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Gaetano Ciancio, MD

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Gaetano Ciancio, MD
Gaetano Ciancio in operating room after a kidney transplantation.File:Gaetano-operating-room.jpg File:Gaetano-operating-room.jpg
Gaetano Ciancio in operating room after a kidney transplantation
BornRoccapiemonte, Italy
🏫 EducationM.D. (1982), MBA (2001)
🎓 Alma materUniversidad Central De Venezuela, Jackson Memorial Hospital
💼 Occupation
Transplant Surgeon, Urologic Oncologist

Gaetano Ciancio is a surgeon at the University of Miami who specializes in kidney transplant.[1] He is the chief medical officer of the Miami Transplant Institute and the director of its Kidney & Kidney-Pancreas Programs at the Miami Transplant Institute.[2] His most significant contributions to medicine are related to surgically treating kidney cancer once it had spread to the inferior vena cava[3][4] and in optimizing the immunosuppression protocol after kidney transplant.[5][6] He is an author or co-author of 2 books, 30 book chapters and over 388 peer-reviewed articles published in medical journals for topics involving the field of solid organ transplantation and urologic oncology. [7] His academic papers have been cited over 10,000 times. [8]

Life[edit]

Ciancio received his Doctor of Medicine from Central University of Venezuela, completed his residency at Jackson Memorial Hospital [2][9], followed by completing a fellowship in multiorgan transplant surgery [9].

Research[edit]

Large Kidney Tumors[edit]

D\Ciancio developed novel techniques for the surgical resection of large kidney tumors[10]. Prior to his work, many urologists approached a large upper pole renal tumor or bulky retrocrural lymphadenopathy via a thoracoabdominal incision[11]. His results demonstrated that by performing a liver mobilization, urological oncologists could avoid a thoracic incision in many patients [12]

Inferior Vena Cava Thrombectomy[edit]

Left renal tumor with inferior vena cava thrombus into the right atrium

Building on the techniques described for resecting large renal tumors, Ciancio adapted his liver mobilization technique to address retrohepatic or even suprahepatic inferior vena caval thrombus associated with renal tumors[4]. With this technique, the whole abdominal inferior vena cava is able to be mobilized, which facilitates milking of the tumor down below the major hepatic veins by the surgeon’s fingers, bypassing the need for a thoracoabdominal incision or cardiopulmonary bypass.[13]

Together with his long time collaborator Mark Soloway, they published a step-by-step guide toward resecting renal cell carcinoma with associated inferior vena cava thrombus.[14]

Immunosuppression[edit]

A major obstacle in immunosuppression treatment following organ transplantation is that one of the most effective medications, tacrolimus, is associated with nephrotoxicity [15]. Therefore, in collaboration with the transplant team, Ciancio helped develop and popularize alternative immunosuppression regimens which successfully lowered the dose of tacrolimus without increasing organ rejection[5]. He has published clinical trials on the usage of alternative immunosuppression regimens including with alemtuzumab,[16] with intravenous immunoglobulin as an agent to lower alloimmunity and improve transplantation in highly sensitized adult patients,[17] and with Daclizumab.[18]

Reconstruction During Kidney Transplant[edit]

During kidney transplantation, the most common arterial reconstruction is for a single renal artery to be anastomosed to the external iliac artery[19]. However, a significant number of patients have anatomical variations, which need to be reconstructed during the time of transplantation[20]. Ciancio has pioneered several such techniques including the usage of the inferior epigastric artery to anastomose to a small upper-pole artery[21]. Another reconstructive challenge during transplantation is significant atherosclerosis of the external iliac artery, which can lead to major injuries to the artery[22]. In this scenario, he has described a complete external iliac artery reconstruction with donor iliac vessels.[22]

Additionally, Ciancio has been part of the Miami Transplant Team that developed the bladder patch technique, where for various indications the kidney together with the ureter and some amount of donor bladder are transplanted en-bloc[23]. This has been utilized in pediatric patients who may have very small ureters making for a very challenging connection of the ureter (donor) to the bladder (recipient)[24]. This technique was also adapted by Ciancio for adults with kidney and bladder dysfunction[25].

