As we welcome Spring, I would like to spotlight our clinical lab changes including our new anti-coagulation curriculum, total lab automation and robotics in the labs, our new specimen processing area in Ronald Reagan Hospital, and faculty updates.
Dr. Zhen Mei has created a new anti-coagulation curriculum to be implemented in the new fiscal year. The impetus to start a Coagulation Pathology rotation is 3-pronged. An opportunity was identified for improving the quality of residency education and experience based on subjective personal experience, past and current trainee feedback, and objective milestones from the ACGME. We are confident these objectives will fulfill the need for a standardized and consistent coagulation curriculum, improve resident perception of the level of coagulation training received during residency, and better prepare trainees in the assessment of coagulation issues and for their board examinations.
The Total Lab Automation (TLA) Project for the UCLA Health Clinical Laboratories is progressing on schedule. The BURL Laboratory is up and running on its new chemistry line, and both the Santa Monica Hospital Core Lab and the Ronald Reagan Hospital Core Lab are in the process of validation. Our new specialist group had a kickoff meeting where we brainstormed ideas for process improvement. In addition, the chemistry specialists from all three sites met to discuss validation/verification standardization. All of these initiatives and projects tie into the One Lab Philosophy as our Clinical Labs build the culture to see ourselves as one cohesive laboratory. Notably, the clinical lab has finished integrating the 200 Medical Plaza specimen processing area into the Ronald Reagan Core Lab specimen processing area. We want to thank everyone involved in that project and have already seen efficiency and patient care improvements. I also would like to thank Drs. Linda Baum and Omai Garner for their outstanding leadership of this significant project.
Additionally, I would like to congratulate Dr. Nam Ku on becoming our new Chief of Hematology and Dr. Linda Baum on her upcoming retirement.
We are excited for the new and innovative changes within the department and how they will positively impact our patients, trainees, the hospital, the university, and the community.
The Department of Pathology & Laboratory Medicine is an integral part of the vibrant UCLA research enterprise and includes faculty members with a broad array of basic, translational, and clinical research interests.
I am proud to profile our new research awards as of July 1st. We congratulate the faculty principal investigators on their grant awards and look forward to their innovative findings and results.
Departmental research has continued to thrive and grow over the past decade. Our faculty publish their findings in many of the top biomedical journals such as Cell, Immunity, Molecular Cell, Nature Immunology, and the Proceedings of the National Academy of Sciences. As a small representative snapshot, since March 2020, our faculty has produced over 250 published papers and abstracts. To date for FY2021, faculty researchers generated over $13 million in active extramural funding, including over $10 million from NIH. A comprehensive listing of the department’s Faculty Publications can be found here.
Additionally, the department’s faculty is engaged in new collaborative work with other Departments and Schools at UCLA. Here are a few spotlighted collaborations:
- Dr. Valerie Arboleda is collaborating with Noah Zaitlen, in the Department of Neurology, to study Genomic Approaches to Population Health in Multi-Ethnic Hospital Systems. This project uses genomic information to reconstruct fine-scale population structure of different populations with EMR. In collaboration with Mt. Sinai School of Medicine and the University of Colorado, Dr. Arboleda and Dr. Gignoux are exploring how population-specific variants can influence clinical phenotypes. Additionally, in collaboration with the Dr. Butte and Dr. Krogstad at UCLA, the Valley Fever Institute seeks to identify some of the population-specific, genetic underpinnings underlying the immune dysregulation observed in disseminated coccidioidomycosis. This work is funded by University of California Office of the President.
- Dr. Kenneth Dorshkind has initiated a collaboration between the Dorshkind laboratory in the Department of Pathology and Laboratory Medicine and the laboratory of Dr. Sotirios Tetradis in the UCLA School of Dentistry. A goal of this collaboration is to determine how bone loss (osteoporosis) leads to age-related changes in the production of lymphoid and myeloid cells.
- Dr. Gregory Fishbein collaborates with UCLA pulmonary oncologists studying lung cancer preneoplasia, UCLA immunogeneticists studying heart and lung transplant rejection, and UCLA cardiologists studying medical devices.
- Dr. Oliver Hankinson initiated a new collaboration with Professor Jesus Araujo, UCLA Department of Medicine, on a grant they have submitted to the NIH to fund this research, which is titled “To test the hypothesis that activation of the Aryl Hydrocarbon Receptor will inhibit or promote atherosclerosis depending on the ratio of omega-3 to omega-6 polyunsaturated fatty acids in the diet”, and which is under review. He is also the contact PI on the renewal of the NIH T32 grant “Training in Molecular Toxicology”, which is currently under review. 14 faculty from 11 departments and 4 schools at UCLA are on the training grant faculty.
