Biography
An honours graduate of Trinity College, Susan McKiernan undertook postgraduate training in gastroenterology and hepatology in St James's Hospital for 4 years. Her thesis examined the immunogenetics of Hepatitis C infection as she was privileged to have access to a single source, single genotype outbreak in a unique all female Irish anti-D cohort. She then spent a year in the National Liver Transplant Center in St Vincents University Hospital, followed by a liver fellowship in Kings College Hospital, London. She took up her post as a consultant Gastroenterologist and Hepatologist at St James's Hospital in 2003.
Her area of interest is liver disease and hepatobiliary malignancy. She delivers the largest service nationally for the treatment of viral hepatitis, including facilitating treatments at sites distant to the hospital more suited to the patient thus improving treatment outcomes. She provides a direct oral cholangioscopy service for the treatment and diagnosis of hepatobiliary disease.
Her secondary area of interest is the delivery of health care, examining efficiency and effectiveness in her own work practice and across the hospital in related areas. In developing patient pathways she has reduced the number of patients requiring endoscopy, reduced the number of patients requiring outpatient follow-up, reduced inpatient stay. This ultimately frees up resources to allow more patients to be treated.
As previous clinical lead in endoscopy in the largest unit in Ireland with over 16,000 procedures undertaken annually, we successfully achieved and retained level 2 JAG accreditation. She was an active participant in the National Colorectal Cancer Screening Service inception, a former member of National Consultative Council for Hepatitis C, a current member of clincial advisory group for the National Hepatitis C treatment Programme, and a committee member of the Irish Society of Gastroenterology.
Publications and Further Research Outputs
Peer-Reviewed Publications
M Elsiddig, M McKenna-Barry, R Varley, C Dunne, F MacCarthy, S McKiernan, DO Toole, D Kevans, K Hartery, Quality of upper gastrointestinal bleeding risk stratification and pre-endoscopic management at an Irish University teaching hospital, Endoscopy, European Society of Gastrointestinal Endoscopy, 2021, 53, (S01), 2021, ppS114-S115
D Byrne, JP Walsh, C Daly, S McKiernan, S Norris, RT Murphy, G King, Improvements in cardiac function detected using echocardiography in patients with hereditary haemochromatosis, Irish Journal of Medical Science, 189, (1), 2020, p109 - 117
David J Gibson, Jayne Doherty, Mairead McNally, John Campion, Denise Keegan, Aine Keogh, Una Kennedy, Kathryn Byrne, Laurence J Egan, Susan McKiernan, FInbar MacCarthy, Subhasish Sengupta, Juliette Sheridan, Hugh E Mulcahy, Garret Cullen, Eoin Slattery, David Kevans, Glen A Doherty, Comparison of medium to long-term outcomes of acute severe ulcerative colitis patients receiving accelerated and standard infliximab induction, Frontline gastroenterology, 11, (6), 2020, p441 - 447
Conor Grant , Sarah O'Connell, Darren Lillis , Anne Moriarty, Ian Fitzgerald , Linda Dalby , Ciaran Bannan , Helen Tuite , Brendan Crowley, Patrick Plunkett, Una Kennedy , Geraldine McMahon , Susan McKiernan , Suzanne Norris5, Gerard Hughes, Darragh Shields , Colm Bergin , Opt-out screening for HIV, hepatitis B and hepatitis C: observational study of screening acceptance, yield and treatment outcomes, Emergency Medicine Journal, 37, (2), 2020, p102 - 105
R Corcoran, S O'Reilly, S Hough, K Hartery, S McKiernan, D Kevans, F MacCarthy, Audit of colonoscopies carried out for the indication of abnormal radiological imaging over a 4 year period in a large tertiary referral centre, ESGE Days, Dublin, 2020
