Organ protection

HT Lee, MD, PhD
Professor of Anesthesiology
Publications

Dr. Lee's research focuses on the pathomechanisms of perioperative acute kidney injury and translational approaches to attenuate this injury. The laboratory is focusing on the role of ischemic preconditioning, adenosine receptors, sphingosine products, volatile anesthetics and local anesthetics in attenuating acute kidney injury in vivo as well as in vitro. The models used to induce acute kidney injury in vivo include renal ischemia reperfusion, cecal ligation and puncture induced sepsis and myoglobinuria rabdomyolysis model. Recently, a model of acute kidney injury in the setting of acute liver failure (hepatorenal syndrome) has been developed and multiple treatment modalities to treat this critical syndrome are being investigated. Dr. Lee uses multiple molecular and biochemical approaches as well as in vivo techniques to better understand both the injurious and protective signaling pathways involved in the injury.

 

Gebhard Wagener, MD
Assistant Professor of Anesthesiology
Publications

Dr. Wagener’s principal research centers on the early detection of acute kidney injury by investigating noval biomakers that allow early the detection of renal injury. The current clinically-used biomarkers such as serum creatinine are highly insensitive and slow to appear. Biomarkers such as urinary Neutrophil Gelatinase-associated Lipocalin (NGAL) increase within hours after renal injury and allow early diagnosis and intervention. Dr. Wagener has studied urinary NGAL after adult cardiac surgery in a large prospective study and evaluated the close relationship of urinary NGAL and acute kidney injury in this population. He demonstrated the superiority of urinary NGAL to detect intra-operative renal injury caused for example by the use of aprotinin or by prolonged cardiopulmonary bypass time compared to serum creatinine. Future studies will evaluate the clinical utility of urinary NGAL in other scenarios of renal injury. His additional research interests include the effect of vasopressin on the portal circulation and the pathophysiology of relative vasopressin deficiency in hepatic failure. In collaboration with Dr. Sladen he developed an intuitive scoring system to predict length of ICU stay after cardiac surgery, the Surgical Procedure Assessment (SPA) score and he studies the effect of preoperative hyperglycemia on postoperative outcome variables.


 

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Columbia University Medical Center Department of Anesthesiology