As a trauma/surgical critical care surgeon, I focus on the immune and inflammatory dysfunction of sepsis and the long term effects of critical illness. My work also involves translating bench findings into bedside observations in ICU patients. Specifically, I foucs on the role of invariant Natural Killer T-cells (iNKT-cells) in modulating the immune dysfunction of critical illness. We have shown in both murine models as well as across a spectrum of ages that iNKT-cells control and modulate a variety of inflammatory and immune responses that are key to the short and long term response to critical illness.
Both the immune and clinical responses are unique among geriatic critically ill surgical patients. A clinical arm of the research component focuses on the unique aspects of geriatric surgical patients with critical illness.
| Lin E, Heffernan DS. "Bowel Obstruction from an Incidentally Ingested Foreign Body." Rhode Island medical journal (2013), vol. 106, no. 5, 2023, pp. 34-37. |
| Reilly AS, Khawaja AM, Ali AB, Madsen T, Molino-Bacic J, Heffernan DS, Zonfrillo MR, Vaitkevicius H, Gormley WB, Izzy S, Rao SS. "Disparities in Decompressive Cranial Surgery Utilization in Severe Traumatic Brain Injury Patients without a Primary Extra-Axial Hematoma: A U.S. Nationwide Study." World Neurosurgery, vol. 169, 2023, pp. e16-e28. |
| Khetpal, Vishal, Berkowitz, Julia, Jiang, Lan, Menon, Anupama, Shah, Nishant, Heffernan, Daithi S., Choudhary, Gaurav, Rudolph, James L., Wu, Wen-Chih, Erqou, Sebhat. "Long-Term Outcomes of Veterans With a Diagnosis of Heart Failure After COVID-19." JACC: Advances, vol. 2, no. 5, 2023, pp. 100381. |
| Wakeley, Michelle E., Armstead, Brandon E., Gray, Chyna C., Tindal, Elizabeth W., Heffernan, Daithi S., Chung, Chun-Shiang, Ayala, Alfred. "Lymphocyte HVEM/BTLA co-expression after critical illness demonstrates severity indiscriminate upregulation, impacting critical illness-induced immunosuppression." Frontiers in Medicine, vol. 10, 2023. |
| Simon K, Cournoyer L, Nwaiwu C, Stephen AH, Heffernan DS. "Management of Acute Appendicitis in HIV/AIDs Patients: A 19-year Review from the National In-Patient Sample." Rhode Island medical journal (2013), vol. 106, no. 4, 2023, pp. 46-51. |
| Heffernan DS, Chung CS, Ayala A. "SPLENIC INVARIANT NATURAL KILLER T CELLS PLAY A SIGNIFICANT ROLE IN THE RESPONSE TO POLYMICROBIAL SEPSIS." Shock, vol. 60, no. 3, 2023, pp. 443-449. |
| Kheirbek, Tareq, Martin, Thomas J., Cao, Jessica, Tillman, Anastasia C., Spivak, Holden A., Heffernan, Daithi S, Lueckel, Stephanie N. "Comparison of Infectious Complications after Surgical Fixation versus Epidural Analgesia for Acute Rib Fractures." Surgical Infections, vol. 23, no. 6, 2022, pp. 532-537. |
| Ganguli R, Franklin J, Yu X, Lin A, Heffernan DS. "Machine learning methods to predict presence of residual cancer following hysterectomy." Scientific reports, vol. 12, no. 1, 2022, pp. 2738. |
| Ganguli, Reetam, Franklin, Jordan, Yu, Xiaotian, Lin, Alice, Lad, Rishik, Heffernan, Daithi S. "Machine learning models to prognose 30-Day Mortality in Postoperative Disseminated Cancer Patients." Surgical Oncology, vol. 44, 2022, pp. 101810. |
| Stephen, Andrew H., Andrea, Sarah B., Banerjee, Debasree, Arafeh, Mohammed, Askew, Morgan, Lueckel, Stephanie N., Kheirbek, Tareq, Mermel, Leonard A., Adams, Charles A., Levy, Mitchell M., Heffernan, Daithi S. "The association between household and neighborhood characteristics and COVID-19 related ICU admissions." SSM - Population Health, vol. 19, 2022, pp. 101133. |
