Department / Division:
Medicine / Pulmonary, Allergy, and Critical Care Medicine

Address:
DUMC 3876
Durham, NC 27710

Appointment Telephone:
919-684-2240

Office Telephone:
919-684-0245

Fax Telephone:
919-681-9571

• MD, Duke University School of Medicine, 1993

• Internal Medicine, Duke University Medical Center, 1993-1996
• Pulmonary and Critical Care Medicine, Duke University Medical Center, 1996-1999

• MHS, Duke University School of Medicine, 1998-2000

Clinical Interests:
Pulmonary and transplant medicine, biostatisics and clinical trials, transplant immunology

Research Interests:
Dr. Palmer’s clinical, translational, and basic research program centers around the area of human lung transplantation.  The Duke University Medical Center has the largest lung transplant program in the United States and consistently performs 70-90 lung transplant operations each year.  Patients with endstage lung diseases including emphysema, cystic fibrosis, and idiopathic pulmonary fibrosis are referred in from around the country for transplantation.  Over 850 patients have received lung transplantation at Duke since the inception of the program, and almost all of these patients continue to receive follow-up at Duke.  Our diverse research program draws upon this unique population and seeks ultimately to improve outcomes for all transplant recipients.

Clinical research studies and clinical trials are currently ongoing to design and implement better strategies to prevent posttransplant infections such as with cytomegalovirus (CMV), and other viral and fungal pathogens.  Outcomes-based research draws upon our large transplant database to better understand the factors pre-transplant that may predict postoperative outcomes.  Single center and multi-center clinical trials of new immunosuppressive agents are also currently underway.  We have also developed a strong interest in the impact of gastroesophageal reflux on pulmonary disease, and have a number of ongoing studies designed to better understand the biological effects of acid reflux in the lung.

Translational and basic studies are also an important component of the lung transplant research program.  Ongoing studies seek to better identify and define genetic variation in donor and recipients that may contribute to successful posttransplant outcomes.  For example, we have identified an important polymorphism in an innate immune receptor associated with reduced early lung rejection.  Additional ongoing studies targeting other potentially important genes are underway.  Finally, our laboratory is also developing an animal model that may be useful to better understand the cellular and molecular mechanisms that occur in pulmonary allograft rejection and design better strategies to prevent posttransplant rejection from occurring.

Representative Publications:
Wahidi MM, Willner DA, Snyder LD, Hardison JL, Chia JY, Palmer SM. Diagnosis and outcome of early pleural space infection following lung transplantation. Chest. 2009 Feb;135(2):484-91. (2009) Abstract

Martinu T, Chen DF, Palmer SM. Acute rejection and humoral sensitization in lung transplant recipients. Proc Am Thorac Soc. 2009 Jan 15;6(1):54-65. (2009) Abstract

Morgan DL, Flake GP, Kirby PJ, Palmer SM. Respiratory toxicity of diacetyl in C57BL/6 mice. Toxicol Sci. 2008 May;103(1):169-80. (2008) Abstract

Martinu T, Babyak MA, O'Connell CF, Carney RM, Trulock EP, Davis RD, Blumenthal JA, Palmer SM, . Baseline 6-min walk distance predicts survival in lung transplant candidates. Am J Transplant. 2008 Jul;8(7):1498-505. (2008) Abstract

Kinnier CV, Eu JP, Davis RD, Howell DN, Sheets J, Palmer SM. Successful bilateral lung transplantation for lymphangiomatosis. Am J Transplant. 2008 Sep;8(9):1946-50. (2008) Abstract

Hartwig MG, Snyder LD, Appel JZ 3rd, Cantu E 3rd, Lin SS, Palmer SM, Davis RD. Rabbit anti-thymocyte globulin induction therapy does not prolong survival after lung transplantation. J Heart Lung Transplant. 2008 May;27(5):547-53. (2008) Abstract

Alexander BD, Petzold EW, Reller LB, Palmer SM, Davis RD, Woods CW, Lipuma JJ. Survival after lung transplantation of cystic fibrosis patients infected with Burkholderia cepacia complex. Am J Transplant. 2008 May;8(5):1025-30. (2008) Abstract

Reddy AJ, Zaas AK, Hanson KE, Palmer SM. A single-center experience with ganciclovir-resistant cytomegalovirus in lung transplant recipients: treatment and outcome. J Heart Lung Transplant. 2007 Dec;26(12):1286-92. (2007) Abstract

Reams BD, Musselwhite LW, Zaas DW, Steele MP, Garantziotis S, Eu PC, Snyder LD, Curl J, Lin SS, Davis RD, Palmer SM. Alemtuzumab in the treatment of refractory acute rejection and bronchiolitis obliterans syndrome after human lung transplantation. Am J Transplant. 2007 Dec;7(12):2802-8. (2007) Abstract

