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Lee

Timmy Lee MD, MSPH

Professor of Medicine, Division of Nephrology, University of Alabama at Birmingham | Vice Chair Research, Department of Medicine, University of Alabama at Birmingham | Section Chief, Nephrology, Birmingham Veterans Affairs Medical Center

VA Birmingham health care

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Personal Statement

Dr. Lee is a physician-scientist with an active role in clinical medicine, teaching, research, and administration. He has been involved in hemodialysis vascular access research since 2003 and oversees a translational research program in this area. The goals of their research program are to: (1) elucidate mechanisms of why arteriovenous fistulas (AVF) fail to mature for dialysis (AVF maturation failure), (2) develop and test novel therapies to improve AVF maturation failure, and (3) improve the delivery of care and health outcomes for hemodialysis patients requiring a new dialysis vascular access.

Their translational research program utilizes rodent (mice and rat) and large animal models (pig) to elucidate mechanisms of arteriovenous fistula remodeling and intimal hyperplasia development. They have employed these animal models to: (1) elucidate biological mechanisms that impact vascular health during arteriovenous fistula development, (2) elucidate biological mechanisms of angioplasty injury in arteriovenous fistulas, (3) develop and test novel bionanomatrix-delivered small molecule and peptide therapies to improve arteriovenous fistula remodeling and inhibit intimal hyperplasia development, (4) evaluate the role of chronic kidney disease in arteriovenous fistula remodeling, and (5) elucidate biologic mechanisms of cardiac remodeling following arteriovenous creation. Moreover, their laboratory has customized an in vitro microfluidic perfusion system to control imposed wall shear stress on cultured endothelial and smooth cells and an ex-vivo perfusion system of rodent and porcine arteries and veins to mimic hemodynamic conditions seen in the AV anastomosis and evaluate mechanistic responses and therapeutic responses on a cellular level. Their laboratory utilizes microsurgical techniques for arteriovenous creation, state of the art rodent arteriovenous fistula imaging with non-contrast magnetic resonance imaging (MRI) and high resolution color doppler ultrasound, computational fluid dynamic modeling, transcriptomics and protein expression studies from cells and vascular tissue, immunohistochemical and immunofluorescence imaging, and ultrastructural imaging with electron microscopy to study the biologic and physiologic questions in the in vitro and in vivo models.

Education

  • BA, Washington University in St. Louis, St. Louis, MO
  • MD, Louisiana State University Health Sciences Center, Shreveport, LA
  • MSPH, University of Alabama at Birmingham, Birmingham, AL

Research Interests

  • Evaluating Barriers to Achieving to Successful AVF Maturation
  • Pre-existing Venous Biology and Arteriovenous Access Outcomes
  • Vascular Health and Hemodynamics in Arteriovenous Fistula Maturation
  • Arteriovenous Fistula and Graft Outcomes in the Elderly Population

Recent Publications

  • Shiu YT, Rotmans J, Lee T (2019). Arteriovenous Conduits for Hemodialysis: How to Better Modulate the Pathophysiological Vascular Response to Optimize Vascular Access Durability, Am J Physiol Renal Physiol., 316, F794–F806. PMCID: PMC6580244
  • Cho JM, Shiu YT, Symons JD, and Lee T (2020). Vasoreactivity of the Murine External Jugular Vein and Carotid Artery. J Vasc Res. 57(5):291-301. PMCID: PMC7486270
  • Lee T, Qian J, Zhang Y, Thamer M, and Allon M (2019) Long-term Outcomes of Arteriovenous Fistulas with Unassisted Versus Assisted Maturation: A Retrospective, National Hemodialysis Cohort Study. J Am Soc Nephrol.  30 (11) 2209-2218. PMCID: PMC6830790
  • Lee T, Qian J, Thamer M, and Allon M (2018). Tradeoffs in Vascular Access Selection in Elderly Patients Initiating Hemodialysis with a Catheter. Am J Kidney Dis., 72(4), 509-518. PMCID: PMC6153087
  • Pike D, Shiu YT, Cho YF, Le H, Somarathna M, Isayeva T, Guo L, Symons JD, Kevil CD, Totenhagen J, and Lee T (2019). The Effect of Endothelial Nitric Oxide Synthase on the Hemodynamics and Wall Mechanics in Murine Arteriovenous Fistulas. Sci Rep., 9(1), 4299. PMCID: PMC6414641
  • Complete List of Published Work: http://www.ncbi.nlm.nih.gov/pubmed/?term=lee+timmy

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