O'Gorman, P., Strahan, O., Ferguson, D., Monaghan, A., Kennedy, M., Forde, C., Melo, A., Doherty, D., O'Brien, K., McKiernan, S., Kenny, R., Coen, R.F., Doherty, C., Bergin, C., Gormley, J., Norris, S. , Improvement in cognitive impairment following a 12-week aerobic exercise intervention in individuals with non-cirrhotic chronic hepatitis C., Journal of Viral Hepatitis , 2020
L Coffey, R Varley, L Piggott, E Mooney, DO Toole, S Mckiernan, D Kevans, F MacCarthy, K Hartery, New oral anticoagulant use and non-variceal upper gastrointestinal bleeding, a single centre retrospective study, Endoscopy, European Society of Gastrointestinal Endoscopy, 2020, 52, (S01), 2020, ppeP48
J O'Connell, R Corcoran, R Argue, P McDonagh, M S Ismail, G Cullen, G Doherty, K Hartery, M Healy, M McCormack, F MacCarthy, S McKiernan, A O'Connor, B Ryan, D McNamara, D Kevans, Early vedolizumab trough levels are associated with induction therapy outcome, ECCO, Vienna, 2020
P McDonagh, F Maccarthy, D Kevans, K Hartery, S McKiernan, An unusual bile duct lesion, Endoscopy, European Society of Gastrointestinal Endoscopy, 2020, 52, (1), 2020
Judge, C, McGettigan N, Ryan T, Hazel K, Singh P, Parihar V, Stack R, O'Connor A, Dunne C, Cullen G, Egan L, Harewood G, MacCarthy F, McKiernan S, Mulcahy H, Murray F, Patchett S, Sheridan J, Cheriyan D, Farrell R, Keohane J, Kelly O, McNamara D, Ryan B, O'Morain C, Sengupta S, O'Toole, A, Buckley M, McCarthy J, Doherty G, Kevans D, Slattery E, Irish data on the safety and efficacy of vedolizumab in the treatment of inflammatory bowel disease. , Scandinavian Journal of Gastroenterology, 55, (7), 2020, p786 - 794
J O'Connell, S Keohane, A McGreal-Bellone, P McDonagh, S Naimimohasses, U Kennedy, C Dunne, K Hartery, J Larkin, F MacCarthy, J Meaney, S McKiernan, S Norris, D O'Toole, D Kevans, Characteristics and outcomes of acute colitis diagnosed on cross-sectional imaging presenting via the emergency department in an Irish academic medical centre, Irish Journal of Medical Science, 2020, p1 - 7
P McDonagh, EHD Wouda, F Maccarthy, D Kevans, S McKiernan, K Hartery, SIGNIFICANT CORRELATION BETWEEN ADENOMA AND SERRATED LESIONS DETECTION RATES AT COLONOSCOPY, Endoscopy, European Society of Gastrointestinal Endoscopy, 52, (01), 2020, ppePP326
J Steen, M McComack, C McShane, M Healy, V Crowley, U Kennedy, O Hayes, C Dunne, K Hartery, S McKiernan, F MacCarthy, D Kevans, Cost-effectiveness of utilising proactive Infliximab therapeutic drug monitorng for inflammatory bowel disease in routine clinical practice, Journal of Crohns and colitis, European Crohns and Colitis organisation, 2019, 13, 2019, pps307 - s308
A Monaghan, M Kennedy, P O'Gorma, B Hynes, C Quinn, S Naimimohasses, S McKiernan S Norris, J Gormley, SAt-249 increased cardiovascular risk associated with chronic hepatitis C infection still remain at SVR24, Journal of Hepatology, 70, (1), 2019, pe741 - e742
J O'Connell, P McDonagh, N Clarke, A Buckley, C Dunne, K Hartery, J Larkin, F MacCarthy, P McCormack, S McKiernan, B Mehigan, C Muldoon, C Ryan, J O'Sullivan, D Kevans, P095 Association between tissue oncostatin M expression and infliximab response in corticosteroid refractory acute severe ulcerative colitis, Journal of Crohns and Colitis, European Crohns Colitis Organisation, 2019, 13, (1), Oxford Academic, 2019, ppS133 - S134
Catherine McShane, John R Campion, Olga Fagan, Cian Muldoon, Ciara Ryan, Paul Browne, Eibhlin Conneally, Cara Dunne, Catherine Flynn, Patrick Hayden, Dermot O'Toole, Karen Hartery, Finbar MacCarthy, Susan McKiernan, Elisabeth Vandenberghe, Larry Bacon, David Kevans, Endoscopic evaluation for gastrointestinal graft versus host disease; a five year retrospective review from the national adult allogenic stem cell transplant programme, Gastroenterology , Digestive Disease Week , 2019, 156, (6), 2019, pps667