Palmer SM, Klimecki W, Yu L, Reinsmoen NL, Snyder LD, Ganous TM, Burch L, Schwartz DA. Genetic Regulation of Rejection and Survival Following Human Lung Transplantation by the Innate Immune Receptor CD14. Am J Transplant. 2007 Jan 11. (2007) Abstract

Garantziotis S, Palmer SM, Snyder LD, Ganous T, Chen BJ, Wang T, Cook DN, Schwartz DA. Alloimmune lung injury induced by local innate immune activation through inhaled lipopolysaccharide. Transplantation. 2007 Oct 27;84(8):1012-9. (2007) Abstract

Tesar BM, Jiang D, Liang J, Palmer SM, Noble PW, Goldstein DR. The role of hyaluronan degradation products as innate alloimmune agonists. Am J Transplant. 2006 Nov;6(11):2622-35. (2006) Abstract

Taylor JL, Palmer SM. Critical care perspective on immunotherapy in lung transplantation. J Intensive Care Med. 2006 Nov-Dec;21(6):327-44. (2006) Abstract

Snyder LD, Palmer SM. Immune mechanisms of lung allograft rejection. Semin Respir Crit Care Med. 2006 Oct;27(5):534-43. (2006) Abstract

Snyder LD, Hartwig MG, Ganous T, Davis RD, Herczyk WF, Reinsmoen NL, Schwartz DA, Palmer SM. Cytokine gene polymorphisms are not associated with bronchiolitis obliterans syndrome or survival after lung transplant. J Heart Lung Transplant. 2006 Nov;25(11):1330-5. (2006) Abstract

Palmer SM. Reflux of bile acids: an innate problem of lung transplantation. Am J Transplant. 2006 Aug;6(8):1757-8. (2006) Abstract

Palmer SM. Lung transplantation: evolving concepts and controversies. Semin Respir Crit Care Med. 2006 Oct;27(5):439-40. (2006) Abstract

Palmer SM, Davis RD, Simsir SA, Lin SS, Hartwig M, Reidy MF, Steele MP, Eu PC, Blumenthal JA, Babyak MA, . Successful bilateral lung transplant outcomes in recipients 61 years of age and older. Transplantation. 2006 Mar 27;81(6):862-5. (2006) Abstract

Palmer SM, Burch LH, Mir S, Smith SR, Kuo PC, Herczyk WF, Reinsmoen NL, Schwartz DA. Donor polymorphisms in Toll-like receptor-4 influence the development of rejection after renal transplantation. Clin Transplant. 2006 Jan;20(1):30-6. (2006) Abstract

Martinu T, Howell DN, Davis RD, Steele MP, Palmer SM. Pathologic correlates of bronchiolitis obliterans syndrome in pulmonary retransplant recipients. Chest. 2006 Apr;129(4):1016-23. (2006) Abstract

Dickson RP, Davis RD, Rea JB, Palmer SM. High frequency of bronchogenic carcinoma after single-lung transplantation. J Heart Lung Transplant. 2006 Nov;25(11):1297-301. (2006) Abstract

Blumenthal JA, Babyak MA, Keefe FJ, Davis RD, Lacaille RA, Carney RM, Freedland KE, Trulock E, Palmer SM. Telephone-based coping skills training for patients awaiting lung transplantation. J Consult Clin Psychol. 2006 Jun;74(3):535-44. (2006) Abstract

Zaas DW, Palmer SM.  The role of the innate immune system in lung allograft rejection.  Current Opinion in Organ Transplantation 2005;10(3):221-25. (2005)

Wilkes DS, Egan TM, Reynolds HY.  For the NIH Working Group on Lung Transplantation.  (Palmer SM, member).  Opportunities for Research and Clinical Advancement.  Amer J Respir Crit Care Med 2005;15;172(8):944-55. (2005)

Snyder LD, Palmer SM. Quality, quantity, or both? Life after lung transplantation. Chest. 2005 Sep;128(3):1086-7. (2005) Abstract

Rocha PN, Rocha AT, Palmer SM, Davis RD, Smith SR. Acute renal failure after lung transplantation: incidence, predictors and impact on perioperative morbidity and mortality. Am J Transplant. 2005 Jun;5(6):1469-76. (2005) Abstract

Palmer SM, Burch LH, Trindade AJ, Davis RD, Herczyk WF, Reinsmoen NL, Schwartz DA. Innate immunity influences long-term outcomes after human lung transplant. Am J Respir Crit Care Med. 2005 Apr 1;171(7):780-5. (2005) Abstract

