David Lawrence CV
David Lawrence CV
David Lawrence CV
Curriculum Vitae
of
Current Appointment
Consultant in Cardiothoracic Surgery
The Heart Hospital, UCL Hospitals NHS Trust
E mail: [email protected]
Age: 45 years
Nationality: British
a) Secondary Education
Exams passed
June 1983 GCE A Level Physics A
Mathematics A
Chemistry B
GCE S Level Mathematics Credit
b) University Education
August 1987 MRC Scholarship for funding of BSc (awarded to the top ten
students at the second MB examination). This year was spent
studying molecular genetics.
November 1998 Grant from the trustees of St George's Hospital, London for one
years' salary and £5000 towards laboratory expenses to study the
effect of combining gene therapy and chemotherapy on malignant
mesothelioma.
I spent three months as PRHO to the Department of Thoracic Medicine and the remaining
three months in the Department of Haematological Medicine. This was a busy job with an
average medical take of 20 patients per day.
I spent the first three months of this appointment in General Surgery and the second three
months in Cardiothoracic Surgery. It was during this job that I developed a special
interest in Cardiothoracic Surgery.
1. August 1991 to July 1992 - SHO Accident and Emergency & Anatomy Demonstrator
Kings' College Hospital, London SE5.
Head of Anatomy: Professor K Webster. Consultant A&E: Dr E Glucksman.
This year was spent working part time in the busiest A & E Department in London and
part time as an Anatomy demonstrator at the attached University. This had the advantage
over two separate six month jobs in that I spent a full academic year teaching anatomy,
enabling me to demonstrate the entire human body. During this appointment I gained
valuable experience in the management of trauma.
2. August 1992 to January 1993 - SHO Cardiothoracic Surgery
Hammersmith Hospital, London W12.
Consultants: Professor K Taylor, Mr Bruce Keogh and Mr Peter Smith.
During this appointment I was responsible for covering the patients on the ward and the
ITU. There was no shortage of operative exposure and at the end of my six months I was
able to harvest a long saphenous vein and was regularly the first assistant at coronary
artery bypass grafting. I also gained experience in assisting at valve surgery and a weekly
thoracic list. I was allowed to perform median sternotomy and close chests under
supervision.
3. February 1993 to July 1993 - SHO Orthopaedic Surgery
Whipps Cross Hospital, London E11 1NR.
Consultant: Mr Tom Mc Auliffe.
I enjoyed working in this busy Orthopaedic center as the teaching was excellent. I had, by
the end of the job gained valuable experience with an arthroscope and had good exposure
to current methods of external and internal fixation.
4. August 1993 to July 1994 - SHO General Surgery
St Helier Hospital, Carshalton, Surrey, SM5 1AA.
Consultants: Mr N J Bett, Mr A Nash, Mr J Edwards and Mr A Chilvers.
In undertaking this appointment, I completed the requirements for the clinical part of the
FRCS (Eng) exam. This job exposed me to busy elective major and day case lists and also
given me good emergency surgical experience as the hospital has a busy A & E
Department. By the end of this job I was performing my own day case lists and being
supervised in major surgery. I was able to gain experience in laparoscopic procedures,
having assisted at laparoscopic cholecystectomies, laparoscopic Nissen fundoplications,
laparoscopic hernia repairs and laparoscopically assisted hemicolectomies. I have
performed 3 laparoscopic cholecystectomies. It was during this post that I passed the
clinical section of the FRCS (Eng) examination.
This six month position enabled me to build on the experience I had previously gained as
Cardiothoracic SHO at the Hammersmith Hospital. My ward duties included taking ward
rounds, admitting patients and being responsible for their post-operative care.
Operatively, in addition to harvesting the long saphenous and arm vein, I began routinely
opening and closing chests. I gained some experience in aortic cannulation and
preparation of the internal mammary artery for grafting.
This post gave me good exposure to adult cardiac and thoracic surgery. I performed
thirty eight cases of coronary artery bypass grafting, seven of which were with SHO
assistance only. I also performed three aortic valve replacements. I routinely prepared
and cannulated patients undergoing mitral valve surgery. I performed three right lower
lobectomies and also a left upper lobectomy. I was also exposed to video assisted
thoracoscopic surgery and able to build on this experience at the Ethicon VATS course I
attended in Hamburg in September 1995.
My other duties included covering intensive care, taking ward rounds and being able to
admit patients. I attended a weekly outpatient clinic, where I saw patients with follow up
appointments. I sometimes saw new patients as well. I presented a monthly audit and a
paper review at the weekly journal club.
