Clinical Associate Professor, Department of Surgery
Biosketch
After finishing her undergraduate (University of Rochester) and post-graduate education (SUNY Stony Brook Medical School), Tjasa Hranjec, MD/MS-CR, pursued her General Surgery training at the University of Virginia. In 2014, she completed the fellowship in Trauma/Critical Care Surgery from the University of Texas at Southwestern (UTSW)/Parkland. To better serve the injured patients, Dr. Hranjec pursued additional training in Abdominal Transplantation (UTSW). Over the past decade, she has specialized in caring for the patients with the most challenging acute and chronic conditions: cirrhosis and acute liver failure, large abdominal wall defects, bowel fistulas, injuries to retroperitoneum, hilum, ureter or pelvis, severe coagulopathy following injury, and many others. After becoming the Vice-Chief, then Chief of Surgery at Memorial Regional Hospital in May 2019, she initiated a multitude of projects to better patient outcomes. She created the “TEG (thromboelastography) task force” in an attempt to study and eliminate coagulopathy (bleeding and clotting in trauma, transplant and critically ill patients), her main research interest. Dr. Hranjec has also studied surgical infections, immunosuppression, malnutrition, use of extracorporeal membrane oxygenation (ECMO) to improve and increase organ donation, and decellularization and recellularization of organs. She has worked with numerous medical students, residents and staff as an educator, colleague and research mentor and looks to inspire the next generation of surgeons and scientists.
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Education and Training
- Clinical Fellowship 2015, Transplant Surgery, University of Texas at Southwestern Medical Center
- Clinical Fellowship 2014, Trauma/Critical Care Surgery, University of Texas at Southwestern Medical Center
- Residency 2013, General Surgery, University of Virginia
- Research Fellowship 2010, University of Virginia
- MS 2009, Clinical Research, University of Virginia
- Internship 2007, General Surgery, University of Virginia
- MD 2006, Medical Doctor, SUNY Stony Brook School of Medicine
- BS 2002, Cell and Developmental Biology, University of Rochester
- BA 2002, Psychology, University of Rochester
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Research
- Venous Clotting
- Trauma Care
- Transplantation
- Thrombosis
- Thromboelastometry in Neurointensive Care
- Surgical resident education
- Surgical Innovation
- Liver Transplantation
- Liver Cirrhosis
- Kidney Transplantation
- Hepatobiliary surgery
- General abdominal surgery
- End-stage renal disease
- Disorders of Coagulation
- Adult Critical Care
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Publications
Hranjec T., Mayhew M., Rogers B., Solomon R., Hurst D., Estreicher M., Augusten A., Nunez A., Green M., Malhotra S., Katz R., Rosenthal A., Hennessy S., Pepe P., Sawyer R., Arenas J., Katz R, Rosenthal A, Hennessy S, Pepe P, Sawyer R, Estreicher M, Hurst D, Solomon R, Rogers B, Mayhew M, Hranjec T, Arenas J, Augusten A, Nunez A, Green M, Malhotra S Diagnosis and treatment of coagulopathy using thromboelastography with platelet mapping is associated with decreased risk of pulmonary failure in COVID-19 patients Blood Coagul Fibrinolysis. 2023;34:508-516.
Ratnasekera A.M., Kim D., Seng S.S., Jacovides C., Kaufman E.J., Sadek H.M., Perea L.L., Monaco C., Shnaydman I., Lee A.J., Sharp V., Miciura A., Trevizo E., Rosenthal M., Lottenberg L., Zhao W., Keininger A., Hunt M., Cull J., Balentine C., Egodage T., Mohamed A., Kincaid M., Doris S., Cotterman R., Seegert S., Jacobson L.E., Williams J., Whitmill M., Palmer B., Mentzer C., Tackett N., Hranjec T., Dougherty T., Morrissey S., Donatelli-Seyler L., Rushing A., Tatebe L.C., Nevill T.J., Aboutanos M.B., Hamilton D., Redmond D., Cullinane D.C., Falank C., Mcmellen M., Duran C., Daniels J., Ballow S., Schuster K., Ferrada P. Early VTE prophylaxis in severe traumatic brain injury: A propensity score weighted EAST multicenter study Journal of Trauma and Acute Care Surgery. 2023;95(1):94-104.
