Nancy Ascher

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

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. Liver transplantation is highly regulated, and only performed at designated transplant medical centers by highly trained transplant physicians. Favorable outcomes require careful screening for eligible recipients, as well as a well-calibrated live or deceased 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. The first successful kidney transplant was performed in 1954 by a team including Joseph Murray, the recipient's surgeon, and Hartwell Harrison, surgeon for the donor. Murray was awarded a Nobel Prize in Physiology or Medicine in 1990 for this and other work. In 2018, an estimated 95,479 kidney transplants were performed worldwide, 36% of which came from living donors.

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, also known as hepatic cancer, primary hepatic cancer, or primary hepatic malignancy, is cancer that starts in the liver. Liver cancer can be primary in which the cancer starts in the liver, or it can be liver metastasis, or secondary, in which the cancer spreads from elsewhere in the body to the liver. Liver metastasis is the more common of the two liver cancers. Instances of liver cancer are increasing globally.

Histidine-tryptophan-ketoglutarate, or Custodiol HTK solution, is a high-flow, low-potassium preservation solution used for organ transplantation. The solution was initially developed by Hans-Jürgen Bretschneider.

<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:

Organ transplantation in Japan is regulated by the 1997 Organ Transplant Law which legalized organ procurement from "brain dead" donors. After an early involvement in organ transplantation that was on a par with developments in the rest of the world, attitudes in Japan altered after a transplant by surgeon Juro Wada in 1968 failed, and a subsequent ban on cadaveric organ donation lasted 30 years. The first transplant after the Organ Transplant Law had defined "brain death" took place in February 1999.

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

Dr. Arvinder Singh Soin is an Indian surgeon and the Chief Hepatobiliary and Liver Transplant Surgeon & Chairman of the Institute of Liver Transplantation and Regenerative Medicine, Medanta-The Medicity. Known for his work in the field of liver transplantation, Soin also runs the Liver Transplant institute at the Sir H. N. Reliance Foundation Hospital, Mumbai. He 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. 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> American transplant surgeon

Francis L. Delmonico, MD, FACS is an American 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.

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

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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

The Liver Imaging Reporting and Data System is a quality assurance tool created and trademarked by the American College of Radiology in 2011 to standardize the reporting and data collection of CT and MR imaging patients at risk for hepatocellular carcinoma (HCC), or primary cancer of the liver cells. It provides a standardized framework for classification of liver lesions by a radiologist, and only applies in patients with chronic liver disease, the main risk factor for liver cancer. The hierarchical classification, from LR1 to LR5, is based on specific imaging features of the lesion in question, and corresponds to the degree of suspicion for malignancy. For example, a lesion with features corresponding to the highest category, LR5, is "definitely" HCC. Importantly, the increasing acceptance of the LI-RADS system of reporting by referring clinicians has reduced the need for tissue biopsy confirmation of cancer in patients with chronic liver disease.

Ernesto Pompeo Molmenti is an American transplant surgeon, scientist, and author. Currently practicing in Reno, Nevada. He is Chief of Transplantation at Renown Health, Executive Director of the Renown Transplant Institute, Director and Executive Vice President of the Nevada Transplant Institute, and Professor at the University of Nevada, Reno.

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 (7 June 2013). "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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