The first 6 months of this rotation focussed on Thoracic Surgery. I attended daily
operating lists and was responsible for the pre and post op management of the patients on
the wards. On-call duties were centered around the busy intensive care unit.
I then moved into the department of Cardiac Surgery where I gained further experience in
Coronary artery bypass grafting and began operating independently. I also had exposure
to the use of homografts and stentless valves in cardiac surgery. I learned to perform
organ retrieval for transplantation during this time.
During this job I was able to consolidate the basic cardiac surgical work, the thoracic
surgical experience and the transplant experience I had gained at Harefield Hospital.
My research was carried out with a grant from the trustees of St George's Hospital,
London. The work was actually performed at the Rayne Institute, King's College London
in the Department of Molecular Medicine. Professor Farzin Farzaneh is head of
Department and Dr Bernard Souberbielle is my lab supervisor. My project involved the
investigation of gene therapy in the treatment of mesothelioma and lung cancer.
8. January 2002 to 30th June 2002. Final year SpR in Cardiothoracic Surgery
The Heart Hospital, UCL Hospitals Trust, Westmoreland Street, London W1.
I enjoyed the last six months of my rotation being allowed to tackle difficult clinical cases
including aortic root surgery, redo coronary and valvular surgery and resection of stage
IIIa lung cancer. The trust then offered me the position of Locum Consultant in
Cardiothoracic Surgery with effect from 01 July 2002.
I now enjoy the experience of working as a consultant, yet having the benefit of working
with senior colleagues with whom I am familiar. They will be to hand for discussion and
supporting me with challenging clinical scenarios. I believe that the current clinical
climate that we work in requires that we recognize our limitations and are not shy to seek
help from more experienced colleagues when appropriate. I continue to be involved in
teaching medical students and other junior doctors at our twice weekly meeting. I have
also continued to be involved in the administration of the SHO and SpR rotas and
ensuring compliance of the unit with the national junior doctors hours requirements.
I have undertaken three audits projects this year. Analysis of the above average death
rates for patients undergoing cardiac surgery in the UCLH Trust during 1999-2001
revealed that small coronary vessels were associated with an increased mortality in low
risk patients undergoing coronary artery surgery. This was supported in the second audit
for the year 2001-2002. An audit of the deaths for 2002-2003 (part year) showed that
poor left ventricular function, diabetes, peripheral vascular disease and renal
insufficiency were associated with increased mortality in high risk patients. Our practice
has consequently been adjusted and has helped result in a reduction in our units operative
mortality from 4.8% (2001-2002) to 2.9% (2002-2003) (8 months) for patients
undergoing 1st time coronary artery bypass surgery.
My research was carried out with a grant from the trustees of St George's Hospital,
London. The work was performed at the Rayne Institute, King's College London in the
Department of Molecular Medicine. Professor Ferzin Farzaneh is head of Department
and Dr Bernard Souberbielle is my lab supervisor.
The project involved the investigation of the effect of combining Herpes Simplex Virus
Thymidine Kinase (HSV-tk) suicide gene therapy with established chemotherapy regimens
in the treatment of malignant mesothelioma and lung cancer.
This thesis was completed, bound and submitted to the University of London for
consideration for the award of the MS degree on the 11th October 2002. The degree of
MS (London) was conferred on 31st January 2005.
Objective. To investigate the effect of combining allogeneic suicide gene therapy with
traditional chemotherapy in the treatment of malignant mesothelioma.
Methods. a) in vitro: Three human mesothelioma cell lines were treated with
allogeneic Herpes Simplex Virus Thymidine Kinase (HSV-tk) gene therapy and
Gancyclovir. The same cell lines were treated with Mitomycin, Vinblastine and
Cisplatin. Expression of p53, p21 (WAF-1), cyclin D1 and retinoblastoma proteins
were assessed by western blotting. Apoptosis and cell death were assessed by trypan
blue exclusion, Annexin V expression and propidium iodide exclusion. Survival was
assessed by MTT assay. b) in vivo: Mesothelioma was induced in the peritoneal cavity
of 55 mice. These were treated with gene therapy, chemotherapy and a combination of
the two modalities. The effects were assessed by post mortem study at 9 days.
