About

Dr. David Foley is a Professor and the Folkert O. Belzer Chair in the Division of Transplantation at the University of Wisconsin School of Medicine and Public Health. He serves as the Surgical Director of the UW Health Liver Transplant Program and the Director of the UW Health Renal Autotransplant Program. His clinical focus is in liver and kidney transplantation, providing services such as kidney and liver transplants, laparoscopic donor nephrectomy, liver resection, wedge resection of the liver, and renal autotransplant. Dr. Foley's research interests include studying protective strategies to decrease organ damage and enhance organ function after kidney and liver transplantation. He focuses on identifying and modifying clinical risk factors that lead to poor liver function post-transplantation, including the use of older donor livers, livers from donation after circulatory determination of death donors, and livers with steatosis. His basic research efforts are centered on identifying novel protective strategies to minimize ischemia-reperfusion injury in liver and kidney transplantation, particularly through investigating cell-specific effects of augmenting endogenous antioxidant pathways to decrease oxidative stress and promote cellular recovery. Dr. Foley has been actively involved in leadership roles within national surgical and transplant societies, including serving as Co-Chair for the Grants Review Committee for the American Society of Transplant Surgeons and holding positions on the executive committees of related organizations.

Research topics

• Medicine
• Internal medicine
• Intensive care medicine
• Surgery
• Cancer research
• Oncology
• Law
• Gastroenterology

Selected publications

• Delay in Surgical Fixation of Operatively Treated Thoracolumbar Fractures in the Elderly Associated With Minimal Increase in Short-Term Complications

  Global Spine Journal · 2026-05-21

  articleOpen access

  Study DesignRetrospective cohort study.ObjectivesOptimal timing of surgical fixation for neurologically intact unstable thoracolumbar fractures (NIUTLFx) in elderly patients remains poorly defined. This study evaluated the association between delay to surgical fixation and short-term postoperative outcomes in elderly patients with NIUTLFx.MethodsThe American College of Surgeons National Surgical Quality Improvement Program database was queried to identify patients aged 60 years or older who underwent operative fixation for unstable NIUTLFx between 2012 and 2023. Multivariable logistic regression and change-point analyses were used to evaluate the association between surgical delay and 30-day mortality, major complications, perioperative transfusion, and discharge disposition, adjusting for demographic and clinical covariates.ResultsA total of 976 patients met inclusion criteria. The mean time to surgery was 2.8 ± 2.0 days. Surgical delay was not associated with increased 30-day mortality or major postoperative complications. Delays exceeding four days were independently associated with a higher likelihood of discharge to a non-home destination (odds ratio 1.60, 95% CI 1.07-2.38). Delay was not an independent predictor of perioperative blood transfusion after adjustment. Over the study period, mean time to surgery decreased significantly, reflecting a national trend toward earlier operative intervention.ConclusionsIn elderly patients with NIUTLFx, surgical delays of up to four days do not increase short-term mortality or major complications. However, delays beyond four days are associated with a significantly increased risk of non-home discharge. Our data suggest that over short timescales, surgical fixation delays are not associated with significant morbidity but are associated with worse discharge disposition.

  PublisherDOI

• The Lived Experiences of Patients Seeking Renal Autotransplant: A Qualitative Study

  American Journal of Transplantation · 2025-08-01

  article
  PublisherDOI

• Urinary Tract Infection After Kidney Transplantation: Some Centers are Doing Better Than Others

  Clinical Transplantation · 2025-10-24

  article

  BACKGROUND: Urinary tract infection (UTI) is the most common infection after kidney transplantation and a source of significant morbidity and cost. The extent to which UTI rates vary across transplant centers remains unclear. METHODS: We analyzed kidney transplant recipients with operation dates 3/2017-7/2020 in the National Surgical Quality Improvement Program (NSQIP) Transplant beta phase pilot database. Multivariable logistic regression was used to identify factors associated with 30-day UTI. A hierarchical logistic model was used to assess center outlier status. RESULTS: A total of 5128 kidney recipients at 25 transplant centers were included. Overall, 30-day UTI incidence was 6.1% (n = 312). Variation existed between centers (range: 0%-12.9%) in unadjusted analyses with five centers identified as outliers. Ureteral stent use (OR 2.33, 95% CI 1.45-3.75, p < 0.01), longer urinary catheter duration (OR 1.03 per day, 95% CI 1.01-1.05, p < 0.01), female gender (OR 2.24, 95% CI 1.76-2.84, p < 0.01) and recipient age (OR 1.01 per year, 95% CI 1.00-1.02, p < 0.01) were all independently associated with higher UTI risk. These variables were found to explain 17% of the variation in UTI rate among centers. After adjustment, three centers were still identified as outliers. CONCLUSIONS: Early UTI incidence varies widely across United States transplant centers. Established risk factors explain some but not all the center variation. Future collaboration and comparison of practices across centers would help to reduce post-transplant complications such as UTIs.