Pancreatic Transplantation[edit]

Together with George Burk, Ciancio has made major contributions to the field of pancreas transplantations both regarding management of surgical complications and immunosuppression strategies, including publishing the first series of an effective technique for thrombectomy for complete venous thrombosis of the transplanted pancreas[26]. Additionally, they described fungal arteritis, which unfortunately often requires pancreatectomy and vascular reconstruction for the affected arteries[27].

Ciancio described several successful regimens including tacrolimus[28], tacrolimus + mycophenolate[29], and everolimus with low-dose tacrolimus[30]. Similarly together with the transplant team he described tacrolimus for the treatment of acute rejection[31].

In 2013, he served as President of the Urologic Society for Transplantation and Renal Surgery[32] .

Awards and honors[edit]

Ciancio taking a resident through a living related kidney transplant

Humanitarian awards include the Miracle Maker Award (1997), the Honorary Citizen National Award (Italy, 2000), the Dr. Martin Luther King, Jr. Spirit Award (2002) for his contribution to health care, and the Honor and Merit Award by the Haiti Transplant Foundation for performing the first kidney transplant in Haiti[32] and was most recently recognized by the American Society of Transplant Surgery with the Francis Moore Excellence in Mentorship in the Field of Transplantation Surgery Award for 2021[33].

Ciancio became the first recipient of the University of Miami Faculty Hero Award and received the Urology Lifetime Achievement Award.[34] Additionally, for his contribution to educating Latin American surgeons in transplantation techniques, Ciancio had an operating room in Argentina named after him - the Dr. Gaetano Ciancio Operating Room. [35]

He was knighted in Italy by Sergio Mattarella and is a member of the Order of Merit of the Italian Republic[36].

References[edit]