Orla Strahan, Damien Ferguson, Robert Coen, Paul Dockree, Colin Doherty, Philip O'Gorman, John Gormley, Susan Mary McKiernan, Colm Bergin, Suzanne Norris, Reversal of neurocognitive dysfunction in non-cirrhotic HCV infected patients; impact of DAA's beyond the liver, Hepatology, American Association for Study of Liver Disease, edited by 2019 , 70, 2019, pp987A
Crowley D, Murtagh R, Cullen W, Keevans M, Laird E, McHugh T, McKiernan S, Miggin SJ, O'Connor E, O'Reilly D, Betts-Symonds G, Tobin C, Van Hout MC, Lambert JS, Evaluating peer-supported screening as a hepatitis C case-finding model in prisoners., Harm reduction journal, 2019
D Crowley, R Murtagh, W Cullen, M Keevans, E Laird, T McHugh, S McKiernan, SJ Miggin, E O'Connor, D O'Reilly, G Betts-Symonds, C Tobin, MC Van Hout, J Lambert, Evaluating the impact of peer supported mass hepatitis C screening initiative in prisoners , Harm Reduction Journal, 16, (42), 2019
Crowley D, Lambert JS, Betts-Symonds G, Cullen W, Keevans M, Kelly E, Laird E, McHugh T, McKiernan S, Miggin SJ, Murphy C, Murtagh R, O'Reilly D, Tobin C, Van Hout MC. , The seroprevalence of untreated chronic hepatitis C virus (HCV) infection and associated risk factors in male Irish prisoners: a cross-sectional study, , Eurosurveillance, 24, (14), 2019
C Judge, N McGettigan, T Ryan, K Hazel, P Singh, V Parihar, R Stack, A O'Connor, C Dunne, G CullenL Egan, G Harewood, F MacCarthy, S McKiernan, H Mulcahy, FMurray, S Patchett, J SheridanD Trevian, N Breslin, RFarrell, J Keohane, O Kelly, D McNamara, B Ryan, CSmyth, C O'Morain, S Sengupta, E Slattery, G Doherty, D Kevans, A O'Toole, effectiveness and safety of vedolizumab therapy in an ulcerative colitis cohort with significant prior anti-TNF exposure, Journa of Crohns and Colitis, Euorpean Crohns and Colitis Organisation, 2018, 12, (1), 2018, pps410 - s411
Clarke L, Adduri RS, Smyth P, Quinn F, Jeffers M, Dunne B, O'Leary J, McKiernan S, Vandenberghe E, Pyne S, Bashyam MD, Sheils O, Flavin R, Potentially important miRNAs in enteropathy-associated T-cell lymphoma pathogenesis: A pilot study. , Leukaemia research reports, 10, 2018, p52 - 54
Abbie Kelly, Jonathan Dean, Aisling O'Leary, Stephen Stewart, Eoin Feeney, Barry Kelleher, Susan Mary McKiernan, P Aiden McCormick, Frank E Murray, Orla M Crosbie, Diarmuid Houlihan, Colm Bergin, Liam J Fanning, Suzanne Norris, Jack Lambert, Sam McConkey, Garry Courtney, John Lee, Cillian De Gascun, Direct-acting antiviral treatment failures and resistance associated substitutions in hepatitis C virus infection in Ireland, Hepatology, American Association for Study of Liver Disease, 2018, 2018, pp406A-407A
YY Hong, M Al Tarrah, K Elguzouli, S Hough, M Iqbal, B O'Connell, D O'Toole, F MacCarthy, D Kevans, S McKiernan, Helicobacter pylori resistance pattern over last 14 years in a university teaching hosptial, Endoscopy, Digestive Disease Week , 2018, 50, (4), 2018, ppeP068
D Crowley, W Cullen, M Keevans, E Kelly, E Laird, S McKiernan, SJ Miggin, T McHugh, C Murphy, R Murtagh, D O'Reilly, G Betts-Symonds, C Tobin, MC Van Hout, J Lambert, The prevalence of chronic untreated hepatitis Cvirus infection and associated risk factors within a prison population:a cross sectional study, Journal of Viral Hepatitis , European Association for Study of Liver Diseases, 2018, 25, 2018, pp207
D. Gibson, M. McNally, J. Doherty, A. Keogh, D. Keegan, K. Byrne, U. Kennedy, H. Mulcahy, S. McKiernan, F. MacCarthy, L. Egan, G. Cullen, J. Sheridan, S. Sengupta, E. Slattery, D. Kevans, G. Doherty, Medium to long-term outcomes in patients receiving accelerated dose infliximab induction for acute severe ulcerative colitis (ASUC) in a multi-centre cohort, Journal of Crohns and Colitis, European Crohns Colitis Organisation, 2018, 12, (1), 2018, pps332 - s333
Clarke, L., Adduri, R.S., Smyth, P., Quinn, F., Jeffers, M., Dunne, B., O'Leary, J., McKiernan, S., Vandenberghe, E., Pyne, S., Bashyam, M.D., Sheils, O., Flavin, R., Potentially important miRNAs in enteropathy-associated T-cell lymphoma pathogenesis: A pilot study, Leukemia Research Reports, 10, 2018, p52-54
