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The Transplant and Oncology Infectious Diseases (TOID) Program

The comprehensive Transplant and Oncology Infectious Diseases (TOID) program was launched in 2008. The mission of the TOID Program, directed by Dr. Kieren Marr, is to expand institutional expertise in clinical and academic activities focused on infectious complications in transplant (solid organ and stem cell) and oncology patients at Johns Hopkins Medical Institutions. In addition to clinical expertise (see below), key efforts are currently directed to developing standardized algorithms for prevention and treatment of infections in these vulnerable patients and to establish an expanded infrastructure to facilitate clinical and translational studies in TOID.

The clinical transplant and oncology infectious disease service, named the Tucker Service, is dedicated to the scholarship and spirit of Dr. Pamela C. Tucker, who served as teacher and mentor, advocate and healer to patients with infectious diseases, particularly in the fields of transplant and oncology, before her untimely death in November, 2000. The goal of this service is to provide comprehensive inpatient and outpatient care for medically immunocompromised patients at Johns Hopkins. The Pamela Cresson Tucker Scholarship Award was established to honor Dr. Tucker's memory by her friends and family. Additional information on the life and career of Dr. Tucker as well as how to apply for a scholarship award or to donate are available at The Pamela Tucker Foundation.

The TOID program has four full-time specialized physicians and a clinical fellow:

The TOID Program's Medical Director is Dr. Kieren Marr, Professor of Medicine and Oncology. Dr. Marr trained at Hahnemann University, Duke University and the University of Washington / Fred Hutchinson Cancer Research Center, where she was on faculty for 13 years prior to relocation to Johns Hopkins. Dr. Marr is a member of several national and international professional organizations, numerous national scientific steering committees, has authored over 150 peer-reviewed publications and textbook chapters, and edited two books in the area of infectious diseases involving immunosuppressed hosts. She is an elected member of the American Society for Clinical Investigators (ASCI) and is known worldwide for her laboratory and clinical research focused on diagnostics and treatment of invasive fungal infections. She currently serves as the Liaison between the Johns Hopkins University Department of Medicine and the Carey Business School, as part of the Discovery to Market course. Dr. Marr has a strong interest in training physicians in infectious diseases and medicine, and currently serves as a member of the Barker Firm faculty in the Department of Medicine. She has personal and professional interests in emotional education and has developed a patient and health-care provider coaching program focused on emotions surrounding illness.

Dr. Robin Avery, Professor of Medicine, is an infectious disease physician who joined the Johns Hopkins faculty in 2012, with two decades of experience in transplant infectious disease. She is a past chair of the American Society of Transplantation (AST) Infectious Disease Community of Practice, was a co-editor of the first edition of the AST ID Guidelines, and serves on a Guidelines Committee for the Infectious Disease Society of America (IDSA) on immunizations in the immunocompromised host. She was the founding head of the Transplant Infectious Disease Section at the Cleveland Clinic and served as the founding director of the Cleveland Clinic Transplant ID Special Fellowship, authoring a curriculum that served as the basis for curricula later endorsed by the AST and IDSA. Her clinical and research interests include pre-transplant donor and recipient evaluation, and prevention and treatment of post-transplant infections, particularly transplant-associated viruses, viral load monitoring, novel therapies for CMV, hypogammaglobulinemia, immunizations, and strategies for safer living post-transplant. She has a strong interest in patient education and co-authored the script for a video designed to educate patients on decreasing post-transplant infection risks.

Dr. Shmuel Shoham, Assistant Professor of Medicine, trained at Thomas Jefferson and Boston Universities. He joined the faculty at Johns Hopkins in April, 2011, after ten years at Washington Hospital Center, where he was Scientific Director of the MedStar Clinical Research Center and headed the Transplant Infectious Diseases service. Dr. Shoham has multiple years of experience in conducting research studies as both principle investigator and co-investigator. He has published and lectured extensively on infections in transplant recipients and has been an active member in the American Society of Transplantation. Dr. Shoham hosts a medical blog focusing on relevant clinical issues and concerns for professionals caring for patients with, or at risk for, complex infections. The goal is to report on the interface between research, clinical care, and public health in the area of infectious diseases. This blog shares interesting cases, clinical pearls of useful information, and relevant journal articles. The blog encourages the exchange of information in an unbiased and open manner.

Dr. Christine Durand, Assistant Professor of Medicine, performs clinical research focused on understanding and preventing infectious complications of cancer and transplant therapies in patients with HIV. In addition, she performs translational research to determine the impact of these therapies on HIV reservoirs in order to inform strategies for HIV cure.

Dr. Richard Larue, clinical fellow, research concentrates on asymptomatic bacteruria in renal transplant recipients. The presence of bacteria in the urine of renal transplant recipients without associated symptoms, otherwise known as asymptomatic bacteriuria (ASB), is a common finding about which there is little data regarding the need for treatment and subsequent outcomes. Our group is investigating associated risk factors for the development of ASB along with outcomes in treated versus untreated patients. Our nurse practitioner, Janice Skinner, has over ten years' experience in the inpatient and outpatient care of hematologic malignancies in the Bone Marrow Transplant Unit.

Training in TOID is a large focus of the program. Since its development, Johns Hopkins has been recognized as a primary training site for TOID, and has hosted numerous visiting clinicians, clinical fellows, medical students, and undergraduates for electives in the subspecialty, from both US and international hospitals. A formal curriculum of training at multiple levels has been developed. For more information, contact Darin Ostrander at (410) 614-6702,

The infrastructure of the TOID Program is directed and managed by Darin Ostrander, PhD, who is responsible for the overall coordination, management, and representation of the administrative, operational, and functional components of the Program. Dr. Ostrander has more than twenty-five years' experience in antimicrobial pharmaceutical research and development. He is an experienced research protocol analyst who assists young faculty and fellows in the planning, submission, and execution of clinical and translational studies. The clinical research group employs three full-time clinical research coordinators, a database specialist, and an administrative coordinator. The clinical research efforts include a) the design, implementation, and execution of investigator-initiated and sponsored clinical trials; b) development and management of a retrospective and prospective cohort study of transplant recipients at Hopkins from 2000 to the present to facilitate analysis of risk factors and outcomes of infectious complications; and c) the creation of the administrative infrastructure used by ID and ID-associated investigators and fellows for the funding, approval, implementation, and reporting of clinical and translational studies.

Dr. Marr has a laboratory dedicated to basic, diagnostic, and translational research in fungal infections. Current research projects focus on diagnostics for invasive fungal infections and specialized studies of the pathogenesis of candidiasis and aspergillosis.

If you wish to make a donation to further our research and training efforts, please contact Darin Ostrander at (410) 614-6702,


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