Results. Gene therapy of mesothelioma cells resulted in a rapid non sustained induction
of cell cycle proteins compared to a more gradual but sustained (72 hour) response to
chemotherapy. Gene therapy was more effective at killing human mesothelioma cells
than chemotherapy (p less than 0.02). Combining the two therapies resulted in
synergistic killing of cells in vitro. Gene therapy was more effective reducing
mesothelioma tumour load than chemotherapy (p less than 0.05). Combining
chemotherapy with gene therapy however resulted in a reduction of the efficacy of gene
therapy.
a. Non Cardiothoracic
HSV ligations 12 74
Lichtenstein hernia repair 10 38
Right hemicolectomy 03 02
Hemi thyroidectomy 14 01
Transplantation
Retrievals for transplant
Heart 38
Heart Lung 14
Transplantation
Heart 16 1
Lungs (single) 09 -
Heart Lung 08 -
I spent a week in the Department of Clinical Perfusion at Kings' College Hospital where I was
instructed in running a Cardiopulmonary Bypass Machine. I learnt about the construction and
disassembly of the pump and concluded with performing two supervised cases.
Oesophagectomy 51 3
Trans Thoracic Hiatus Hernia 12 -
This involves thoracoscopy for lung biopsy, pleurodesis, pleurectomy and excision of
pericardial cyst. I have also performed VATS for assessing resectability of lung carcinoma
and in the treatment of empyema.
1. A 45 degree two stage venous cannula: advantages over standard two stage
venous cannulation. Lawrence DR, Desai JB. Ann Thorac Surg 1997; 63: 253-4
3. Homograft as a conduit for Superior Vena Cava Syndrome. Ohri SK, Lawrence
DR, Townsend ER. Ann Thorac Surg 1997;64:531-533.
10. Indications for cardiopulmonary bypass for non cardiac operations. Nair KS,
Lawrence DR, Punjabi PP, Taylor KM. Perfusion 2002;17(3):161-166.
11. An unusual cause of mixed mitral valve disease. Nair KS, Lawrence DR, Smith
P. Heart 2002;88(6):560-561
18. Beyond late gadolinium enhancement: the role of diffuse myocardial fibrosis in
severe aortic stenosis – an Equilibrium Contrast CMR study Andrew S. Flett,
Dan Sado, Giovanni Quarta, Sanjay Banypersad, DerekHausenloy, Denis
Pellerin, David Lawrence, Christopher McGregor, Perry M. Elliott, Andrew M
Taylor, James C. JournCardiovasMagRes 2012:13(1)O39
20. Pulmonary mass in a 19 year old male. Laura-Jane E Smith1, Sam Janes2, Irfan
Kayani3 Mary Falzon4, David Lawrence5, Neal Navani2. Thorax
2011:doi:10.1136/thoraxjnl-2011-200732
24. Massive pulmonary carcinoid tumor deemed inoperable until 68Gallium Dotatate
Positron Emission Tomography/Magnetic Resonance Imaging. Katherine
Ordidge James Brown, Laura Succony, Georgia Hardavella, David Lawrence,
Francesco Fraioli, Ashley Groves.
25. Primary mucoepidermoid carcinoma of the thymus presenting with myasthenia gravis.
Woo WL,Panagiotopoulos N, Gvinianidze L, Proctor I, Lawrence D. J Thorac Dis.
2014 Oct;6(10):E223-5.doi: 10.3978/j.issn.2072-1439.2014.09.19.
31. Inflammatory Myofibroblastic Tumor of the lung: a reactive lesion or a true neoplasm?
Panagiotopoulos N, Gvinianidze L, Borg E, Lawrence D. Journal of Thoracic
Oncology.
33. Spatial and temporal diversity in genomic instability processes define early stage lung
cancer evolution Elza de Bruin1,*, Nicholas McGranahan2,*, Richard Mitter2,*, Max
Salm2,*, David Wedge3,*, Lucy Yates3,§, Mariam Jamal-Hanjani1,§, Nirupa Murugaesu1,
Seema Shafi1, Marco Gerlinger2,#, Andrew Rowan2, Stuart Horswell2, Ignacio Varela4,
David Lawrence5, Mary Falzon5, Arrigo Capitanio5, Timothy Harkins?, Clarence Lee6,
Warren Tom6, Chaitali Parikh6, Sharmin Begum2, Benjamin Phillimore2, Zoltan
Szallasi7, Nik Matthews2, Aengus Stewart2, Peter Campbell3, Charles Swanton1,2.