O'Connell J, Rowan C, Stack R, Harkin G, Parihar V, Chan G, Breslin N, Cullen G, Dunne C, Egan L, Harewood G, Leyden J, MacCarthy F, MacMathuna P, Mahmud N, McKiernan S, McNamara D, Mulcahy H, Murray F, O'Connor A, O'Toole A, Patchett S, Ryan B, Sheridan J, Slattery E, Doherty G, Kevans D., Golimumab effectiveness and safety in clinical practice for moderately active ulcerative colitis., European Journal of Gastroenterology, 30, (9), 2018, p1019 - 1026
Gibson, David J., Doherty, Jayne, McNally, Mairead, Keogh, Aine M., Keegan, Denise, Byrne, Kathryn, Kennedy, Una, Mulcahy, Hugh E., McKiernan, Susan, MacCarthy, Finbar, Egan, Laurence, Cullen, Garret, Sheridan, Juliette, Sengupta, Subhasish, Slattery, Eoin, Kevans, David, Doherty, Glen A., Medium to Long Term Outcomes in Patients Receiving Accelerated Dose Infliximab Induction for Acute Severe Ulcerative Colitis (ASUC) in a Mulit-Centre Cohort, 154, (6), 2018, ppS-832
Gray E, Pasta DJ, Norris S, O'Leary A; Irish Hepatitis C Outcomes and Research Network (ICORN). , Effectiveness of triple therapy with direct-acting antivirals for hepatitis C genotype 1 infection: application of propensity score matching in a national HCV treatment registry. , BMC Health Services Research , 17, (1), 2017, p288
S Naimimohasses, O El-Sherif, J O'Connell, B Hynes, H Irish, C Quinn, SJ Miggins, F MacCarthy, D Kevans, M Iqbal, S McKiernan, S Norris, The prognostic value of transient elastography: a single centre irish study, GUT, United European Gastroenterology Week, 2017, 66, 2017, ppA12
S Naimimohasses, O El-Sherif, S McKiernan, S Norris, High Incidence of Advanced Liver disease in patients with Non-alcoholic Fatty Liver Disease: A single center Irish study, Irish Society of Gastroenterology, 2017, 186, 2017, pps377
N Orfali, N Appleby, Bakri Mohamed, F Quinn, B Bird, V Byrnes, J McCarthy, S McKiernan, A Hayat, E Vandenberghe, Autologous stem cell transplantation in refractory coeliac disease type II-The Irish experience: P605, Bone Marrow Transplantation, European blood and marrow transplantation, 2017, 52, 2017, ppp605
S O'Brien, S O'Hanlon, O El Sherif, S McKiernan, M Iqbal, Time to tap? an audit of diagnostic paracentesis in inpatients with cirrhosis at a university teaching hospital, GUT, 2017, 66, 2017, ppA18
Elsherif O, Bannan C, Keating S, McKiernan S, Bergin C, Norris S, Outcomes from a large 10 year hepatitis C treatment programme in people who inject drugs: No effect of recent or former injecting drug use on treatment adherence or therapeutic response. , PLoS One, 12, (6), 2017, pe0178398
E Gray, A O'Leary, C Bergin, M Cannon, G Courtney, O Crosbie, CF De Gascun, LJ Fanning, E Feeney, DD Houlihan, B Kelleher, JS Lambert, J Lee, PWG Mallon, S McConkey, A McCormick, S McKiernan, C McNally, F Murray, G Sheehan, S Stewart, C Walsh, S Norris, Effectiveness of interferon-free therapy for the treatment of HCV-patients with compensated cirrhosis treated through the Irish early access program , Expert review of gastroenterology & hepatology, 11, (6), 2017, p593 - 601
Naimimohasses S, El Sherif O, Ashfaq M, Nolan N, Iqbal M, McKiernan S, Norris S. , Spontaneous Hepatitis B Seroclearance upon Development of Hepatocellular Carcinoma. , Gastroenterology, 11, (3), 2017, p797 - 808
O El-Sherif, S Stewart, C Bergin, S McKiernan,O Crosbie, S Khoo, S Norris, Determination of Ledipasvir concentrations in patients with decompensated cirrhosis receiving low dose proton pump inhibitors during sofosbuvir-ledipasvir treatment, Journal of Hepatology, European Association for Study of Liver, 2, 2016, pps805 - s806
C Kelly, A Tierney, G Chan, C Dunne, S Naimimohasses, S Norris, S McKiernan, Malnutrition in the Cirrhotic In-Patient: an Audit of Prevalence, Protein-Energy Requirement and the Impact of Clinical Nutrition, Irish Journal of Medical Science, Irish Society of Gastroenterology, 2016, 185, 2016, pps224