- Dr. Jeffrey Krane is collaborating with Dr. Maie St. John's group in the Department of Head and Neck Surgery to evaluate a novel imaging technique (DOCI) to better detect the presence of squamous cell carcinomas intraoperatively and guide diagnosis, treatment, and extent of surgery.
- Dr. Thomas Lawton is collaborating with: Dr. Greg Senofsky (Surgery) on a study comparing telomere length in benign breast biopsy patients who subsequently developed triple negative breast cancer and comparing to age-matched controls who had benign biopsies who did not go on to develop breast cancer; Dr. Jennifer Baker (Surgery) and two other institutions (UNC and UW) on a study looking at the natural history of in situ lobular neoplasia diagnosed at core needle biopsy; Dr. Helena Chang (Surgery) looking at CD44+/CD24high vs. low triple negative breast cancers and survival/response to neoadjuvant or adjuvant docetaxel-based chemotherapy; and Dr. Mary Sehl (Internal Medicine) on a study looking at adipose inflammation and DNA methylation age in women at high risk for breast cancer.
- Dr. Hane Lee has continued collaborative work within the Undiagnosed Diseases Network and California Center for Rare Diseases to identify molecular diagnosis for rare disease patients, including active research and developments around integrating transcriptome sequencing with whole genome sequencing data and increasing the efficiency of transcriptome sequencing. This collaborative work is not only for diagnosing rare disease patients, but also for founding the groundwork of bringing up whole genome sequencing and transcriptome sequencing as clinical tests in the Molecular Diagnostic Laboratories.
- Dr. Neda Moatamed is collaborating with several investigators at UCLA as a co-investigator, including: Triple-negative breast cancers (PI: Richard Pietras, MD); Abnormal cervical cytology in pediatric patients who have been vaccinated for HPV (PI: Anna-Barbara Moscicki, MD); and Platinum resistant ovarian cancer (PI: Sanaz Memarzadeh, MD, PhD).
- Dr. Bita Naini is collaborating on the PediCode consortium with Dr. Martin and Dr. Venick from Division of Pediatric Gastroenterology, Hepatology and Nutrition at UCLA as well as other academic centers. The Pediatric Congenital Diarrhea and Enteropathies Consortium (PediCODE) is a group of academic medical centers dedicated to research in rare genetic causes of early onset diarrheal disease and intestinal failure. UCLA is one of the four founding centers of this consortium and Dr. Naini is the director of pathology for UCLA site.
- Dr. Stanley Nelson collaborated with the Miceli Lab in MIMG, and within the Center for Duchenne Muscular Dystrophy, developed a novel muscle biopsy procedure coupled with a newly developed technique to purify individual nuclei to assess individual cell gene expression to identify novel cell types in muscle and changes in relation to lack of dystrophin in Duchenne and cellular responses from genomic medicines that restore dystrophin in skeletal muscle.
- Dr. Jian Yu Rao’s new collaborative works include: studying cancer cell mechanotypic biomarkers for cancer diagnosis and management; collaborating with Drs. James Gimzewski, Dino Di Carlo, and Amy Rowat from CNSI, a multicenter study for testing Computer-Aided System by Artificial Intelligence in the differential cell count on digital images of Bone Marrow Aspirates with pathologists from UT Southwestern; test the MUSE technology for rapid tissue analysis with pathologists from University of Rochester and Brigham and Women’s Hospital; Optimization of preanalytical variables affecting saliva ctDNA integrity and implications for use in clinical molecular testing with Dr. Liying Zhang and Dr. David Wong from UCLA Dental School; Optimization of preanalytical studies of HRD testing for ovarian cancer with Dr. Liying Zhang and Dr. Gottfried Konecny; and studying the associations of TMPRSS2 expression and COVID-19 disease with Dr. Liying Zhang, Dr. Huihui Ye, and Dr. Mathew Rettig.