  PublisherDOI

• Left Ventricular Ejection Fraction and Previous Cardiac Revascularization: Impact on Patient Survival, Graft Survival, and Complications in Kidney Transplant Recipients

  Transplantation Direct · 2025-06-12

  articleOpen access

  Background. Kidney transplant physicians believe that the cardiac status of kidney transplant recipients influences posttransplant outcomes. However, the Scientific Registry of Transplant Recipients (SRTR) does not include cardiac variables in its risk-adjustment model, raising the question of whether it fairly risk adjusts recipients. Methods. This study conducted a retrospective analysis of the prospectively collected National Surgical Quality Improvement Program Transplant database to assess the impacts of pretransplant cardiac revascularization and left ventricular ejection fraction (LVEF) &lt;55% on posttransplant outcomes in deceased donor renal transplantation. Recipients from 2017 to 2019 were stratified into those with versus without prior revascularization and those with LVEF &lt;55% versus LVEF ≥55%. Primary outcomes included differences in 1-y patient and graft survival. Secondary outcomes included postoperative complications. An a priori-specified multivariable Cox-proportional hazards model including existing SRTR variables assessed the independent effect of prior revascularization on patient and graft survival. Results. A total of 2377 recipients were included: 13.3% had prior cardiac revascularization and 11.2% had LVEF &lt;55%. Previous revascularization was significantly associated with an increased risk of deep surgical site infection (3.8% versus 1.1%, P = 0.001), delayed graft function (39.2% versus 28.3%, P &lt; 0.001), myocardial infarction (4.4% versus 0.8%, P &lt; 0.001), longer length of stay (6.57 versus 5.54 d, P = 0.001), and more readmissions (32.9% versus 23.1%, P &lt; 0.001). In univariable analysis, previous revascularization was associated with death (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.11-5.1; P = 0.03) but not graft loss (HR, 1.3; 95% CI, 0.54-3.1; P = 0.55). LVEF &lt;55% was only associated with a higher rate of sepsis (4.3% versus 1.7%, P = 0.011). After adjusting for SRTR variables (age, diabetes, peripheral vascular disease), previous revascularization was not independently associated with death (HR, 1.33; 95% CI, 0.57-3.1; P = 0.50). Conclusions. Previous cardiac revascularization is associated with patient survival and complications, more than LVEF &lt;55%. However, we show that existing variables of the SRTR risk model largely capture the impact of previous cardiac revascularization on patient survival.

  PublisherDOI

• P55. Heterotopic ossification and subsequent adjacent segment degeneration following cervical disc arthroplasty: a retrospective analysis of five-year follow-up

  The Spine Journal · 2025-10-09

  article1st authorCorresponding
  PublisherDOI

• Five years outcomes of recipients of dual kidney transplantation are better compared to the single kidney transplantation with comparable early post-transplant complications

  American Journal of Transplantation · 2025-01-01

  articleOpen access
  PublisherOA PDFDOI

• Twelve Thousand Kidney Transplants Over More Than 55 Y: A Single-center Experience

  Transplantation Direct · 2024-01-19 · 2 citations

  articleOpen access

  Background: Kidney transplant outcomes have dramatically improved since the first successful transplant in 1954. In its early years, kidney transplantation was viewed more skeptically. Today it is considered the treatment of choice among patients with end-stage kidney disease. Methods: Our program performed its first kidney transplant in 1966 and recently performed our 12 000th kidney transplant. Here, we review and describe our experience with these 12 000 transplants. Transplant recipients were analyzed by decade of date of transplant: 1966-1975, 1976-1985, 1986-1995, 1996-2005, 2006-2015, and 2016-2022. Death-censored graft failure and mortality were outcomes of interest. Results: Of 12 000 kidneys, 247 were transplanted from 1966 to 1975, 1147 from 1976 to 1985, 2194 from 1986 to 1995, 3147 from 1996 to 2005, 3046 from 2006 to 2015, and 2219 from 2016 to 2022 compared with 1966-1975, there were statistically significant and progressively lower risks of death-censored graft failure at 1 y, 5 y, and at last follow-up in all subsequent eras. Although mortality at 1 y was lower in all subsequent eras after 1986-1995, there was no difference in mortality at 5 y or the last follow-up between eras. Conclusions: In this large cohort of 12 000 kidneys from a single center, we observed significant improvement in outcomes over time. Kidney transplantation remains a robust and ever-growing and improving field.