Gray E, O'Leary A, Stewart S, Bergin C, Cannon M, Courtney G, Crosbie O, De Gascun CF, Fanning LJ, Feeney E, Houlihan DD, Kelleher B, Lambert JS, Lee J, Mallon P, McConkey S, McCormick A, McKiernan S, McNally C, Murray F, Sheehan G, Norris S; Irish Hepatitis C Outcomes and Research Network (ICORN)., High mortality during direct acting antiviral therapy for hepatitis C patients with Child's C cirrhosis: Results of the Irish Early Access Programme., Journal of Hepatology, 65, (2), 2016, p446 - 448
Kieran JA, Norris S, O'Leary A, Walsh C, Merriman R, Houlihan D, McCormick PA, McKiernan S, Bergin C, Barry M, Hepatitis C in the era of direct-acting antivirals: real-world costs of untreated chronic hepatitis C; a cross-sectional study. , BMC Infectious Diseases, 15, 2015, p471-
Fitzmaurice K, Hurst J, Dring M, Rauch A, McLaren PJ, Günthard HF, Gardiner C, Klenerman P; Irish HCV Research Consortium; Swiss HIV Cohort Study. , Additive effects of HLA alleles and innate immune genes determine viral outcome in HCV infection., GUT, 64, (5), 2015, p813 - 819
JA Kieran, R Adams, JL Chin, H Mushtaq, PA McCormick, S McKiernan, C Walsh, C Bergin, Health-state utilities for patients with chronic Hepatitis C infection, SSTI, 2015, 184, (1), 2015, ppS230
D Byrne, JP Walsh, D Cadogan, L Ellis, S Norris, S McKiernan, G King, RT Murphy, Improvements in radial strain detected by speckle tracking echocardiography in patients with Hereditary Haemochromatosis following venesection, Irish Journal of Medical Science, Irish Society of Gastroenterology, 2015, 184, 2015, pps234
D Byrne, JP Walsh, D Cadogan, L Ellis, S Norris, S McKiernan, G King, RT Murphy, Improvements in radial strain detected by speckle tracking echocardiography in patients with Hereditary Haemochromatosis following venesection, Irish Journal of Medical Science, Irish Society of Gastroenterology, 2015, 184, 2015, pps234
Durcan L, Gleeson N, McKiernan S, Cunnane G, A benign tumor as the apparent trigger for myopathy., Journal of Clinical Rheumatology, 20, (2), 2014, p115 - 117
Elliott JA, McCormack O, Tchrakian N, Conlon N, Ryan CE, Lim KT, Ullah N, Mahmud N, Ravi N, McKiernan S, Feighery C, Reynolds JV, Eosinophilic ascites with marked peripheral eosinophilia: a diagnostic challenge., European Journal of Gastroenterology and Hepatology, 26, (4), 2014, p478 - 484
Niamh Conlon, Elaine Logan, Sundaram Veerappan, Susan McKiernan, Sean O'Briain . , Duodenal gastric heterotopia: further evidence of an association with fundic gland polyps. , 44, (4), 2013, p636 - 642
Abdul Zaheer, Malik M Anwar, Claire Donohoe, Sinead O'Keeffe, Hamid Mushtaq, Barry Kelleher, Eileen Clarke, Murat Kirca, Susan McKiernan, Nasir Mahmud, Napolean Keeling, Padraic Macmathuna, Dermot O'Toole, The diagnostic accuracy of endoscopic ultrasound in suspected biliary obstruction and its impact on endoscopic retrograde cholangiopancreatography burden in real clinical practice: a consecutive analysis. , European Journal of Gastroenterology and Hepatology, 25, (7), 2013, p850 - 857
Kimberley J. Smith, Suzanne Norris, Susan McKiernan, Barbara Hynes, Anne M. O'Dwyer, Shane M. O'Mara. , An Exploration of Depressive Symptoms in Hepatitis C Patients Taking Interferon-alpha: Increase in Sickness Behaviors but not Negative Cognitions . , Jounral of Experimental and Clinical Hepatology, 2, (3), 2013, p218 - 223
C O'Meara, OF Craig, N Mahmud, S McKiernan, F Maccarthy, A pilot study on the introduction of a low FODMAP diet in a subgroup of symptomatic IBS patients referred by the gastroenterology service in an Irish Tertiary Referral Centre, United European Gastroenterology Week, 2013, 62, (2), 2013, ppA3 - A4