Ghneim M., Brasel K., Vesselinov R., Albrecht J., Liveris A., Watras J., Michetti C., Haan J., Lightwine K., Winfield R., Adams S., Podbielski J., Armen S., Zacko J.C., Nasrallah F., Schaffer K., Dunn J., Smoot B., Schroeppel T., Stillman Z., Cooper Z., Stein D., Adams C., Lueckelm S., Murry J., Hsu C., Bhatti U., Lissauer M., LaFonte M., Najafi K., Lewandowski K., Mukherjee K., Imperio-Lagabon K., Martin N., Hirsch K., Berry C., Freitas D., Cullinane D., Ramwani R., Truitt M., Pearcy C., Hashimi H., Kaups K., Claridge J., Ladhani H., Hartwell J., Ballou J., Croce M., Markle S., Osserwaarde S., Posluszny J., Stocker B., Hranjec T., Solomon R., Martinek L., Gupta A., Grabo D.J., Khan U., Tatum D., Jacome T., Gates J., Jawani A., Berndtson A., Curry T., Bala M., Dultz L., Houshmand N., Pieri P., Zielinski M., Hughes J., Malhotra A., Lee T., Petrone P., Joseph D., Marshall G., Carrick M., Pathak A., Van Zandt A., Glass N., Livingston D., Gregg S., Webb T., Drumheller B., Kozar R., Barraco R., Joseph B. Traumatic Brain Injury in Older Adults: Characteristics, Outcomes, and Considerations. Results From the American Association for the Surgery of Trauma Geriatric Traumatic Brain Injury (GERI-TBI) Multicenter Trial Journal of the American Medical Directors Association. 2022;23:568-575.e1.
Jain A., Haussner D., Hranjec T., Butt F., Stine J.G., Ankola A., Al Yousif H., Dicristina R., Krok K.L., Arenas J. Review of Sarcopenia and Testosterone Deficiency With Chronic Liver Disease and Postoperative Liver Transplant Utility of Short-Term Testosterone Replacement Therapy Experimental and Clinical Transplantation. 2022;20(11):1000-1008.
Kashkoush A., Petitt J.C., Ladhani H., Ho V.P., Kelly M.L., Ghneim M., Albrecht J.S., Brasel K., Livaris A., Watras J.B., Michetti C.P., Haan J.M., Lightwine K., Winfield R.D., Adams S.D., Podbielski J.M., Armen S.B., Zacko J.C., Nasrallah F.S., Schaffer K.B., Dunn J., Widdel L., Schroeppel T.J., Stillman Z., Cooper Z., Stein D., Adams C., Lueckel S., Murry J., Patel N., Hsu C., Bhatti U.F., Lissauer M.E., LaFonte M., Najafi K., Lewandowski K., Mukherjee K., Imperio-Lagabon K.J., Martin N.D., Hirsch K., Berry C., Freitas D., Cullinane D., Ramawi R., Truitt M., Pearcy C., Hashimi H., Kaups K., Claridge J., Hartwell J.L., Ballou J., Croce M., Markle S., Osserwaarde S., Posluszny J., Stocker B., Hranjec T., Solomon R., Martinek L., Gupta A., Grabo D.J., Khan U., Tatum D., Jacome T., Gates J., Jawani A., Berndtson A.E., Curry T.G., Bala M., Dultz L.A., Houshmand N.N., Pieri P., Zielinski M.D., Hughes J.D., Hartwell J., Malhotra A.K., Lee T., Petrone P., Joseph D., Marshall G.T., Carrick M.M., Pathak A., Van Zandt A., Glass N., Livingston D., Gregg S., Webb T., Drumheller B., Kozar R., Barraco R., Joseph B. Predictors of Mortality, Withdrawal of Life-Sustaining Measures, and Discharge Disposition in Octogenarians with Subdural Hematomas World Neurosurgery. 2022;157:e179-e187.
Mayhew M., Solomon R., Laguardia H., Shaw K., Arenas J., Hranjec T. Vascular Complications in Renal Transplantation: Surgical Salvage of Renal Artery Dissection Transplantation Direct. 2022;8(6):E1340.
Cibulas M.A., Carrillo E.H., Hranjec T., Kiffin C.D., Lee S.K., Pigneri D.A., Sanchez R.E., Spitzer R.D., Toro T.Z., Rosenthal A.A. Overwhelming Mucormycosis Abdominal Gunshot Wound Infection in an Immunocompetent Host American Surgeon. 2021;87(1):140-141.
Hranjec T., Estreicher M., Rogers B., Kohler L., Solomon R., Hennessy S., Cibulas M., Hurst D., Hegazy M., Lee J., Perez D., Doctor N., Kiffin C., Pigneri D., Laguardia H., Shaw K., Arenas J., Rosenthal A., Katz R.S., Sawyer R.G., Pepe P.E. Integral Use of Thromboelastography With Platelet Mapping to Guide Appropriate Treatment, Avoid Complications, and Improve Survival of Patients With Coronavirus Disease 2019–Related Coagulopathy Critical Care Explorations. 2020;2:E0287.