| Montas, Genevieve, Nwaiwu, Chibueze, Stephen, Andrew H., Heffernan, Daithi S. "The Impact of Protective Devices Across the Spectrum of Trauma Care and Across Racial Groupings." The American Surgeon, 2022, pp. 000313482211357. |
| Pierre-Louis, Youry S., Perla, Krissia M. Rivera, Perez, Giancarlo Medina, Jean-Charles, Skenda, Tang, Oliver, Nwaiwu, Chibueze A., Weil, Robert, Shah, Nish S., Heffernan, Daithi S., Moreira, Carla. "The Insurance Coverage Paradox – Characterizing Outcomes among Dual-Eligible Hemorrhagic Stroke Patients." Journal of Clinical Neuroscience, vol. 97, 2022, pp. 99-105. |
| Olivieri DJ, Heffernan DS, Koness RJ. "A Case of Recurrent Malignant Melanoma of the Left Foot with In-Transit Metastases." Rhode Island medical journal (2013), vol. 104, no. 7, 2021, pp. 42-45. |
| Tindal, Elizabeth W., Heffernan, Daithi S., Kheirbek, Tareq, Stephen, Andrew, Lueckel, Stephanie N. "Adding Infectious Insult to Traumatic Injury: The Impact of Infectious Complications in End-of-Life Decision Making." Surgical Infections, vol. 22, no. 9, 2021, pp. 884-888. |
| Tindal, Elizabeth W., Armstead, Brandon E., Monaghan, Sean F., Heffernan, Daithi S., Ayala, Alfred. "Emerging therapeutic targets for sepsis." Expert Opinion on Therapeutic Targets, vol. 25, no. 3, 2021, pp. 175-189. |
| Barie, Philip S., Ho, Vanessa P., Hunter, Catherine J., Kaufman, Elinore J., Narayan, Mayur, Pieracci, Fredric M., Schubl, Sebastian D., Heffernan, Daithi S., Huston, Jared M., None, None. "Surgical Infection Society Guidance for Restoration of Surgical Services during the Coronavirus Disease-2019 Pandemic." Surgical Infections, vol. 22, no. 8, 2021, pp. 818-827. |
| Fallon, Eleanor A., Chung, Chun-Shiang, Heffernan, Daithi S., Chen, Yaping, De Paepe, Monique E., Ayala, Alfred. "Survival and Pulmonary Injury After Neonatal Sepsis: PD1/PDL1's Contributions to Mouse and Human Immunopathology." Frontiers in Immunology, vol. 12, 2021, pp. 634529. |
| Wakeley, Michelle E., Gray, Chyna C., Monaghan, Sean F., Heffernan, Daithi S., Ayala, Alfred. "Check Point Inhibitors and Their Role in Immunosuppression in Sepsis." Critical Care Clinics, vol. 36, no. 1, 2020, pp. 69-88. |
| Wakeley ME, Shubin NJ, Monaghan SF, Gray CC, Ayala A, Heffernan DS. "Herpes Virus Entry Mediator (HVEM): A Novel Potential Mediator of Trauma-Induced Immunosuppression." Journal of Surgical Research, vol. 245, 2020, pp. 610-618. |
| Rai, Ishita, Stephen, Andrew H., Lu, Qing, Heffernan, Daithi S. "Impact of Multi-Drug–Resistant Pneumonia on Outcomes of Critically Ill Trauma Patients." Surgical Infections, vol. 21, no. 5, 2020, pp. 422-427. |
| Heffernan, Daithi S., Evans, Heather L., Huston, Jared M., Claridge, Jeffrey A., Blake, David P., May, Addison K., Beilman, Greg S., Barie, Philip S., Kaplan, Lewis J. "Surgical Infection Society Guidance for Operative and Peri-Operative Care of Adult Patients Infected by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)." Surgical Infections, vol. 21, no. 4, 2020, pp. 301-308. |
| Heffernan IM, McGeary JE, Chung CS, Ayala A, Heffernan DS. "Unmasking Unique Immune Altering Aspects of the Microbiome as a Tool to Correct Sepsis-Induced Immune Dysfunction." Surgical Infections, vol. 22, no. 4, 2020, pp. 400-408. |
| Stephen AH, Shah M, Sim JT, Soipe A, Lueckel SN, Kheirbek T, Heffernan DS, Monaghan SF, Adams CA Jr. "Dismal outcomes following damage control laparotomy in injured older adults, a cohort study." The American Journal of Surgery, vol. 218, no. 1, 2019, pp. 82-86. |