Lahiff C, Shields W, Cretu I, Mahmud N, McKiernan S, Norris S, Silke B, Reynolds JV, O'Toole D., Upper gastrointestinal bleeding: predictors of risk in a mixed patient group including variceal and nonvariceal haemorrhage, European Journal of Gastroenterology & Hepatology, 24, (2), 2012, p149-54
Dring MM, Morrison MH, McSharry BP, Guinan KJ, Hagan R, O'Farrelly C, Gardiner CM, Innate immune genes synergize to predict increased risk of chronic disease in hepatitis C virus infection., PNAS, 108, (14), 2011, p5736-41
M. M. Dring, M. H. Morrison, B. P. McSharry, K. J. Guinan, R. Hagan, C. O'Farrelly, C. M. Gardiner, G. Courtney, O. Crosbie, J. Crowe, J. Hegarty, D. Kelleher, E. Lawlor, J. Lee, S. McKiernan, F. Murray, S. Norris, L. Thornton . , Innate immune genes synergize to predict increased risk of chronic disease in hepatitis C virus infection . , Proceedings National Academy of Science, 108, (14), 2011, p5736 - 5741
Fitzmaurice K, Petrovic D, Ramamurthy N, Simmons R, Merani S, Gaudieri S, Sims S, Dempsey E, Freitas E, Lea S, McKiernan S, Norris S, Long A, Kelleher D, Klenerman P , Molecular footprints reveal the impact of the protective HLA-A*03 allele in hepatitis C virus infection. , GUT, 60, 2011, p1563-
Fitzmaurice K, Petrovic D, Ramamurthy N, Simmons R, Merani S, Gaudieri S, Sims S, Dempsey E, Freitas E, Lea S, McKiernan S, Norris S, Long A, Kelleher D, Klenerman P, Molecular footprints reveal the impact of the protective HLA-A*03 allele in hepatitis C virus infection., Gut, 60, (11), 2011, p1563-71
Shahzma Merani, Danijela Petrovic, Ian James, Abha Chopra, Don Cooper, Elizabeth Freitas, Andri Rauch, Julia di Iulio, Mina John, Michaela Lucas, Karen Fitzmaurice, Susan McKiernan, Suzanne Norris, Dermot Kelleher, Paul Klenerman, Silvana Gaudieri , Effect of immune pressure on hepatitis C virus evolution: insights from a single-source outbreak. , Hepatology, 53, (2), 2011, p396 - 405
Neumann-Haefelin C, Timm J, Schmidt J, Kersting N, Fitzmaurice K, Oniangue-Ndza C, Kemper MN, Humphreys I, McKiernan S, Kelleher D, Lohmann V, Bowness P, Huzly D, Rosen HR, Kim AY, Lauer GM, Allen TM, Barnes E, Roggendorf M, Blum HE, Thimme R. , Protective effect of human leukocyte antigen B27 in hepatitis C virus infection requires the presence of a genotype-specific immunodominant CD8+ T-cell epitope. , Hepatology, 51, (1), 2010, p54 - 62
Davina Swan, Jean Long, Olivia Carr, Jean Flanagan, Helena Irish, Shay Keating, Michelle Keaveney, John Lambert, P Aiden McCormick, Susan McKiernan, John Moloney, Nicola Perry, Walter Cullen, Barriers to and facilitators of hepatitis C testing, management, and treatment among current and former injecting drug users: a qualitative exploration. , AIDS patient care and STDs , 24, (12), 2010, p753 - 762
John Lambert, P Aiden McCormick, Susan McKiernan, Barriers to and Facilitators of Hepatitis C Testing, Management, and Treatment Among Current and Former Injecting Drug Users: A Qualitative Exploration, AIDs patient care and STDs, AIDs patient care and STDs, 2010, 24, (12), 2010
K. J. Smith, S. Norris, S. McKiernan, B. Hynes, D. Kelleher, A. M. O'Dwyer, D. McLoughlin, S. M. O'Mara , Primary Depression and Interferon-Alpha Induced Depression: Comparison of Symptom Profiles , Irish Journal Medical Science, 179, 2010, p140 - 141
Christoph Neumann-Haefelin, Joerg Timm, Julia Schmidt, Karen Fitzmaurice, Susan McKiernan, Dermot Kelleher, Daniela Huzly, Michael Roggendorf, HE Blum, R Thimme, The protective effect of HLA-B27 in hepatitis C virus infection requires presence of a genotype-specific immunodominant CD8+ T cell epitope, Zeitschrift für Gastroenterologie, Zeitschrift für Gastroenterologie, 2009, 47, (9), 2009, ppA110
Dazert E, Neumann-Haefelin C, Bressanelli S, Fitzmaurice K, Kort J, Timm J, McKiernan S, Kelleher D, Gruener N, Tavis JE, Rosen HR, Shaw J, Bowness P, Blum HE, Klenerman P, Bartenschlager R, Thimme R, Loss of viral fitness and cross-recognition by CD8+ T cells limit HCV escape from a protective HLA-B27-restricted human immune response, Journal of Clinical Investigation, 119, (2), 2009, p376 - 386