Khoury M.K., Pickett M.L., Cripps M.W., Park S.Y., Nagaraj M.B., Hranjec T., Hennessy S.A. Transfer Is Associated with a Higher Mortality Rate in Necrotizing Soft Tissue Infections Surgical Infections. 2020;21(2):136-142.
Subramanian M., Hirschkorn C., Eyerly-Webb S.A., Solomon R.J., Hodgman E.I., Sanchez R.E., Davare D.L., Pigneri D.A., Kiffin C., Rosenthal A.A., Pedraza Taborda F.E., Arenas J.D., Hennessy S.A., Minei J.P., Minshall C.T., Hranjec T. Clinical Diagnosis of Infection in Surgical Intensive Care Unit: You're Not as Good as You Think! Surgical Infections. 2020;21(2):122-129.
Dawoud S., Solomon R.J., Eyerly-Webb S.A., Abrahams N.A., Pedraza F., Arenas J.D., Hranjec T. Pyeloduodenal Fistula in Xanthogranulomatous Pyelonephritis: A Series of Two Cases The Permanente journal. 2018;22
Guidry C.A., Hranjec T., Shah P.M., Dietch Z.C., Hassinger T.E., Elwood N.R., Sawyer R.G. Aggressive Antimicrobial Initiation for Suspected Intensive Care Unit-Acquired Infection Is Associated with Decreased Long-Term Survival after Critical Illness Surgical Infections. 2017;18:664-669.
Rosenthal A.A., Solomon R.J., Eyerly-Webb S.A., Sanchez R., Lee S.K., Kiffin C., Davare D.L., Hranjec T., Carrillo E.H. Traumatic epidural hematoma: Patient characteristics and management American Surgeon. 2017;83(11):E438-E440.
Rosenberger L.H., Guidry C.A., Davis J.P., Hranjec T., Johnston V.K., Wages N.A., Watson C.M., Sawyer R.G. Reducing accidental dislodgement of the percutaneous endoscopic gastrostomy Surgical Innovation. 2016;23:62-69.
Subramanian M., Hranjec T., Liu L., Hodgman E.I., Minshall C.T., Minei J.P. A case for less workup in near hanging Journal of Trauma and Acute Care Surgery. 2016;81(5):925-930.
Guidry C.A., Rosenberger L.H., Petroze R.T., Davies S.W., Hranjec T., McLeod M.D., Politano A.D., Riccio L.M., Sawyer R.G. Temporal Trends in Blood Stream Infection Isolates from Surgical Patients Surgical Infections. 2015;16:388-395.
Hennessy S., Shah P., Guidry C., Davies S., Hranjec T., Sawyer R. Can Nasal Methicillin-Resistant Staphylococcus aureus Screening Be Used to Avoid Empiric Vancomycin Use in Intra-Abdominal Infection? Surgical Infections. 2015;16:396-400.
Charles E.J., Petroze R.T., Metzger R., Hranjec T., Rosenberger L.H., Riccio L.M., McLeod M.D., Guidry C.A., Stukenborg G.J., Swenson B.R., Willcutts K.F., O'Donnell K.B., Sawyer R.G. Hypocaloric compared with eucaloric nutritional support and its effect on infection rates in a surgical intensive care unit: A randomized controlled trial American Journal of Clinical Nutrition. 2014;100:1337-1343.
Davies S., Guidry C., Politano A., Rosenberger L., Mcleod M., Hranjec T., Sawyer R. Aspergillus infections in transplant and non-transplant surgical patients Surgical Infections. 2014;15:207-212.
Davies S.W., Efird J.T., Guidry C.A., Hranjec T., Metzger R., Swenson B.R., Sawyer R.G. Characteristics of surgical patients receiving inappropriate empiric antimicrobial therapy Journal of Trauma and Acute Care Surgery. 2014;77:546-554.
Davies S.W., Efird J.T., Guidry C.A., Hranjec T., Metzger R., Swenson B.R., Sawyer R.G. Does it Matter if we get it right? Impact of appropriateness of empiric antimicrobial therapy among surgical patients Shock (Augusta, Ga.). 2014;42:185-191.
Davies S.W., Gillen J.R., Guidry C.A., Newhook T.E., Pope N., Hranjec T., Sawyer R.G., Hallowell P.T. A comparative analysis between laparoscopic and open adhesiolysis at a tertiary care center American Surgeon. 2014;80:261-269.
