Robert A. Fisher, MD
H.M. Lee Professor of Surgery and Pediatrics
Program Director Liver Transplant Program
Department of Surgery
Division of Transplantation Surgery

Appointments:

Appointed as Regional Councilor, UNOS Region 11,
Member Board of Directors

Education:

Texas A & M University
Baylor College of Medicine, MD

Fellowship:

University of Cincinnati Medical Center
Transplant Surgical Fellow

Licensure:

Texas, Ohio, Virginia

Board Certification:

American Board of Surgery

Recent Publications:

Maluf DG, Fisher RA, Maroney T, Cotterell A, Fulcher A, Tisnado J, Contos M, Luketic V, Stravitz R, Shiffman M, Sterling R, Posner M. Non-resective ablation and liver transplantation In patients with cirrhosis and hepatocellular carcinoma (HCC):Safety and efficacy .Am J Transpl. 3:1-6, 2003.

Strom S and Fisher RA. Hepatocyte Transplantation: New Possibilities for Therapy. Gastroenterology 124(2): 568-571,2003.

Mas VM, Fisher RA, Maluf DG, Wilkinson DS, Garrett CT, and Ferreira-Gonzalez A. Hepatic Artery Thrombosis After Liver Transplantation and Genetic Factors: Prothrombin G20210A Polymorphism. Brief Communications 76(1): 247-249, 2003.

Special Interests:

Transplantation
Immunology
Hepatocellular Carcinoma
Living Donor Liver Transplantation

Research Interests:
Clinical Trials:

1. A One Year, Multicenter, Partially Blinded, Double-Dummy, Randomized Study to Evaluate the Efficacy and Safety of FTY720 Combined with Reduced-Dose or Full-Dose Neoral® and Corticosteroids versus Mycophenolate Mofetil (MMF, Cellcept®) Combined with Full-Dose Neoral® and Corticosteroids, in de novo Adult Renal Transplant Recipients.(FTY720)

This exciting study sponsored by Novartis and involving renal transplant patients, will evaluate the effectiveness and safety of a new kind of immunosuppressant. FTY720 works in a way that preserves infection fighting mechanisms in the body while preventing rejection of the transplanted kidney. Dr. Robert A. Fisher is the Principal Investigator.

2. A Multicenter, Randomized, Double blind, Parallel Group Trial to Demonstrate the Efficacy of Fondaparinux Sodium in Association with Intermittent Pneumatic Compression Versus Intermittent Pneumatic Compression Used Alone for the Prevention of Venous Thromboembolic Events in High-Risk Patients Undergoing Major Abdominal Surgery (EFC3558)

This clinical trial, sponsored by Sanofi-Synthelabo, studies the effectiveness of the drug Fondaparinux Sodium in prevention of deep vein thrombosis following abdominal surgery. This drug has already been found to be effective following orthopedic surgery and is FDA approved for this use. It is hoped that the drug will prove a safe, effective therapy for patients at risk for this potentially devastating complication of abdominal surgery. The Principal Investigator is Dr. Robert A. Fisher.

3. A Randomized, Open-Label, Comparative Evaluation of Conversion from Calcineurin Inhibitor Treatment To Sirolimus Treatment Versus Continued Calcineurin Inhibitor Treatment in Liver Allograft Recipients Undergoing Maintenance Therapy (0468H-313)

This study, sponsored by Wyeth, will attempt to evaluate the effectiveness of the immunosuppressant sirolimus for preservation of renal function in liver transplant patients. Historically, patients have been converted to sirolimus immunosuppressive therapy at the onset of renal insufficiency related to calcineurin inhibitors. This study will evaluate efficacy of sirolimus in the prevention of renal insufficiency. Dr. Robert A. Fisher is the Principal Investigator.