  1. ↑ "Dr. Gaetano Ciancio, MD, MBA, FACS - Kidney Transplant Surgery, Pancreas Transplant Surgery, Transplant Surgery, Urologic Oncology - Book Appointment". doctors.umiamihealth.org. Retrieved 18 May 2021.
  2. ↑ 2.0 2.1 "Gaetano Ciancio". Jackson Health System. Retrieved 29 December 2020.
  3. ↑ Ciancio, Gaetano; Vaidya, Anil; Savoie, Mark; Soloway, Mark (2002). "Management of Renal Cell Carcinoma With Level III Thrombus in the Inferior Vena Cava". Journal of Urology. Ovid Technologies (Wolters Kluwer Health). 168 (4 Part 1): 1374–1377. doi:10.1016/s0022-5347(05)64452-7. ISSN 0022-5347.
  4. ↑ 4.0 4.1 Ciancio, Gaetano; Livingstone, Alan S.; Soloway, Mark (2007). "Surgical Management of Renal Cell Carcinoma with Tumor Thrombus in the Renal and Inferior Vena Cava: The University of Miami Experience in Using Liver Transplantation Techniques". European Urology. Elsevier BV. 51 (4): 988–995. doi:10.1016/j.eururo.2006.11.055. ISSN 0302-2838. PMID 17175095.
  5. ↑ 5.0 5.1 Ciancio, Gaetano; Burke, George W.; Gaynor, Jeffrey J.; Mattiazzi, Adela; Roth, David; Kupin, Warren; Nicolas, Maud; Ruiz, Phillip; Rosen, Anne; Miller, Joshua (2004). "A randomized long-term trial of tacrolimus/sirolimus versus tacrolimus/mycophenolate mofetil versus cyclosporine (NEORAL)/sirolimus in renal transplantation. Ii. Survival, function, and protocol compliance at 1 year". Transplantation. Ovid Technologies (Wolters Kluwer Health). 77 (2): 252–258. doi:10.1097/01.tp.0000101495.22734.07. ISSN 0041-1337. PMID 14742990. Unknown parameter |s2cid= ignored (help)
  6. ↑ Ciancio, Gaetano; Burke, George W.; Gaynor, Jeffrey J.; Carreno, Manuel R.; Cirocco, Robert E.; Mathew, James M.; Mattiazzi, Adela; Cordovilla, Tatiana; Roth, David; Kupin, Warren; Rosen, Anne; Esquenazi, Violet; Tzakis, Andreas G.; Miller, Joshua (2005). "A Randomized Trial of Three Renal Transplant Induction Antibodies: Early Comparison of Tacrolimus, Mycophenolate Mofetil, and Steroid Dosing, and Newer Immune-Monitoring1". Transplantation. Ovid Technologies (Wolters Kluwer Health). 80 (4): 457–465. doi:10.1097/01.tp.0000165847.05787.08. ISSN 0041-1337.
  7. ↑ "2021 ASTS Recognition Award Recipients Francis Moore Excellence in Mentorship in the Field of Transplantation Surgery Award". Retrieved 2021-06-06.
  8. ↑ "Google Scholar: Gaetano Ciancio". Retrieved 2021-06-06.
  9. ↑ 9.0 9.1 "Dr. Gaetano Ciancio MD". Retrieved 2021-06-06.
  10. ↑ Ciancio G, Hawke C, Soloway M (2000). "The use of liver transplant techniques to aid in the surgical management of urological tumors". J Urol. 164 (3 Pt 1): 665–72. doi:10.1097/00005392-200009010-00012. PMID 10953122.CS1 maint: Multiple names: authors list (link)
  11. ↑ Kumar, Sanjaya; Duque, Jose Luis F.; Guimaraes, Kleber C.O.; DiCanzio, James; Loughlin, Kevin R.; Richie, Jerome P. (1999). "SHORT AND LONG-TERM MORBIDITY OF THORACOABDOMINAL INCISION FOR NEPHRECTOMY: A COMPARISON WITH THE FLANK APPROACH". Journal of Urology. Ovid Technologies (Wolters Kluwer Health). 162 (6): 1927–1929. doi:10.1016/s0022-5347(05)68070-6. ISSN 0022-5347.
  12. ↑ Ciancio, Gaetano; Manoharan, Murugesan; Katkoori, Devendar; De Los Santos, Rosely; Soloway, Mark S. (2010). "Long-term Survival in Patients Undergoing Radical Nephrectomy and Inferior Vena Cava Thrombectomy: Single-Center Experience". European Urology. Elsevier BV. 57 (4): 667–672. doi:10.1016/j.eururo.2009.06.009. ISSN 0302-2838. PMID 19560258.
  13. ↑ Ciancio, Gaetano; Soloway, Mark S. (2005). "Renal cell carcinoma with tumor thrombus extending above diaphragm: Avoiding cardiopulmonary bypass". Urology. Elsevier BV. 66 (2): 266–270. doi:10.1016/j.urology.2005.03.039. ISSN 0090-4295. PMID 16098354.
