- Residency Program: University of Ottawa
- Supervisors: Dr. Guillaume Martel, Dr. Dean Fergusson,
Sean did his undergraduate training in Kinesiology as well as medical school at Dalhousie University. In between the two he also spent a year completing an M.Sc in Adapted Physical Activity in Leuven, Belgium, studying the outcomes of deep brain stimulation of the subthalamic nucleus in patients with Parkinson’s disease. He has completed 2 clinic years of General Surgery training at uOttawa, and then entered the CIP and the M.Sc Epidemiology program. He has recently returned to full-time clinical training.
In addition to his main research area regarding the role of red blood cell transfusions in patients undergoing liver resection, Sean has published work on selective non-operative management of stable penetrating abdominal trauma, the role of routine preoperative upper endoscopy in bariatric surgery, and intraductal papillary neoplasms of the biliary tract. He intends to pursue a career in HPB Surgical Oncology.
Liver resection is commonly associated with significant blood loss and subsequent red blood cell transfusion. This has trended down over the past few decades with improvement in surgical and anesthetic techniques as well as evidence from many areas of medicine of the detrimental effects of transfusion. Perioperative transfusions are still given in about 1 in 4 liver resections. Sean’s thesis work included 3 components: a systematic review, a provider survey, and a study of transfusion appropriateness.
The systematic review of the effects of blood transfusion in patients undergoing liver resection demonstrated the lack of good quality evidence. Given the available evidence, there does seem to be a true association between transfusions and increased post-operative complications, independent of known confounders. The potential association with long-term cancer recurrence is equivocal, and there appears to be no association with increased post-operative mortality. This work was recently accepted for publication in HPB.
A provider survey of Canadian anesthesiologists and liver surgeons was circulated, elucidating interesting findings and differences in perioperative blood management and decision-making regarding blood transfusions.
The major component of the thesis was a study of transfusion appropriateness, using the RAND/UCLA Appropriateness Method. This is essentially a two-iteration consensus conference of a multi-centre, multi-disciplinary expert panel to determine the clinical scenarios for which a blood transfusion would be appropriate or inappropriate. The end result of which has created the Ottawa Criteria for Appropriate Transfusions in Hepatectomy (OCATH) – to be published in Annals of Surgery.