5. Adult to Adult Living Donor Liver Transplantation Cohort Study

Sponsored by the National Institutes of Health, this is a multi-center, five year study of both living donors and their recipients. It includes a retrospective arm that will entail extensive data retrieval and a prospective arm to track patient progress. There is a sub-study, written by Dr. Robert Fisher and Dr. Valeria Mas that will study Hepatocellular Carcinoma on the molecular level in this patient population as well. Dr. Robert A. Fisher and Dr. Mitchell Shiffman are Co-Principal Investigators in this study.

6. Hepatic Regeneration in Donors and Recipients following Living Donor Liver Transplantation

This study is to evaluate regeneration of liver tissue in both recipients and donors of transplanted livers. It includes, for example, determination of which factors are most critical to regeneration, to discover markers that will parallel normal regeneration and the relationships that may occur between regeneration and growth factors. Dr. Robert A. Fisher is the Principal Investigator.

7. The Use of Human Hepatocyte Transplantation as a Life support Bridge in Terminal Liver Failure

The purpose of this research is to gain knowledge about the result of infusing liver cells, carefully matched to blood type, into a subject’s body. The hope is that is procedure will aid functions of the liver and prevent death, enable a transplant procedure to be carried out if a donated liver becomes available and lessen complications in postoperative recovery. The Principal Investigator is Dr. Robert A. Fisher.

8. Cryptococcus neoformans Infection in Organ Transplant Recipients: Impact of Immunosuppressive Agent Resistance and Virulence Factors on Tissue Tropism, and Outcome

This study is being undertaken with Dr. Nina Singh at the University of Pittsburg under and NIH grant along with 14 other sites in the country. It will study several aspects of the infective agent Cryptococcus to try to discover a better way to fight the organism in transplant patients. Dr. Robert Fisher is the Principal Investigator.

9. Liver Tissue Procurement and Distribution System (LTPADS)

This NIH sponsored program is in place to procure, store and distribute normal and diseased liver tissue to researchers worldwide. Dr. Robert A. Fisher is the Principal Investigator.

10. Studies of Pediatric Liver Transplantation (SPLIT), A Multicenter Prospective Study to Collect Scientific Data on Pediatric Liver Transplantation

This NIH sponsored study is designed to help the transplant community better understand the problems and potential solutions surrounding liver transplantation in children. Data is collected on patient graft survival, incidents of rejection, growth, immunosuppressants, risk factors, mortality and morbidity. The data is periodically analyzed and shared with the community. Dr. Robert A. Fisher is the Principal Investigator.

11. Transplant Registry

The Transplant Registry is an IRB approved data base with information gathered from medical records of patients with conditions relating or leading to transplantation. This data base has been invaluable in evaluating efficacy of treatments and in the publication of papers for professional journals. Dr. Robert Fisher is the Principal Investigator.

Laboratory Studies:

1. Liver cells transplantation

In our research laboratories, we established a steady method to isolate human liver cells. Liver cells transplantation has been used in our group to bridge the patients who have liver function failure. By using human liver cells, we genetically engineered human insulin gene and made the cells expressing mature, functional human insulin. The goal is to create factories of blood sugar-regulating cells in the liver that one day may be used in the treatment of patients with severe diabetes. Because liver cells are the only cells in the body that can continually regenerate, they are not vulnerable to autoimmune disease that destroys islet cells in people with diabetes. Dr. Robert A. Fisher is the Principal Investigator.

2. Organ Transplant Tolerance Studies

Animal model of renal transplantation was created in our research laboratories. Kidney of ACI rat was transplanted into Lewis rat. Mechanisms of tolerance of allografts were investigated by analysis of functional data, renal histological structures and cytokines profiles. Our past studies have demonstrated that Th-2 cytokines (IL-4, IL-10) played key role in the long-term tolerance. One of our ongoing projects is the investigation of the early stages of cytokines profile. These studies could improve our understanding of transplant tolerance. Dr. Robert A. Fisher is the Principal Investigator.

Contact Information:

P.O Box 980254
1101 East Marshall Street
Sanger Hall 8-012
Richmond, VA
23298-0254
Phone: 804-828-2461
Fax: 804-828-2462
E-mail: rafisher@vcu.edu

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