Guidry C.A., Mallicote M.U., Petroze R.T., Hranjec T., Rosenberger L.H., Davies S.W., Sawyer R.G. Influence of bronchoscopy on the diagnosis of and outcomes from ventilator-associated pneumonia Surgical Infections. 2014;15:527-532.
Guidry C.A., Swenson B.R., Davies S.W., Dossett L.A., Popovsky K.A., Bonatti H., Evans H.L., Metzger R., Hedrick T.L., Tache-Léon C.A., Hranjec T., Chaudry I.H., Pruett T.L., May A.K., Sawyer R.G. Sex- and diagnosis-dependent differences in mortality and admission cytokine levels among patients admitted for intensive care Critical Care Medicine. 2014;42:1110-1120.
Hranjec T., Sawyer R.G. Management of infections in critically ill patients Surgical Infections. 2014;15:474-478.
Riccio L.M., Popovsky K.A., Hranjec T., Politano A.D., Rosenberger L.H., Tura K.C., Sawyer R.G. Association of excessive duration of antibiotic therapy for intra-abdominal infection with subsequent extra-abdominal infection and death: A study of 2,552 consecutive infections Surgical Infections. 2014;15:417-424.
Rosenberger L.H., Gillen J.R., Hranjec T., Stokes J.B., Brayman K.L., Kumer S.C., Schmitt T.M., Sawyer R.G. Donor risk index predicts graft failure reliably but not post-transplant infections Surgical Infections. 2014;15:94-98.
Davies S., Guidry C., Petroze R., Hranjec T., Sawyer R. Vancomycin and nephrotoxicity: Just another myth? Journal of Trauma and Acute Care Surgery. 2013;75:830-835.
Hennessy S., Gillen J., Hranjec T., Kozower B., Jones D., Kron I., Lau C. Influence of hemodialysis on clinical outcomes after lung transplantation Journal of Surgical Research. 2013;183(2):916-921.
Hranjec T., Sawyer R. Aggressive versus conservative initiation of antibiotics - Authors' reply The Lancet Infectious Diseases. 2013;13:390.
Hranjec T., Sawyer R. Conservative initiation of antimicrobial treatment in ICU patients with suspected ICU-Acquired infection: More haste less speed Current Opinion in Critical Care. 2013;19:461-464.
Rosenberger L.H., Hranjec T., McLeod M.D., Politano A.D., Guidry C.A., Davies S., Sawyer R.G. Improvements in pulmonary and general critical care reduces mortality following ventilator-associated pneumonia Journal of Trauma and Acute Care Surgery. 2013;74:568-574.
Flohr T.R., Bonatti H., Hranjec T., Keith D.S., Lobo P.I., Kumer S.C., Schmitt T.M., Sawyer R.G., Pruett T.L., Roberts J.P., Brayman K.L. Elderly recipients of hepatitis c positive renal allografts can quickly develop liver disease Journal of Surgical Research. 2012;176:629-638.
Guidry C.A., Hranjec T., Rodgers B.M., Kane B., McGahren E.D. Permissive hypercapnia in the management of congenital diaphragmatic hernia: Our institutional experience Journal of the American College of Surgeons. 2012;214(4):640-647.e1.
Hranjec T., Rosenberger L., Swenson B., Metzger R., Flohr T., Politano A., Riccio L., Popovsky K., Sawyer R. Aggressive versus conservative initiation of antimicrobial treatment in critically ill surgical patients with suspected intensive-care-unit-acquired infection: A quasi-experimental, before and after observational cohort study The Lancet Infectious Diseases. 2012;12:774-780.
Hranjec T., Sawyer R., Young J., Swenson B., Calland J. Mortality factors in geriatric blunt trauma patients: Creation of a highly predictive statistical model for mortality using 50,765 consecutive elderly trauma admissions from the national sample project American Surgeon. 2012;78:1369-1375.
Hranjec T., Turrentine F.E., Stukenborg G., Young J.S., Sawyer R.G., Calland J.F. Burn-center quality improvement: Are burn outcomes dependent on admitting facilities and is there a volume-outcome "sweet-spot"? American Surgeon. 2012;78:559-566.
Turza Campbell K., Rosenberger L.H., Politano A.D., Hranjec T., Sawyer R.G. Management of Infectious Complications in the Critically Ill Obese Patient Critical Care Management of the Obese Patient. 2012:83-92.