- Dr. Elaine Reed is collaborating with Dr. Enrique Rozengurt, Department of Medicine and Director of CURE: Digestive Diseases Research Center and Dr. Robert Fairchild, Cleveland Clinic on a NIAID funded grant to study targeting YAP with statins to prevent antibody-mediated transplant rejection. The major goal of the research is to study the effect of donor specific HLA antibodies on the activation of the YAP/TAZ pathway in promoting proliferation and migration of ECs and to determine if drugs of the statin family inhibit YAP function in these cells. Dr. Reed, Matteo Pellegrini, and Michael Yeaman, collaborated on a study to unravel antibiotic resistance in MRSA “superbug” infections. The team identified 276 DNA sites in patients where methylation differed between those MRSA infections that were quickly resolved through the use vancomycin — one antibiotic that frequently is successful in combatting MRSA — and those infections that failed the antibiotic therapy. Pinpointing these epigenetic signatures at early diagnosis will enable physicians to predict which patients are likely to respond to a frontline antibiotic treatment for MRSA and which require different treatment strategies to clear the infection. This personalized approach also holds promise for improving outcomes for viral infections like COVID-19, HIV and influenza, as well as bacterial infections like tuberculosis, urinary-tract infections, and pneumonia. The findings were published March 1 in Proceedings of National Academy of Sciences. Additionally, a new study to determine whether preexisting immunity to SARS-CoV-2 can provide protection against repeat exposure has just opened at Harbor-UCLA, led by Dr. Elaine Reed. The Los Angeles SeroPrevalence And Respiratory Tract Assessment (LA SPARTA) study is funded by the NIH and supported by the UCLA CTSI. The study will enroll 100 front line providers who are health care workers, non-clinical Harbor UCLA employees, law enforcement, or paramedics and emergency medical service, representing the diverse racial and ethnic population of Los Angeles. Subjects will be tested by screening for symptoms of COVID-19, testing saliva for SARS-CoV-2, and monthly blood tests to evaluate the antibody response. This collaborative effort joins UCLA immunologic expertise of Dr. Reed and Infectious Diseases physician Dr. Joanna Schaenman, with the clinical and translational research expertise of Dr. Loren Miller and Dr. Michael Yeaman, collaborators from the Harbor-UCLA and the Lundquist Institute.
- Dr. Jonathan Said is engaging in a combined teaching and research conference with UCLA, UCSF, and Stanford for trainees and faculty in 2021.
- Dr. Shaun Yang is collaborating on multiple projects, including Candida auris genomic surveillance – working with the UCLA Department of Clinical Epidemiology and Infection Prevention (CEIP). Candida auris is an emerging multidrug resistant fungal pathogen causing outbreaks In the United States, and considered as one of five “urgent threats” to public health, prompting the need for active surveillance and appropriate infection prevention. Whole genome sequencing (WGS) based phylogenetic analyses can reveal the specific genotypes of C. auris and characterize its lineage and phylogenetic relationship with each other, therefore providing crucial information in helping with outbreak investigation and epidemiological studies. This study is an ongoing infection prevention and quality improvement project aiming to screen patients with C. auris colonization and infection and prevent its spread in the UCLA hospitals. He is also collaborating with the UCLA Department of Environment, Health and Safety (EHS) regarding COVID-19 campus surveillance by sewage testing. SARS-CoV-2 has been shown to be able to infect gastrointestinal tract and shed in stool for prolonged time after a patient is infected. Testing SARS-CoV-2 directly in the sewage has been shown to be capable of providing timely warning for potential outbreaks on college campus. They developed and validated a COVID-19 Stool PCR test that’s also working well for the sewage samples with high sensitivity, and have been using this test to help UCLA EHS to monitor the sewage samples, of which many tested positive during the COVID-19 winter surge in the LA area.
- Dr. Liying Zhang collaborated with Dr. Matthew Rettig, Medical Director of Prostate Cancer Program at Institute of Urologic Oncology, Dr. Andrew Goldstein in the departments of Molecular, Cell & Developmental Biology and Urology, as well as Dr. Huihui Ye and Dr. Jianyu Rao to study transcriptional inhibition of TMPRSS2 and received a COVID-19 research award from the Broad Stem Cell Center/School of Medicine; with Dr. David Wong in School of Dentistry to develop new methods for detecting COVID-19 infection and received NIH grant; with Dr. Edward Garon in Department of Medicine to study preanalytical variables affecting saliva ctDNA integrity and implications in clinical testing and submitted NIH U01 grant; with Dr. Timothy Donahue in Department of Surgery to study ctDNA in pancreatic cancer; and with Dr. Gottfried E. Konecny to develop assays for HRD detection in ovarian cancer.
- Dr. Alyssa Ziman has collaborated on: COVID-19 Convalescent Plasma (CCP) – Developed collaborative research program with Division of Infectious Disease and Clinical Research enterprise to recruit and screen individuals who had recovered from COVID-19 for participation in immunology research and as convalescent plasma donors. Also developed comprehensive donor recruitment and screening processes to collect and manufacture CCP for transfusion under an EUA for hospitalized patients and for various clinical research protocols in the outpatient and emergency department settings; Research on Novel Blood Components.