Pakhale SS, Hadjiliadis D, Howell DN, Palmer SM, Gutierrez C, Waddell TK, Chaparro C, Davis RD, Keshavjee S, Hutcheon MA, Singer LG. Upper lobe fibrosis: a novel manifestation of chronic allograft dysfunction in lung transplantation. J Heart Lung Transplant. 2005 Sep;24(9):1260-8. (2005) Abstract

Hadjiliadis D, Chaparro C, Reinsmoen NL, Gutierrez C, Singer LG, Steele MP, Waddell TK, Davis RD, Hutcheon MA, Palmer SM, Keshavjee S. Pre-transplant panel reactive antibody in lung transplant recipients is associated with significantly worse post-transplant survival in a multicenter study. J Heart Lung Transplant. 2005 Jul;24(7 Suppl):S249-54. (2005) Abstract

Goldstein DR, Palmer SM. Role of Toll-like receptor-driven innate immunity in thoracic organ transplantation. J Heart Lung Transplant. 2005 Nov;24(11):1721-9. (2005) Abstract

Trindade AJ, Palmer SM. Current concepts and controversies in lung transplantation. Respir Care Clin N Am. 2004 Dec;10(4):427-47, v. (2004) Abstract

Palmer SM, Schwartz DA.  The role of the innate immune system in mediating lung allograft rejection.  Current Opinion in Organ Transplantation 2004;9:320-324. (2004)

Palmer SM, Grinnan DC, Diane Reams B, Steele MP, Messier RH, Duane Davis R. Delay of CMV infection in high-risk CMV mismatch lung transplant recipients due to prophylaxis with oral ganciclovir. Clin Transplant. 2004 Apr;18(2):179-85. (2004) Abstract

Palmer SM, Burch LH, Schwartz DA.  Toll-like receptors and allograft rejection (letter).  American Journal of Respiratory and Critical Care Medicine 2004;169:971-972. (2004)

Nielsen TD, Bahnson T, Davis RD, Palmer SM. Atrial fibrillation after pulmonary transplant. Chest. 2004 Aug;126(2):496-500. (2004) Abstract

Lau CL, Patterson GA, Palmer SM. Critical care aspects of lung transplantation. J Intensive Care Med. 2004 Mar-Apr;19(2):83-104. (2004) Abstract

Hadjiliadis D, Steele MP, Govert JA, Davis RD, Palmer SM. Outcome of lung transplant patients admitted to the medical ICU. Chest. 2004 Mar;125(3):1040-5. (2004) Abstract

Drew RH, Dodds Ashley E, Benjamin DK Jr, Duane Davis R, Palmer SM, Perfect JR. Comparative safety of amphotericin B lipid complex and amphotericin B deoxycholate as aerosolized antifungal prophylaxis in lung-transplant recipients. Transplantation. 2004 Jan 27;77(2):232-7. (2004) Abstract

Cantu E 3rd, Appel JZ 3rd, Hartwig MG, Woreta H, Green C, Messier R, Palmer SM, Davis RD Jr. J. Maxwell Chamberlain Memorial Paper. Early fundoplication prevents chronic allograft dysfunction in patients with gastroesophageal reflux disease. Ann Thorac Surg. 2004 Oct;78(4):1142-51; discussion 1142-51. (2004) Abstract

Zaas D, Palmer SM. Respiratory failure early after lung transplantation: now that we know the extent of the problem, what are the solutions? Chest. 2003 Jan;123(1):14-6. (2003) Abstract

Young LR, Hadjiliadis D, Davis RD, Palmer SM. Lung transplantation exacerbates gastroesophageal reflux disease. Chest. 2003 Nov;124(5):1689-93. (2003) Abstract

Reams BD, McAdams HP, Howell DN, Steele MP, Davis RD, Palmer SM. Posttransplant lymphoproliferative disorder: incidence, presentation, and response to treatment in lung transplant recipients. Chest. 2003 Oct;124(4):1242-9. (2003) Abstract

Palmer SM, Garantziotis S, Reinsmoen NL.  Clinical significance of anti-HLA antibodies in lung transplantation.  Current Opinion in Organ Transplantation 2003;8(3):217-221. (2003)

Palmer SM, Burch LH, Davis RD, Herczyk WF, Howell DN, Reinsmoen NL, Schwartz DA. The role of innate immunity in acute allograft rejection after lung transplantation.  Am J Respir Crit Care Med.  2003;168:628-632 (with accompanying editorial). (2003) Abstract