1
University College London Cancer Institute, UK, 2 Cancer Research UK London
Research Institute, UK, 3Wellcome Trust Sanger Institute, UK, 4Instituto de
Biomedicina Y Biotecnologia de Cantabria, Spain, 5University College London
Hospitals, UK, 6 ThermoFisher Scientific, CA, USA, 7 Technical University of
Denmark, Denmark. Accepted by Science
40. Is brachytherapy effective for local recurrence control in sublobar resections for non-
small-cell lung cancer? Patrini D, Lawrence D, Adams B, Panagiotopoulos N. Interact
Cardiovasc Thorac Surg. 2015 Nov; 21(5):677-81.
41. 2. The application of Plasmajet Surgical System for the Thoracic Empyema
decortication- A novel technique. Panagiotopoulos N, Patrini D, Shukla R, Hayward M,
Lawrence D. Published on CTSnet (http://ctsnet.org).
46. 7. A novel sutureless technique for the repair of coronary sinus injuries.
Panagiotopoulos N, Patrini D, Adams B, Lawrence D, Roberts N. J Thorac Dis. 2015
Dec;7(12):2359-61. doi: 10.3978/j.issn.2072-1439.2015.12.43.
47. 8. 3rd Generation EGFR TKIs- A Major Breakthrough for NSCLC Treatment.
Panagiotopoulos N, Lawrence D. J. of Respiratory Res.2015 November 1(1):49-60.
ISSN 2409-0579.
49. 10. Sclerosing hemangioma of the lung showing strong FDG avidity on PET scan: Case
report and review of the current literature. Patrini D, Shukla R, Lawrence D, Borg E,
Hayward M, Panagiotopoulos N. Respiratory Medicine Case Reports, Vol. 17, p20–23.
50. 11. The Potential Malignancy of a Solitary Fibrous Tumour of the Lung. Shukla R,
Patrini D, Borg E, Lawrence D, Hayward M, Panagiotopoulos N. Case Rep Pathol.
51. IgG4 related lung disease extending to the thoracic vertebrae, get info
ii) Presentations
1. A not so Septic Shock. A presentation to the General Grand Round of the Hammersmith
Hospital on a case of a dissecting aortic aneurysm. This audiovisual presentation
included a discussion on the current methods of imaging the thoracic aorta and the
options available in the management of such a case. December 1992.
2. The use of Bilateral ITA for CABG gives good early results in patients aged 70 years
and over. Lawrence DR, Desai JB, Marrinan M, Forsyth A.Presented at the Annual
Meeting of the Society of Cardiothoracic Surgeons of Great Britain and Ireland at
Llandudno, 20-22 March 1996.
6. The effect of combining Gene Therapy and Chemotherapy on mesothelioma cell lines
Lawrence DR, Zweri J, Farzeneh F and Souberbielle B. Presented at the British Cancer
Research Meeting, Edinburgh, 13th July 1999.
8. A review of the low Parsonnet deaths following coronary artery surgery in our unit. A
review of 1300 cases (1999-2001). An audit presentation following the release of the
Doctor Foster report. Lawrence DR. Presented to the Audit meeting of the Heart
Hospital, April 2002.
9. Why do patients with low Parsonnet Scores sometimes die following Coronary artery
bypass surgery Lawrence DR. An audit presentation to the Board of University
College Hospitals NHS Trust including members from the Department of Health. UCH
Audit Day, 11th July 2002.
10. A review of the mortality following cardiac surgery in our unit (2002 2003).
Identification of risk factors for surgery and preparation of protocols for the optimisation
of patients prior to undergoing cardiac surgery.Lawrence DR, Smith A. 11th December
2002.
11. Are coronary angiograms of value in the risk stratification of patients undergoing
coronary artery bypass surgery? Lawrence DR, Somaskanthan R, Barnard MJ, Curtis
M, Keogh BE. Presented at the 56th meeting of the European Society for Cardio-
Vascular Surgery, Venice Italy 19th May 2007. C11-5.
12. Outcomes from Surgical Management of pleural infections: 12-year experience from a
tertiary Cardiothoracic Centre: DJB Marks1,2*, M Fisk, CY Koo, D Lawrence, RF
Miller, A Zumla; BTS 2010 dci:101136/thx2010,15097918.
15. The application of Argon Plasma Energy for thoracic empyema decortication: a novel
technique. Patrini D, Hayward M, Shukla R, Lawrence D, Panagiotopoulos N. 24th
European Conference on General Thoracic Surgery, Naples, 29 May- 1 June 2016.