| Heffernan, Daithi S. "Influenza and the Surgeon." Surgical Infections, vol. 20, no. 2, 2019, pp. 119-128. |
| Connolly MD, Monaghan SF, Heffernan D, Lueckel SN, Adams CA Jr. "Practice Makes Perfect: The Evolution of Blunt Chest Trauma." Rhode Island medical journal (2013), vol. 102, no. 8, 2019, pp. 27-29. |
| Gandhi, Christy, Fowler, Rachel L, Hersey, Sean, Heffernan, Daithi S, Stafford, Todd. "Wandering spleen in a geriatric patient – a rare presentation of gastric volvulus." JRSM Open, vol. 10, no. 6, 2019, pp. 205427041985132. |
| Delmonico, Theodore, Stephen, Andrew H., Heffernan, Daithi S. "A Case of Severe Lumbar Necrotizing Soft Tissue Infection from an Ileal Pouch Fistula." Surgical Infections, vol. 19, no. 5, 2018, pp. 548-550. |
| Fallon, Eleanor A, Biron-Girard, Bethany M, Chung, Chun-Shiang, Lomas-Neira, Joanne, Heffernan, Daithi S, Monaghan, Sean F, Ayala, Alfred. "A novel role for coinhibitory receptors/checkpoint proteins in the immunopathology of sepsis." Journal of Leukocyte Biology, vol. 103, no. 6, 2018, pp. 1151-1164. |
| Pilieci, Stephanie N., Salim, Saad Y., Heffernan, Daithi S., Itani, Kamal M.F., Khadaroo, Rachel G. "A Randomized Controlled Trial of Video Education versus Skill Demonstration: Which Is More Effective in Teaching Sterile Surgical Technique?." Surgical Infections, vol. 19, no. 3, 2018, pp. 303-312. |
| Monaghan, Sean F., Banerjee, Debasree, Chung, Chun-Shiang, Lomas-Neira, Joanne, Cygan, Kamil J., Rhine, Christy L., Fairbrother, William G., Heffernan, Daithi S., Levy, Mitchell M., Cioffi, William G., Ayala, Alfred. "Changes in the process of alternative RNA splicing results in soluble B and T lymphocyte attenuator with biological and clinical implications in critical illness." Molecular Medicine, vol. 24, no. 1, 2018, pp. 32. |
| Chun TT, Chung CS, Fallon EA, Hutchins NA, Clarke E, Rossi AL, Cioffi WG, Heffernan DS, Ayala A. "Group 2 Innate Lymphoid Cells (ILC2s) Are Key Mediators of the Inflammatory Response in Polymicrobial Sepsis." The American Journal of Pathology, vol. 188, no. 9, 2018, pp. 2097-2108. |
| Dickinson, Catherine M., LeBlanc, Brian W., Edhi, Muhammad M., Heffernan, Daithi S., Faridi, Mohd. Hafeez, Gupta, Vineet, Cioffi, William G., O’Brien, Xian, Reichner, Jonathan S. "Leukadherin-1 ameliorates endothelial barrier damage mediated by neutrophils from critically ill patients." Journal of Intensive Care, vol. 6, no. 1, 2018, pp. 19. |
| Lueckel, Stephanie N., Kosar, Cyrus M., Teno, Joan M., Monaghan, Sean F., Heffernan, Daithi S., Cioffi, William G., Thomas, Kali S. "Outcomes in nursing home patients with traumatic brain injury." Surgery, vol. 164, no. 1, 2018, pp. 150-154. |
| Dickinson, Catherine M., Karlin, Daniel R., Nunez, Hector R., Cao, Shiliang A., Heffernan, Daithi S., Monaghan, Sean F., Kheirbek, Tareq, Adams, Charles A., Stephen, Andrew H. "Do Patients with Pre-Existing Psychiatric Illness Have an Increased Risk of Infection after Injury?." Surgical Infections, vol. 18, no. 5, 2017, pp. 545-549. |
| Chun, Tristen T., Garcia-Toca, Manuel, Eng, James F., Slaiby, Jeffrey, Marcaccio, Edward J., Cioffi, William G., Heffernan, Daithi S. "Postoperative Infections are Associated with Increased Risk of Cardiac Events in Vascular Patients." Annals of Vascular Surgery, vol. 41, 2017, pp. 151-159. |