Mariencheck WI, Alcorn JF, Palmer SM, Wright JR. Pseudomonas aeruginosa elastase degrades surfactant proteins A and D. Am J Respir Cell Mol Biol. 2003 Apr;28(4):528-37. (2003) Abstract

Hadjiliadis D, Duane Davis R, Steele MP, Messier RH, Lau CL, Eubanks SS, Palmer SM. Gastroesophageal reflux disease in lung transplant recipients. Clin Transplant. 2003 Aug;17(4):363-8. (2003) Abstract

Davis RD Jr, Lau CL, Eubanks S, Messier RH, Hadjiliadis D, Steele MP, Palmer SM. Improved lung allograft function after fundoplication in patients with gastroesophageal reflux disease undergoing lung transplantation. J Thorac Cardiovasc Surg. 2003 Mar;125(3):533-42. (2003) Abstract

Reams BD, Davis RD, Curl J, Palmer SM. Treatment of refractory acute rejection in a lung transplant recipient with campath 1H. Transplantation. 2002 Sep 27;74(6):903-4. (2002) Abstract

Palmer SM, Davis RD, Hadjiliadis D, Hertz MI, Howell DN, Ward FE, Savik K, Reinsmoen NL. Development of an antibody specific to major histocompatibility antigens detectable by flow cytometry after lung transplant is associated with bronchiolitis obliterans syndrome. Transplantation. 2002 Sep 27;74(6):799-804. (2002) Abstract

Lau CL, Palmer SM, Howell DN, McMahon R, Hadjiliadis D, Gaca J, Pappas TN, Davis RD, Eubanks S. Laparoscopic antireflux surgery in the lung transplant population. Surg Endosc. 2002 Dec;16(12):1674-8. (2002) Abstract

Hadjiliadis D, Sporn TA, Perfect JR, Tapson VF, Davis RD, Palmer SM. Outcome of lung transplantation in patients with mycetomas. Chest. 2002 Jan;121(1):128-34. (2002) Abstract

Hadjiliadis D, Davis RD, Palmer SM. Is transplant operation important in determining posttransplant risk of bronchiolitis obliterans syndrome in lung transplant recipients? Chest. 2002 Oct;122(4):1168-75. (2002) Abstract

Palmer SM, Drew RH, Whitehouse JD, Tapson VF, Davis RD, McConnell RR, Kanj SS, Perfect JR. Safety of aerosolized amphotericin B lipid complex in lung transplant recipients. Transplantation. 2001 Aug 15;72(3):545-8. (2001) Abstract

Palmer SM, Baz MA, Sanders L, Miralles AP, Lawrence CM, Rea JB, Zander DS, Edwards LJ, Staples ED, Tapson VF, Davis RD. Results of a randomized, prospective, multicenter trial of mycophenolate mofetil versus azathioprine in the prevention of acute lung allograft rejection. Transplantation. 2001 Jun 27;71(12):1772-6. (2001) Abstract

Garantziotis S, Howell DN, McAdams HP, Davis RD, Henshaw NG, Palmer SM. Influenza pneumonia in lung transplant recipients: clinical features and association with bronchiolitis obliterans syndrome. Chest. 2001 Apr;119(4):1277-80. (2001) Abstract

Palmer SM, Miralles AP, Howell DN, Brazer SR, Tapson VF, Davis RD. Gastroesophageal reflux as a reversible cause of allograft dysfunction after lung transplantation. Chest. 2000 Oct;118(4):1214-7. (2000) Abstract

Palmer SM, Alexander BD, Sanders LL, Edwards LJ, Reller LB, Davis RD, Tapson VF. Significance of blood stream infection after lung transplantation: analysis in 176 consecutive patients. Transplantation. 2000 Jun 15;69(11):2360-6. (2000) Abstract

Hadjiliadis D, Howell DN, Davis RD, Lawrence CM, Rea JB, Tapson VF, Perfect JR, Palmer SM. Anastomotic infections in lung transplant recipients. Ann Transplant. 2000;5(3):13-9. (2000) Abstract

Palmer SM, Miralles AP, Lawrence CM, Gaynor JW, Davis RD, Tapson VF. Rabbit antithymocyte globulin decreases acute rejection after lung transplantation: results of a randomized, prospective study. Chest. 1999 Jul;116(1):127-33. (1999) Abstract

Palmer SM and Tapson VF. Infection in Organ-Transplant Recipients (letter). New England Journal of Medicine 1998;339:1245-1246. (1998)

Palmer SM Jr, Henshaw NG, Howell DN, Miller SE, Davis RD, Tapson VF. Community respiratory viral infection in adult lung transplant recipients. Chest. 1998 Apr;113(4):944-50. (1998) Abstract