Qasim A, Muldoon C, McKiernan S, Colonic adenoma patients have higher incidence of hyperplastic polyps on surveillance colonoscopy., European journal of gastroenterology & hepatology, 21, (8), 2009, p877 - 881
Kimberley J Smith, Declam McLoughlin, Suzanne Norris, Susan McKiernan, Ross Dunne, Barbara Hynes, Clodagh Quinn, Matthew Lawless, Darren Ennis, Shane O'Mara , x Primary and Secondary Interferon-Alpha induced depression: Cytokine levels and depression ratings , The World Journal of Biological Psychiatry , 10, (1), 2009, p234-
Smyth CM, McKiernan SM, Hagan R, Pilkington R, O'Regan M, Lawlor E, Kelleher D. , Chronic hepatitis C infection and sicca syndrome: a clear association with HLA DQB1*02, European Journal of Gastroenterology and Hepatology, 19, (6), 2007, p493 - 498
Neumann-Haefelin C, McKiernan S, Ward S, Viazov S, Spangenberg HC, Killinger T, Baumert TF, Nazarova N, Sheridan I, Pybus O, von Weizsacker F, Roggendorf M, Kelleher D, Klenerman P, Blum HE, Thimme R. , Dominant influence of an HLA-B27 restricted CD8+ T cell response in mediating HCV clearance and evolution, 43, (3), 2006, p563 - 572
R Cooney, J Groarke, N Mahmud, PWN Keeling, S McKiernan, Comparison of ERCP procedures performed in a tertiary referral centre in 1996 and 2002, Digestive Disease Week , 2006, 38, (11), 2006, pp59
C Goulding, A Murphy, G MacDonald, S Barrett, J Crowe, J Hegarty, S McKiernan, D Kelleher, The CCR5-delta32 mutation: impact on disease outcome in individuals with hepatitis C infection from a single source, Gut, 54, (8), 2005, p1157 - 1161
Goulding C, McManus R, Murphy A, MacDonald GS, Barrett S, Crowe J, Hegarty J, McKiernan S, Kelleher D., The CCR5-delta32 Mutation- Impact on disease outcome in individuals with hepatitis C infection from a single source, Gut, 54, (8), 2005, p1157 - 1161
McKiernan SM, Hagan R, Curry M, McDonald GS, Kelly A, Nolan N, Walsh A, Hegarty J, Lawlor E, Kelleher D, Distinct MHC class I and II alleles are associated with hepatitis C viral clearance, originating from a single source. , Hepatology, 40, (1), 2004, p108 - 114
S McKiernan, S Norris, R Vaughan, AJ Czaja, PT Donaldson, MICA polymorphism and susceptibility to autoimmune hepatitis: Further evidence that susceptibility maps to the HLA class II region on chromosome 6p21. 3, GUT, United European Gastroenterology Week, 2003, 52, (5), 2003
MacDonald AJ, Duffy M, Brady MT, McKiernan S, Hall W, Hegarty J, Curry M, Mills KHG. , CD4+ T helper type 1 and regulatory T cells induced against the same epitopes on the core protein in hepatitis C virus-infected individuals. , Journal of Infectious Diseases, 185, (6), 2002, p720 - 727
Comparative Rates of Nucleotide Sequence Variation in the Hypervariable Region of E1/E2 and the NS5b Region of Hepatitis C Virus in Patients with a Spectrum of Liver Disease Resulting from a Common Source of Infection. , Duffy M, Salemi M, Sheehy N, Vandamme A, Hegarty J, Curry M, Nolan N, Kelleher D, McKiernan S, Hall W. , Virology, 301, (2), 2002, p354 - 364
S. McKiernan and D. Kelleher, Immunogenetics of hepatitis C virus, Journal of viral hepatitis, 7 Suppl 1, 2000, p13-Apr
S. M. McKiernan, R. Hagan, M. Curry, G. S. McDonald, N. Nolan, J. Crowley, J. Hegarty, E. Lawlor and D. Kelleher, The MHC is a major determinant of viral status, but not fibrotic stage, in individuals infected with hepatitis C, Gastroenterology, 118, (6), 2000, p1124-30
S McKiernan, J Daly, MP Curry, JE Hegarty, D Kelleher, Polymorphism of the TNF-alpha gene promoter region in hepatitis C infection, Hepatology, American Association for the Study of Liver Diseae, 1999, 30, (4), 1999, pp360A
McKiernan S, HAgan R, Curry M, McDonald GS, Nolan N, Crowley J, Hegarty J, Lawlor E,Kellher D, The MHC is a major determinant of outcome in individuals infected with Hepatitis C, GUT, United European Gastroenterology Week, 1999, 45, (V), 1999, ppA63 (74.03)