| Fallon, Eleanor A., Chun, Tristen T., Young, Whitney A., Gray, Chyna, Ayala, Alfred, Heffernan, Daithi S. "Program Cell Death Receptor-1-Mediated Invariant Natural Killer T-Cell Control of Peritoneal Macrophage Modulates Survival in Neonatal Sepsis." Frontiers in Immunology, vol. 8, 2017. |
| Ottinger ME, Monaghan SF, Gregg SC, Stephen AH, Connolly MD, Harrington DT, Adams CA Jr, Cioffi WG, Heffernan DS. "Trauma morning report is the ideal environment to teach and evaluate resident communication and sign-outs in the 80 hour work week." Injury, vol. 48, no. 9, 2017, pp. 2003-2009. |
| Kao MJ, Nunez H, Monaghan SF, Heffernan DS, Adams CA Jr, Lueckel SN, Stephen AH. "Trauma patients who present in a delayed fashion: a unique and challenging population." Journal of Surgical Research, vol. 208, 2017, pp. 204-210. |
| Young, Whitney A., Fallon, Eleanor A., Heffernan, Daithi S., Efron, Philip A., Cioffi, William G., Ayala, Alfred. "Improved survival after induction of sepsis by cecal slurry in PD-1 knockout murine neonates." Surgery, vol. 161, no. 5, 2016, pp. 1387-1393. |
| Heffernan DS, Monaghan SF, Ayala A. "Lymphocyte integrin expression differences between SIRS and sepsis patients." Irish Journal of Medical Science (1971 -), vol. 186, no. 4, 2016, pp. 981-987. |
| Monaghan SF, Chung CS, Chen Y, Lomas-Neira J, Fairbrother WG, Heffernan DS, Cioffi WG, Ayala A. "Soluble programmed cell death receptor-1 (sPD-1): a potential biomarker with anti-inflammatory properties in human and experimental acute respiratory distress syndrome (ARDS)." Journal of Translational Medicine, vol. 14, no. 1, 2016, pp. 312. |
1) Shock Society Junior Faculty Award 07/01/2011-06/30/2013
The Role of the Invariant Natural Killer T-cell in Hemorrhagic Shock: Regulation of Neutrophil Response.”
Role: Principal Investigator
Agency: Shock Society - $75,000
The major goal of this work is to delineate the effect of hemorrhage on invariant Natural Killer T-cells (iNKT-cells) and the effect of iNKT-cells on the neurtophil response following hemorrhagic shock.
2) SURDNA Foundation Fellowship Award 07/01/2011 – 06/30/2013
Aging and Inflammation: Trauma induced alteration in inflammatory phenotype
Role: Principal Investigator
Agency: SURDNA Foundation for the Geriatric Care - $20,000
The major goal of this project is to define the phenotypic and functional changes in the lymphocytic and inflammatory response to traumatic injuries in critically ill geriatric trauma patients.
3) R01 GM107149-02 (PI: A. Ayala) 09/01/2013 – 05/31/2017
Co-Inhibitory Molecules and the Pathology of Indirect Acute Lung Injury
Role: Collaborator
Agency – NIH/NIGMS
Aims: To determine what the contribution of family of co-inhibitory cell surface-associated molecules, expressed on immune and non-immune cells in the development of acute lung injury in the critically ill surgical/trauma patient.
4) 2R01GM046354-20 (PI: Ayala) 01/01/2014 – 11/30/2017
NIH/NIGMS
Differential Effects of Sepsis on Immune Cell Function
Role: Collaborator
Agency – NIH/NIGMS
Aims: To determine the impact of a novel family of cell-associated co-inhibitor molecules/ ligands, on the development of immune/ organ dysfunction/injury and death resulting from sepsis. The contribution of these molecules to the development of both septic morbidity and mortality will be examined in the setting of experimental sepsis using genetically altered mice as well as drug interventions directed at genes or mediators thought to be involved in the regulation of these cells.
