Hillary Braun, MD Awarded Prestigious Resident Research Scholarship by American College of Surgeons (ACS)
Hillary Braun, MD, a third-year (PGY-3) general surgery resident at UCSF, has been awarded a prestigious two-year resident research scholarship by the American College of Surgeons for 2019-2021. The scholarships are supported by the generosity of Fellows, Chapters, and friends of the College, to encourage residents to pursue careers in academic surgery.
Dr. Braun's research will focus on the impact of domestic and international travel for transplantation on disparities in U.S. solid organ transplantation with the goal of generating data to inform national policy around these issues.
Dr. Braun has had an extremely productive career, having already co-authored 38 Resident Publications, 94 Posters & Oral Presentations and written individual Book Chapters in five medical treatises. She has also received numerous grant funding awards.
Dr. Braun credits her mentors, Nancy L. Ascher, M.D., Ph.D., Peter G. Stock, M.D., Ph.D., John P. Roberts, M.D. and Ryutaro Hirose, M.D., as having had a major impact on her career as well as the faculty, staff, and fellows in the division of transplant who have been exceptionally supportive throughout her entire time at UCSF.
Research Project Summary
The purpose of my research project is to characterize the impact of domestic and international travel for transplantation on the organ transplant system in the United States (US). Each year in the US, more than 30,000 solid organ transplants are performed, but the demand for organs continues to outpace the supply, and as a result, nearly 7000 people die each year awaiting transplant. Organs are allocated according primarily to disease severity (liver) and waiting time (kidney) and are distributed within arbitrary geographic regions in the US.
Patients awaiting transplant, therefore, face different waiting times according to the area of the country in which they reside. Patients who have the means to travel - either within the US or from foreign countries to the US - are technically permitted to do so, but it is hypothesized that their presence may cause increased competition within regions and detrimentally impact the wait-listed patients who do not have the luxury of mobility.
In the U.S., as many as 10% of individuals listed for kidney or liver transplantation travel to regions outside of their home region where it is perceived they may have a better chance at a more timely transplant. International travelers, referred to as non-citizen, non-residents (NCNR), make up approximately 2% of the transplant population each year, but the amount of transplants performed in these patients is highly variable according to region.
The proposed study will utilize data available from the United Network for Organ Sharing (UNOS) and the Scientific Registry of Transplant Recipients (SRTR). These organizations provide comprehensive demographic and outcomes data on organ donors, transplant candidates, and transplant recipients. The research will address three primary aims in both liver and kidney transplant populations:
- Compare demographics of domestic travelers, international travelers, and non-traveler patients
- Compare outcomes of domestic travelers, international travelers, and non-traveler patients
- Determine the impact of domestic and NCNR travelers on wait-listed transplant candidates in the Destination regions.
The overall goal is to generate data to inform national policy around domestic and international travel for transplantation.