- Division of Neuropathology – The Division of Neuropathology continues collaboration with multiple clinical and research colleagues in neurosurgery, neurology and the Mary S. Easton Center for Alzheimer disease research.
- Division of Transfusion Medicine – The Division of Transfusion Medicine is collaborating with our clinical colleagues on several studies to evaluate novel blood products (Whole Blood for Cardiac Surgery, Pediatric Cardiac Surgery and Pediatric Intensivists; Pathogen Reduced RBCs, Adult Cardiac Surgery; Cold-Stored Platelets, Anesthesia); and the Bruin Blood Initiative: Providing mentorship for the Bruin Blood Initiative, an undergraduate UCLA club focused on blood donor education and recruitment. The Transfusion Medicine faculty is proving mentorship to club members on a research project aimed at analyzing blood donor demographics and donation trends at a college donor center.
The above publications, grants and collaborations underscore that UCLA is a highly interactive and collaborative environment in which interdisciplinary research flourishes. I am grateful that, despite the challenges of the last year, our faculty and students have continued to conduct important and meaningful basic, translational and clinical research and I look forward to learning about their future discoveries.
Each day we strive to uphold the UCLA mission to heal humankind by delivering leading-edge research, education, patient care, and community engagement. In light of our departmental achievements toward these goals, I would like to spotlight our monthly Staff Recognition Program. We thank these amazing individuals for their hard work, dedication, and excellence.
Our department takes immense pride in our continued outreach to better serve the community. These contributions include the Light the Night, I Heart Walk, and so much more. Please see the detailed listing below.
Blood & Platelet Center and Transfusion Service
- COVID-19 Pandemic
- COVID-19 Convalescent Plasma (CCP):
- Collected CCP from 250+ unique donors in 400+ visits
- Collected 1,200+ CCP units
- Transfused approx. 20 patients as part of the Johns Hopkins CCP study
- Transfused 240+ UCLA patients as part of the Mayo study and then under the Extended Use Authorization (EUA)
- Shipped 500+ CCP to other hospitals as part of the Mayo study
- Transfusion Service
- 1st UC to have a permanent Transfusion Safety Officer position (Floricel Guillermo)
- RRUCLA achieved Magnet Designation with the help of our Transfusion Safety Officer
- Community Engagement
- Lab Tours for the DGSOM Medical Students throughout the year
- Bethany Porter presented CLS career information at multiple events for UCLA Health and UCLA Alumni
- Ed Griffin presented a webinar for AABB on Leading Through Change
- Floricel Guillermo presented at Marymount High School in promotion of blood donation
- Floricel Guillermo led a blood drive during nurses week with a total of 72 nurses who donated
- Performed over 175,000 COVID PCR tests by the end of the year (next highest test volume is ~70,000 tests/year)
- Community Engagement
- Provided COVID-19 testing for people in the community experiencing homelessness
- Were featured by the World Series winning Dodgers saying, “It’s Time for Dodger Baseball” before a game
- Several LA Times articles have featured our laboratory
- Members of our lab appeared in an ASCP Townhall video discussing the Coronavirus pandemic
Community Event Participation
American Heart Association Virtual Walk
- The event aims to fund lifesaving science and promote the Health For Good movement.
- Lab Team Captain Nathan Okawa raised $9336
I Heart Walking
- The event promotes heart health through prevention education and healthy practices.
- 14th annual event
- Held on February 12, 2020
Light the Night Event
- The Leukemia & Lymphoma Society's Light The Night Walk funds treatments that are saving the lives of patients today. LLS is making cures happen by providing patient support services, advocating for lifesaving treatments, and pioneering the most promising cancer research anywhere.
- Organized by Tom Callahan, Brian Ahrens, Deanna Fang, Cristina Ghiani, Ronald Gonzalez, Yulia Kucherova, Nathan Okawa, and Nikki Salami
- Community Engagement
- Lab Tours for the DGSOM Medical Students throughout the year
- 7 CLS students graduation, 8 CLS students onboarded
- 1 CGMBS student graduated
- Provided Histocompatibility and Immunogenetic testing for 1,236 solid organ transplants for the 5 transplant centers we serve (UCLA, UC Davis, Harbor-UCLA, Scripps Green Hospital, Saint Joseph’s Orange) and 850 deceased donor workups for One Legacy, the Organ Procurement Operation for Los Angeles
- Provided Immunogenetics and Histocompatibility testing for >90 kidney paired donations at UCLA
- Added value and standardization to living and deceased donation workflows by providing written reports of virtual crossmatches to transplant centers
- Increased clinical footprint
- Providing deceased non-renal donor crossmatch services for 2 additional outside transplant centers
- Developed strategy to address UNOS Policy change eliminating donor areas and affecting deceased donor transplants. UIC will manage and perform deceased donor crossmatch services for 8 Los Angeles transplant centers.