  PublisherDOI

• ASO Author Reflections: Hepatic Resection as the Primary Treatment Modality for Hepatocellular Carcinoma After Orthotopic Liver Transplantation

  Annals of Surgical Oncology · 2024-09-14

  article
  PublisherDOI

• Cancer Surveillance in Solid Organ Transplant Recipients With a Pretransplant History of Malignancy: Multidisciplinary Collaborative Expert Opinion

  Transplantation · 2024-05-21 · 12 citations

  review

  With improved medical treatments, the prognosis for many malignancies has improved, and more patients are presenting for transplant evaluation with a history of treated cancer. Solid organ transplant (SOT) recipients with a prior malignancy are at higher risk of posttransplant recurrence or de novo malignancy, and they may require a cancer surveillance program that is individualized to their specific needs. There is a dearth of literature on optimal surveillance strategies specific to SOT recipients. A working group of transplant physicians and cancer-specific specialists met to provide expert opinion recommendations on optimal cancer surveillance after transplantation for patients with a history of malignancy. Surveillance strategies provided are mainly based on general population recurrence risk data, immunosuppression effects, and limited transplant-specific data and should be considered expert opinion based on current knowledge. Prospective studies of cancer-specific surveillance models in SOT recipients should be supported to inform posttransplant management of this high-risk population.

  PublisherDOI

• A-046 Quantification of Corticosteroids and Androgens in Serum, utilizing Waters MassTrak™ Steroid Serum Sets 2 &amp; Sets 3 for Clinical Research

  Clinical Chemistry · 2024-10-01

  articleOpen access

  Abstract Background Steroid hormones encompass a large class of small molecules that play a central role in metabolic processes, such as the regulation of sexual characteristics, blood pressure, and inflammation. Enzymes that form part of the steroid biosynthetic pathway are pivotal in these metabolic processes, and their dysfunction can be examined through the correct measurement of steroid hormones in a clinical research setting. The availability of lyophilized calibrators and QCs reduces sample preparation time, aids in method harmonization, and assists with metrological traceability in accordance with ISO15189:2022, when used alongside an analytically selective chromatographic method. Methods A quantitative clinical research method utilizing Waters MassTrak Steroid Serum Sets 2 and 3, Cals &amp; QCs and Waters Oasis™ PRiME HLB µElution plate technology for the extraction of testosterone, androstenedione, 17-hydroxyprogesterone (17- OHP), dehydroepiandrosterone sulfate (DHEAS), Cortisol, 11-deoxycortisol and 21-deoxycortisol from human serum samples. Chromatographic separation was performed on an Waters ACQUITY™ UPLC™ I Class Plus (FL-I) System, using an ACQUITY UPLC HSS T3 Column, accompanied by a Xevo™ TQ-S micro Mass Spectrometer. Results Accuracy (±6%) and precision (±10%) have been confirmed through comparison to External Quality Assurance (EQA) LC-MS/MS schemes, panels and QC material for all seven steroid hormones. All analytes were assessed at the low, medium and high concentrations for each MassTrak Steroid Serum Set, which yielded excellent results across the range (±10%). Deming and Linear regression analysis were performed. No statistically significant bias was observed for each compound, with a mean method bias of ±1.3% for Set 2 and ±1.0% for Set 3. The clinical research method was shown to be linear for all analytes over the calibration ranges specified, furthermore, calibration lines created using Set 2 and Set 3 were analysed over a five-day period and were linear with a co-efficient of determination of (r2) &amp;gt; 0.999 for all analytes. Analytical sensitivity using Signal:Noise (S/N) of the low calibrator (Calibrator 1) of each set, was &amp;gt;10:1 for each analyte across several analytical runs. Conclusions This evaluation has demonstrated that the MassTrak Steroid Serum Calibrator and Quality Control Sets 2 and 3 can provide precise and accurate quantification of steroid hormones in serum. An analytically sensitive and selective clinical research method has been developed for the analysis of testosterone, androstenedione, 17- OHP, DHEAS, cortisol, 11-deoxycortisol and 21-deoxycortisol in serum using Waters I-Class Xevo TQ-S micro system. For Research Use Only. Not for Use in Diagnostic Procedures.

  PublisherOA PDFDOI

Frequent coauthors

• Patrick W. Serruys

  196 shared

• Michael R. Lucey

  171 shared

• Rashmi Agni

  164 shared

• Philip Y. Wai

  Oxford Fertility

  164 shared

• Rebeca Alvarez

  University of Washington

  162 shared

• S Sebree

  University of North Carolina at Chapel Hill

  162 shared

• Mezrich Fernandez

  University of North Carolina at Chapel Hill

  162 shared

• Chen Jh

  162 shared

Awards & honors

• All-American Top Doctors (2016)
• Madison Magazine Top Docs 2016 Award
• All-Stars (2024)