5) R01 HL125265-01 (PI: M. Kim, J. Reichner, R. Waugh) 9/15/2014 – 5/31/2019
Neutrophil-Endothelial Interactions and Barrier Function in Sepsis
Role: Collaborator
Agency – NHLBI/University of Rochester
Aims: To determine the underlying mechanisms that lead to the accumulation of neutrophils of the vasculature with ensuing damage to barrier function. Understanding how to control vascular damage through manipulation of neutrophil extravasation has potential applications in many acute/chronic inflammatory settings including sepsis
6) KO8 GM110495-01A1 (PI: D. Heffernan) 08/01/2015 – 07/01/2019
NIH/NIGMS
Sepsis induced changes in iNKT-cells and their effect on Phagocyte Function
Role: Principal Investigator
Agency – NIH/NIGMS - $785,808
Aims: To determine the effect of sepsis on iNKT-cells and the role of iNKT-cells in modulating the immune dysfunction induced by sepsis, specifically the mechanisms of how iNKT-cells modulate macrophages following polymicrobial sepsis.
| Year | Degree | Institution |
|---|---|---|
| 1996 | MD | Trinity College Dublin |
| 1993 | MA | Trinity College Dublin |
POSTGRADUATE HONORS AND AWARDS
2002 1st Place (Krudibal Award) New Mexico Chapter College of Surgeons Meeting Resident Research
2003 1st Place Surgical Resident Research Award University of New Mexico
2003 1st Place Region 6 Committee on Trauma Resident Research Meeting
2004 Khatali Award for Best Medical Student Teaching awarded by the UNM Medical School
2004 1st Place (Krudibal Award) New Mexico Chapter College of Surgeons Meeting Resident Research
2004 2nd Place Surgical Resident Research Award University of New Mexico
2004 2nd Place Region 6 Committee on Trauma Resident Research Meeting
2005 1st Place (Krudibal Award) New Mexico Chapter College of Surgeons Meeting Resident Research
TEACHING AWARDS
2000 Best Resident Teaching Award Blanchardstown Hospital, Dublin, Ireland
2004 University of New Mexico Dean's Teaching Award for Medical Students
2006 Department of Surgery University of New Mexico Best Resident Teaching Award
2009 Brown University Medical School Dean's Teaching Award for Medical Students
2010 Brown University Medical School Dean's Teaching Award for Medical Students
2010 Dept. of Surgery Brown University Outstanding Faculty Teaching Award
2011 Brown University Medical School Dean's Teaching Award for Medical Students
2011 Faculty Alpha Omega Alpha award
2012 Brown University Medical School Dean's Teaching Award for Medical Students
2012 Brown University Dean's Teaching Award for the translation of basic science into clinical practice.
2015 – Dept. of Surgery Brown University – Outstanding Faculty Teaching Award
2017 – Brown University Medical School – Dean’s Teaching Award for Medical Students
| Name | Title |
|---|---|
| Ayala, Alfred | Professor of Surgery (Research) |
| Gravenstein, Stefan | David S. Greer Professor of Geriatric Medicine, Director, Division of Geriatrics and Palliative Care, Professor of Health Services, Policy and Practice |
| McGeary, John | Professor of Psychiatry and Human Behavior |
| Monaghan, Sean | Associate Professor of Surgery |
Alpha Omega Alpha Honor Medical Society – 2011 – present
Association of Academic Surgeons – 2009 – present
Committee roles – member Membership Committee (2010-2012)
- member Informatics Committee (2012-2015)
Society of Critical Care Medicine – 2011 – present
Surgical Infection Society – 2007 – present
Committee role - member Informatics Committee 2010 – 2012
- Chairman Informatics Committee 2012 – 2015
- Chairman Informatics Committee 2015 – 2018
- Member – Strategic Planning Committee 2009 – 2011
Strategic Planning Committee 2013 – 2015
- Member – Program Committee – 2018 – 2021
Councilor – 2018 - 2020
Shock Society – 2011 – present
Committee role - Member Strategic Planning Committee 2015 – 2017
- Chairman Strategic Planning Committee 2017-2019
- Member – Informatics and Website Committee – 2016 – 2018
- Member – Finance Committee – 2018 – 2021
Society of University Surgeons – 2018 – present
Committee role – Member of Membership committee
Society of Leukocyte Biology
Rhode Island Medical Society – 2009 – present
| Surgical Critical Care | American Board of Surgery, Surgical Critical Care | 2009- | |
| American Board of Surgery | American Board of Surgery, General surgery | 2008- | |
| Rhode Island Board of Medical Licensure | 2007- | ||
| Advanced Trauma Life Support (ATLS) | ATLS, Instructor | - |
| Surgeon. Providence Veterans Affairs Medical Center, 2016- |
| Surgeon. Rhode Island Hospital, 2008- |
| Surgeon. Vanderbilt University Medical Center, 2007-2008 |