- Provided 3 educational lecture series via Zoom for physicians, fellows, residents, and coordinators at UCLA, UC Davis, Harbor-UCLA, Scripps Green Hospital, Saint Joseph’s Orange, One Legacy, and Kaiser
- Created a library of recorded lectures to be able to provide training on demand
- Work with faculty and fellows for publications and obtaining grants
- 4 new NIH Grants and 31 publications
- Yuxin Yin, Project Scientist, Research and Development for assay development and translating research findings to diagnostic testing
- IT Integration
- Designed, validated and put into production order/reporting interface for 2 transplant programs
- Reference Program
- UIC serves as CAP proficiency test provider since 2003
- UIC received 100% Supplier Report card from CAP in 2020
Despite the changes we have endured due to COVID-19, hope and perseverance shine as brightly as our hard work and determination to serve the university, hospital, community, and beyond. I am proud of our accomplishments this past year and look forward to all we will achieve in the academic, clinical, and research arenas.
In the spirit of the new year, I would like to spotlight our departmental education programs and contributions. The David Geffen School of Medicine and the Department of Pathology & Laboratory Medicine strive to provide opportunities for world-class education, training, and professional development. We foster and cultivate a rich learning environment that prepares each individual for the next steps on their chosen career path. The associated lists below provide a snapshot of our many programs and affiliations. We are proud of our accomplishments in the educational arena and continue to revolutionize our curriculum, programs, and clinical work.
Additionally, I would like to extend my congratulations to Dr. Dipti Sajed on her new appointment as Anatomic Pathology Associate Program Director!
This position will have a primary responsibility of overseeing the educational content of the AP program, including the resident curriculum, rotation goals/expectations, and conferences. The AP APD will function independently, but will also work closely with the Program Director to assist in other aspects of the program including recruitment, clinical competencies, and real-time issues raised by trainees, faculty, or staff. Recent improvements to the educational program since the her appointment include: a new PGY1 frozen section rotation to ensure adequate training for on-call duties, a quality and content update of the official AP conference curriculum, and an increase in efficiency of clinical competency committee meetings.
As we move forward in 2021, I encourage you to participate in opportunities to enhance your learning experience and professional development. Education, collaboration, and continued learning are the foundation of the field of medicine. May the new year bestow discovery, innovation, and exemplary clinical care.
Non-MD/DO/PhD Clinical Training Programs
MD/DO ACGME Clinical Training Programs
MD/DO/PhD Non-ACGME Clinical Training Programs
As we approach the new year, I would like to highlight some of our department's achievements in 2020.
The Department of Pathology and Laboratory Medicine's One Lab Philosophy encompasses the innovation, dedication, and continuity within our laboratory structure. Our strategy within UCLA Health is we are one lab with many sites, including Santa Monica, Brentwood, BURL, CHS, and Ronald Reagan. We share methodology, operating procedures, project prioritization, and informatics; our new Vice Chair for Clinical Lab Strategy, Dr. Omai Garner, is working very closely with faculty and senior staff to ensure that internally and externally, to our vendors and clients, we all work as one lab.
This one lab approach will enhance our ability to provide the best care for our patients, while acting as good stewards of the resources provided to us. We appreciate the expertise of our managers, supervisors and specialists at all of our sites, and will continue to maximize the ability of staff to work across our sites to share experience and best practices. The One Lab Committee's next immediate focus is to spearhead the rebranded quarterly Pathology Newsletter and host additional faculty discussions and forums.
In the spirit of the holiday season, I would like to express my immense gratitude for the incredible support, effort, energy, and creativity our department has shown since the emergence of COVID-19. Despite unprecedented changes to all facets of our daily lives, our team has persisted in doing everything they can to help our patients, clinicians, and each other. The department has ensured that we have continued to deliver outstanding clinical care, found creative ways to provide critical education remotely and in person to medical students, residents, fellows, and technicians, and have persevered to make research discoveries, submit grants, and publish papers.
I look forward to our continued excellence and advancement in clinical care, education, and research in the new year.