regenerative Medicine, Medanta-The Medicity, India. A surgeon and pioneer in the field of liver transplantation, acknowledged for his work in establishing liver transplantation in India. Dr. Soin also runs the Liver Transplant institute at the Sir H. N. Reliance Foundation Hospital, Mumbai. Dr Soin has performed more than 3500 living donor liver transplants in India, which is the highest in the country, and the second-highest in the world.

Christoph Broelsch was a German surgeon and former high school teacher. Broelsch pioneered the liver transplant surgery, when he performed the first successful liver transplant on a child in 1989.

<span class="mw-page-title-main">Francis L. Delmonico</span>

Francis L. Delmonico, MD, FACS is a surgeon, clinical professor and health expert in the field of transplantation. He serves on numerous committees and is affiliated with various leading organizations and institutions. He is the chief medical officer of the New England Organ Bank (NEOB) and Professor of Surgery, Part-Time at Harvard Medical School in Boston, Massachusetts, where he is emeritus director of renal transplantation. He served as president of The Transplantation Society (TTS) from 2012 to 2014, an international non-profit organization based in Montreal, Canada that works with international transplantation physicians and researchers. He also served as the president of the United Network of Organ Sharing (UNOS) in 2005, which overseas the practice of organ donation and transplantation in the United States. He was appointed and still serves as an advisor to the World Health Organization in matters of organ donation and transplantation. He was appointed by Pope Francis to the Pontifical Academy of Science in 2016. In 2020, he became the recipient of the Medawar Prize of The Transplantation Society.

MIRA is a multidisciplinary and complementary method for treating many chronic diseases. The MIRA Procedure is a result of combining efforts from different medical fields developed in the University of Chicago in 1992. It basically consists in medically grafting live rejuvenated tissue in the form of autologous adipose adult stem cells to a damaged organ in order to restore it and improve its function. This method is currently approved by the U.S. Food and Drug Administration (FDA).

<span class="mw-page-title-main">Andrew Kenneth Burroughs</span> British physician, researcher and teacher

Andrew K. Burroughs was a British physician, researcher and teacher. He is renowned for his wide contribution to the field of Hepatology; he has been termed one of the greatest hepatologists of our times and the true representative of Dame Sheila Sherlock's legacy.

ABO-incompatible (ABOi) transplantation is a method of allocation in organ transplantation that permits more efficient use of available organs regardless of ABO blood type, which would otherwise be unavailable due to hyperacute rejection. Primarily in use in infants and young toddlers, research is ongoing to allow for increased use of this capability in adult transplants. Normal ABO-compatibility rules may be observed for all recipients. This means that anyone may receive a transplant of a type-O organ, and consequently, type-O recipients are one of the biggest beneficiaries of ABO-incompatible transplants. While focus has been on infant heart transplants, the principles generally apply to other forms of solid organ transplantation.

<span class="mw-page-title-main">LI-RADS</span> LI Rads for the Classification of HCC

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Minnie M. Sarwal is an adult and pediatric nephrologist, researcher of transplant immunology, and biotechnology entrepreneur in San Francisco. She has made significant contributions to the field of organ transplantation, including conducting the first successful complete steroid avoidance trial in the US and the first dosing safety trial for Rituximab in pediatric renal transplantation. She also spearheaded genomic and proteomics investigations into mechanisms of organ transplant injury and was the first to determine that there was substantive molecular heterogeneity in acute kidney transplant rejection. She has successfully commercialized blood testing for early diagnosis of both acute rejection and operational tolerance in kidney transplant patients, providing tools for proactive and predictive immunosuppression monitoring for transplant recipients.

Ernesto Pompeo Molmenti is an American transplant surgeon, scientist, and author. Currently practicing in Long Island, New York. He is Chief of Surgical Innovation and Vice-Chairman of the Department of Surgery at North Shore University Hospital / Northwell Health, and Professor of Surgery, Medicine, and Pediatrics at Zucker School of Medicine at Hofstra/Northwell. He is known for his description of the “Syndromic Incidence of Ovarian Cancer after Liver Transplantation, with Special Reference to Anteceding Breast Cancer,” and for the development of the vascular reconstruction technique that has been named "Molmenti technique".

References

  1. ↑ "Nancy L. Ascher, M.D., Ph.D. | UCSF Transplant Surgery". transplantsurgery.ucsf.edu. Retrieved 2020-12-12.
  2. 1 2 Malhotra, Noor (2020-12-09). "Dr. Nancy Ascher Now: Where is Transplant Surgeon Today? Netflix Update". The Cinemaholic. Retrieved 2020-12-12.
  3. 1 2 "The Surgeon's Cut | Netflix Official Site". www.netflix.com. Retrieved 2020-12-12.
  4. ↑ "Nancy L. Ascher, M.D., Ph.D. | UCSF Transplant Surgery". transplantsurgery.ucsf.edu. Retrieved 2020-12-12.
  5. ↑ "Nancy Ascher". www.tts-wit.org. Retrieved 2020-12-12.
  6. ↑ "HHS secretary adds new members to organ transplantation advisory committee - OPTN". optn.transplant.hrsa.gov. Retrieved 2020-12-12.
  7. ↑ Conway, Jane Goodman and Claire. "Early Riser: Profile of Surgeon Nancy Ascher". Early Riser: Profile of Surgeon Nancy Ascher | UC San Francisco. Retrieved 2020-12-12.
  8. ↑ "Nancy Ascher, MD, PhD Invited to Serve on WHO Task Force on Donation and Transplantation of Human Organs and Tissues". surgery.ucsf.edu. Retrieved 2020-12-12.
  9. ↑ "WHO Donation and Transplantation of Human Organs and Tissues Task Force Members - 1st Term: 2018 – 2019" (PDF). 2019. Retrieved 2020-12-12.
  10. ↑ "Past Recipients | UCSF School of Medicine". medschool.ucsf.edu. Retrieved 2020-12-12.
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