Emaminia A., Hennessy S., Hranjec T., Lapar D., Kozower B., Jones D., Kron I., Lau C. Bronchiolitis obliterans syndrome occurs earlier in the post-lung allocation score era Journal of Thoracic and Cardiovascular Surgery. 2011;141(5):1278-1282.
Gardenier J., Hranjec T., Sawyer R.G., Bonatti H. Granulicatella adiacens bacteremia in an elderly trauma patient Surgical Infections. 2011;12:251-253.
Hennessy S., Hranjec T., Emaminia A., Lapar D., Kozower B., Kron I., Jones D., Lau C. Geographic distance between donor and recipient does not influence outcomes after lung transplantation Annals of Thoracic Surgery. 2011;92(5):1847-1853.
Kauffmann R.M., Norris P.R., Jenkins J.M., Dupont W.D., Torres R.E., Blume J.D., Dossett L.A., Hranjec T., Sawyer R.G., May A.K. Trends in estradiol during critical illness are associated with mortality independent of admission estradiol Journal of the American College of Surgeons. 2011;212:703-712.
Politano A.D., Hranjec T., Rosenberger L.H., Sawyer R.G., Tache Leon C.A. Differences in morbidity and mortality with percutaneous versus open surgical drainage of postoperative intra-abdominal infections: A review of 686 cases American Surgeon. 2011;77:862-867.
Rosenberger L.H., Hranjec T., Politano A.D., Swenson B.R., Metzger R., Bonatti H., Sawyer R.G. Effective cohorting and "superisolation" in a single intensive care unit in response to an outbreak of diverse multi-drug-resistant organisms Surgical Infections. 2011;12:345-350.
Anvari F., Sharma A.K., Fernandez L.G., Hranjec T., Ravid K., Kron I.L., Laubach V.E. Tissue-derived proinflammatory effect of adenosine A<inf>2B</inf> receptor in lung ischemia-reperfusion injury Journal of Thoracic and Cardiovascular Surgery. 2010;140(4):871-877.
Hennessy S., Dengel L., Hranjec T., Slingluff C. A triangular intermuscular space sentinel node in melanoma: Association with axillary lymphatic drainage Annals of Surgical Oncology. 2010;17(9):2465-2470.
Hennessy S., Hranjec T., Swenson B., Kozower B., Jones D., Ailawadi G., Kron I., Lau C. Donor Factors Are Associated With Bronchiolitis Obliterans Syndrome After Lung Transplantation Annals of Thoracic Surgery. 2010;89(5):1555-1562.
Hranjec T., Swenson B., Dossett L., Metzger R., Flohr T., Popovsky K., Bonatti H., May A., Sawyer R. Diagnosis-Dependent Relationships between Cytokine Levels and Survival in Patients Admitted for Surgical Critical Care Journal of the American College of Surgeons. 2010;210:833-844.
Hranjec T., Swenson B., Sawyer R. Surgical site infection prevention: How we do it Surgical Infections. 2010;11:289-294.
Metzger R., Swenson B.R., Bonatti H., Hedrick T.L., Hranjec T., Popovsky K.A., Pruett T.L., Sawyer R.G. Identification of risk factors for the development of clostridium difficile-associated diarrhea following treatment of polymicrobial surgical infections Annals of Surgery. 2010;251:722-727.
Nagji A.S., Hranjec T., Swenson B.R., Kern J.A., Bergin J.D., Jones D.R., Kron I.L., Lau C.L., Ailawadi G. Donor Age Is Associated With Chronic Allograft Vasculopathy After Adult Heart Transplantation: Implications for Donor Allocation Annals of Thoracic Surgery. 2010;90(1):168-175.
Carter C., Bonatti H., Hranjec T., Barroso L.F., Donowitz G., Sawyer R.G., Schirmer B. Epigastric cystic echinococcus involving stomach, liver, diaphragm, and spleen in an immigrant from afghanistan Surgical Infections. 2009;10:453-456.
Hranjec T., Bonatti H., Roman A., Sifri C., Borowitz S.M., Barnes B.H., Flohr T.R., Pruett T.L., Sawyer R.G., Schmitt T.M. Benign Transient Hyperphosphatasemia Associated With Epstein-Barr Virus Enteritis in a Pediatric Liver Transplant Patient: A Case Report Transplantation Proceedings. 2008;40:1780-1782.
Hranjec T., Kovač A., Kos J., Mao W., Chen J.J., Grollman A.P., Jelaković B. Endemic nephropathy: The case for chronic poisoning by aristolochia Croatian Medical Journal. 2005;46(1):116-125.