  14. ↑ Ciancio, Gaetano; Gonzalez, Javier; Shirodkar, Samir P.; Angulo, Javier C.; Soloway, Mark S. (2011). "Liver Transplantation Techniques for the Surgical Management of Renal Cell Carcinoma with Tumor Thrombus in the Inferior Vena Cava: Step-by-Step Description". European Urology. Elsevier BV. 59 (3): 401–406. doi:10.1016/j.eururo.2010.07.028. ISSN 0302-2838. PMID 20724064.
  15. ↑ Mihatsch MJ, Kyo M, Morozumi K, Yamaguchi Y, Nickeleit V, Ryffel B (June 1998). "The side-effects of ciclosporine-A and tacrolimus". Clin Nephrol. 49 (6): 356–63. PMID 9696431.
  16. ↑ Ciancio, Gaetano; Burke, George W.; Gaynor, Jeffrey J.; Mattiazzi, Adela; Roohipour, Ramin; Carreno, Manuel R.; Roth, David; Ruiz, Phillip; Kupin, Warren; Rosen, Anne; Esquenazi, Violet; Tzakis, Andreas G.; Miller, Joshua (2004). "The Use of Campath-1H as Induction Therapy in Renal Transplantation: Preliminary Results". Transplantation. Ovid Technologies (Wolters Kluwer Health). 78 (3): 426–433. doi:10.1097/01.tp.0000128625.29654.eb. ISSN 0041-1337. PMID 15316372. Unknown parameter |s2cid= ignored (help)
  17. ↑ Jordan, S. C. (2004-12-01). "Evaluation of Intravenous Immunoglobulin as an Agent to Lower Allosensitization and Improve Transplantation in Highly Sensitized Adult Patients with End-Stage Renal Disease: Report of the NIH IG02 Trial". Journal of the American Society of Nephrology. American Society of Nephrology (ASN). 15 (12): 3256–3262. doi:10.1097/01.asn.0000145878.92906.9f. ISSN 1046-6673. PMID 15579530.
  18. ↑ Ciancio G, Burke GW, Suzart K, Roth D, Kupin W, Rosen A; et al. (2002). "Daclizumab induction, tacrolimus, mycophenolate mofetil and steroids as an immunosuppression regimen for primary kidney transplant recipients". Transplantation. 73 (7): 1100–6. doi:10.1097/00007890-200204150-00015. PMID 11965039. Unknown parameter |s2cid= ignored (help)CS1 maint: Multiple names: authors list (link)
  19. ↑ Benoit G (1996). "[Surgical technics of kidney transplantation]". Prog Urol (in French). 6 (4): 594–604. PMID 8924941.CS1 maint: Unrecognized language (link)
  20. ↑ Coen, L. D.; Raftery, A. T. (1992). "Anatomical variations of the renal arteries and renal transplantation". Clinical Anatomy. Wiley. 5 (6): 425–432. doi:10.1002/ca.980050602. ISSN 0897-3806.
  21. ↑ Serena, Giuseppe; Gonzalez, Javier; Guerra, Giselle; Nuss, Mohamed Ammar Al; Valdes, Maykel; Ciancio, Gaetano (2019-03-13). "Vascular Reconstructions in Living Unrelated Kidney Transplant Using Donor Ovarian Vein and Recipient Inferior Epigastric Artery with Simultaneous Enucleation of a Complex Cyst". Case Reports in Transplantation. Hindawi Limited. 2019: 1–4. doi:10.1155/2019/3272080. ISSN 2090-6943. PMC 6436338. PMID 31001446.
  22. ↑ 22.0 22.1 Moon, Jang IL; Ciancio, Gaetano; Burke, George W (2005). "Arterial reconstruction with donor iliac vessels during pancreas transplantation: an intraoperative approach to arterial injury or inadequate flow". Clinical Transplantation. Wiley. 19 (2): 286–290. doi:10.1111/j.1399-0012.2005.00339.x. ISSN 0902-0063. PMID 15740569. Unknown parameter |s2cid= ignored (help)
  23. ↑ Kato, T.; Selvaggi, G.; Burke, G.; Ciancio, G.; Zilleruelo, G.; Hattori, M.; Gosalbez, R.; Tzakis, A. (2008). "Partial Bladder Transplantation with En Bloc Kidney Transplant—The First Case Report of a 'Bladder Patch Technique' in a Human". American Journal of Transplantation. 8 (5): 1060–1063. doi:10.1111/j.1600-6143.2008.02180.x. ISSN 1600-6135. PMID 18312611. Unknown parameter |s2cid= ignored (help)