18. Lobectomy for non-small cell lung cancer in octogenarians. A 7-year single centre
experience. Panagiotopoulos N, Patrini D, De Cabanyes S, Hayward M. European Lung
Cancer Conference (ELCC). Geneva, 13-16 April 2016.
22. The Application Of The Plasmajet Surgical System (PSS) For Thoracic Empyema
Decortication – A Novel Technique. Shukla R, Patrini D, Hayward M, Lawrence M,
Panagiotopoulos N. ANZSCTS Annual Scientific Meeting 2015, Adelaide, 15- 18
November 2015.
24. A sutureless technique for the repair of coronary sinus injuries. Panagiotopoulos N,
Patrini D, Adams B, Roberts N. 23rd Annual Meeting of the Asian Society for
Cardiovascular and Thoracic Surgery, Hong Kong, 11-14 May 2015.
27. A novel technique for the management of recurrent malignant pericardial effusions.
Panagiotopoulos N, Patrini D, Adams B, Lawrence D. European Lung Cancer
Conference ELCC, Geneva, 15-18 April 2015.
9. Courses attended
November 1991 Sloame Course for primary FRCS. This two month evening
course was an essential part of success at the primary FRCS
examination.
May 1994 St Thomas' Hospital Course for part B FRCS. The three week
full time course consolidated the knowledge I had acquired over
the past three years and helped me to be successful at the
examination in June 1994.
May 1994 Rowley Bristow Orthopaedic Course. This two weekend course
was run by Professor Appley and his colleagues at St Peters'
Hospital, Chertsey. It consisted of lectures, practical
demonstrations and assessments.
November 1994 Advanced trauma and life support course at Kings' College
Hospital. After completing this course I was invited return to
undertake the ATLS instructor course.
May 1995 Cardiac Surgery '95. This course was run by Professor Sir
Magdi Yacoub and provided a current update of the basic
sciences (including molecular biology) and clinical aspects of
cardiothoracic surgery.
August 2003 Recruitment and Selection Procedure for UCLH NHS Trust
A 2 day course on the backgroung and Trust Procedures. UCLH
Trust Headquarters.
September 2009 Voyage into Innovation. Course by Sorin for education into the
manufacture of Biological prostheses. 23rd to 24th September 2009
Saluggia, Italy.
October 2013 Tracer –X Study Day. 04th Otober 2013. Tracking Non Small
Cell Cancer through Evolution. UCLH.
November 2013 UCLH Basic Life Support Refresher Course, 12th November
2013. UCLH
September 2014 Mitral Valve Repair (Neochordae Course), 23rd and 24th
September Prof. Gerosa, Padua, Italy.
Aug 2014 : 6th Latin American Conference on Lung Cancer 21-23 Aug 2014
Lima,Peru. MUCOEPIDERMOID CARCINOMA OF THE
THYMUS AND MYASTHENIA GRAVIS. IS THERE AN
ASSOCIATION? Wen Ling Woo, Nikolaos Panagiotopoulos,
Lasha Gvinianidze, David Lawrence.
October 2014 VATS Lobectomy Course, Bristol Royal Infirmary, 6th and 7th
October 2014.
December 2014 Cardiac Surgery 2014 : Oxford Deanery Regional Cardiology Teaching
-Oxford Deanery Regional Cardiology Teaching -. Trust Education
Centre, Royal Berkshire Hospital, RG1 5AN.
I enjoy the all aspects of adult cardiothoracic surgery and am particularly comfortable with
performing coronary artery bypass surgery (both on and off pump) routine aortic and mitral
valvular surgery and all aspects of thoracic surgery. I have made a special effort to gain
experience in off pump coronary artery surgery and mitral valve repair. My operative mortality
for coronary artery surgery, is described on the peer reviewed Healthcare Commission website
as “better than expected” when compared to equivalent surgeons across Europe.
I enjoy teaching both medical students and junior members of staff and believe that this is an
important obligation doctors have. I am aware that it is due to the efforts of my senior
colleagues that I am able to operate independently today and this is only repayable by doing the
same for junior members of the team. I am familiar with current information technology
Tennis I have played tennis at inter school and inter club level. I am
currently captain of the David Lloyd Ealing Mens First Team and
play Middlesex League and National League Tennis. I have a UK
LTA rating of 5.1
Rugby Football Played to under 17 level. Vice captain at under 13 and under 15
year age group. Position: Scrum half.
12. Referees
Professor W McKenna,
Medical Director,
The Heart Hospital,
London W1G 8PH.
Tel: 0207 573 8888.