  24. ↑ Kunzler de Oliveira Maia, Filipe; Tekin, Akin; Nicolau‐Raducu, Ramona; Beduschi, Thiago; Selvaggi, Gennaro; Vianna, Rodrigo; Ammar Al Nuss, Mohamad; González, Javier; Gaynor, Jeffrey J.; Ciancio, Gaetano (2019). "Use of pediatric donor en bloc kidneys along with bladder segment in pediatric liver‐kidney and multivisceral‐kidney transplantation". Pediatric Transplantation. 24 (1): e13596. doi:10.1111/petr.13596. ISSN 1397-3142. PMID 31605438. Unknown parameter |s2cid= ignored (help)
  25. ↑ Ciancio, Gaetano; Kato, Tomoaki; Chen, Linda; Sageshima, Junichiro; Livingstone, Alan S.; Burke, George W. (2009). "Transplantation of en bloc pediatric kidneys with a partial bladder segment in an adult recipient". Transplant International. 22 (3): 350–353. doi:10.1111/j.1432-2277.2008.00815.x. ISSN 0934-0874. PMID 19220872. Unknown parameter |s2cid= ignored (help)
  26. ↑ Ciancio G, Julian JF, Fernandez L, Miller J, Burke GW (2000). "Successful surgical salvage of pancreas allografts after complete venous thrombosis". Transplantation. 70 (1): 126–31. PMID 10919588.CS1 maint: Multiple names: authors list (link)
  27. ↑ Ciancio G, Burke GW, Viciana AL, Ruiz P, Ginzburg E, Dowdy L; et al. (1996). "Destructive allograft fungal arteritis following simultaneous pancreas-kidney transplantation". Transplantation. 61 (8): 1172–5. doi:10.1097/00007890-199604270-00009. PMID 8610413.CS1 maint: Multiple names: authors list (link)
  28. ↑ Burke GW, Ciancio G, Olson L, Roth D, Miller J (2001). "Ten-year survival after simultaneous pancreas/kidney transplantation with bladder drainage and tacrolimus-based immunosuppression". Transplant Proc. 33 (1–2): 1681–3. doi:10.1016/s0041-1345(00)02639-7. PMID 11267467.CS1 maint: Multiple names: authors list (link)
  29. ↑ Ciancio G, Lo Monte A, Buscemi G, Miller J, Burke GW (2000). "Use of tacrolimus and mycophenolate mofetil as induction and maintenance in simultaneous pancreas-kidney transplantation". Transpl Int. 13 Suppl 1: S191–4. doi:10.1007/s001470050323. PMID 11111994. Unknown parameter |s2cid= ignored (help)CS1 maint: Multiple names: authors list (link)
  30. ↑ Sageshima, Junichiro; Ciancio, Gaetano; Chen, Linda; Dohi, Takehiko; El-Hinnawi, Ashraf; Paloyo, Siegfredo; Misawa, Ryosuke; Ekwenna, Obi; Yatawatta, Ashanga; Burke, George W. (2014-06-01). "Everolimus with low-dose tacrolimus in simultaneous pancreas and kidney transplantation". Clinical Transplantation. Wiley. 28 (7): 797–801. doi:10.1111/ctr.12381. ISSN 0902-0063. PMID 24779669. Unknown parameter |s2cid= ignored (help)
  31. ↑ Ciancio G, Burke GW, Roth D, Miller J (1997). "Use of intravenous FK506 to treat acute rejection in simultaneous pancreas-kidney transplant recipients on maintenance oral FK506". Transplantation. 63 (5): 785–8. doi:10.1097/00007890-199703150-00030. PMID 9075856.CS1 maint: Multiple names: authors list (link)
  32. ↑ 32.0 32.1 "Dr. Gaetano Ciancio Recognized for Excellence in Adult Organ Transplantation". 24-7 Press Release Newswire. 7 April 2015. Retrieved 29 December 2020.
  33. ↑ "2021 ASTS Recognition Award Recipients". Retrieved 2021-03-05.
  34. ↑ "Dr. Gaetano Ciancio Receives Outstanding Teaching Award - InventUM | University of Miami Miller School of Medicine". physician-news.umiamihealth.org. Retrieved 29 December 2020.
  35. ↑ "Dr. Gaetano Ciancio is Honored with Named Operating Room in Buenos Aires". InventUM. July 24, 2018. Retrieved 2021-06-09.
  36. ↑ "Dr. Gaetano Ciancio Wins Prestigious National Award for Transplant Surgery Mentorship". Retrieved 2021-06-06.

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