S McKiernan, J Daly, MP Curry, JE Hegarty, D Kelleher, Polymorphisms of TNF- Gene Promoter Region in Hepatitis C Infection, GUT, United European Gastroenterology Week, 1999, 45, (V), 1999, ppA45
McKiernan S, Pilkington R, Ramsay B, Walsh A, Sweeney E, Kelleher D. , Primary cutaneous B-cell lymphoma; an association of chronic hepatitis C infection., European Journal of Gastroenterology and Hepatology, 11, (6), 1999, p669 - 672
Arfin Q, McKiernan S, Crany A, Cullen MJ, Kelleher D, Thyroid binding globulin: a factor in hepatitis C, GUT, United European Gastroenterology Week, Rome, 1999, 45, (V), 1999, ppA153 (P0322)
S McKiernan, R Hagan, M Curry, J Hegarty, E Lawlor, D Kelleher, Human leukocyte antigens related to disease outcome in Hepatitis C, Hepatology, American Association for Study of Liver Disease, 1998, 28, (4), 1998, pp214A
Non-Peer-Reviewed Publications
M Kirca, A Zaheer, S Mckiernan, N Keeling, N Mahmud, Technical success of ERCP in patients with periampullary duodenal diverticulum, Endoscopy, Digestive Diseae Week, 2006, 38, (11), 2006, ppP28
Research Expertise
Projects
- Title
- Does dedicated nutrition review reduce need for colonoscopy
- Summary
- Introduction: Functional disorders account for 40% of gastroenterology referrals.The NICE guidelines recommend Rome IV criteria and non-invasive tests to facilitate diagnosis and avoid unnecessary endoscopy. First-line management involves dietary education/intervention provided by experienced Dieticians, resulting in adequate symptom relief in 80%. This pathway is rarely followed and patients undergo reassuringly negative endoscopies and are sent back to the GP without symptom resolution. Aim: In patients under 50 referred for colonoscopy for the investigation of diarrhoea and/or constipation at St James's Hospital our aim is to assess the impact of a dedicated clinical /dietetic review on 1) symptom relief, and 2) reducing colonoscopy numbers Methods: Patients underwent blood (FBC/electrolytes/CRP/TSH/tTG) and stool (C&S/Calprotectin) tests before attending a medical assessment. Patients fulfilling a diagnosis of IBS then underwent dietetic intervention (1st line-education +/-2nd line-FODMAPs) with a senior Dietician. Response was assessed using a symptom survey pre and post-intervention. Those with an inadequate response underwent further investigation. Results: Of 105 patients, 75(71%) were referred to Dietetics, 24(23%) required endoscopy, and 6(6%) required no intervention. To date, 47 patients have completed dietary intervention. Of these, 44(93.6%) were discharged following adequate symptom relief (74%-1st line and 26%-2nd line intervention), and 3 patients were referred for endoscopy. This has led to the avoidance of 78 colonoscopies and 23 gastroscopies so far - equating to an 80% reduction in endoscopy requirement in this cohort of patients. Conclusions: The implementation of a dedicated clinical diagnostic and dietetic management service has significantly reduced the number of unnecessary endoscopic procedures and facilitated the discharge of these patients following adequate symptom relief. As proof of concept was successful, the programme has now received recurrent funding for wte 0.54 clinical nutrition, and is being presented for national approval.
- Funding Agency
- nil
- Date From
- 01/10/2018
- Title
- Micro-elimination of Hepatitis C in Irish Prisons
- Summary
- All prisoners remanded in custody are committed to one of three remand prisons. A screen to treat program will be highly effective in identifying those with chronic HCV in a high prevalence population and will provide a public health benefit in reducing prevalence, transmission and engage otherwise difficult to engage patients in a closed setting In the Midlands and Portlaoise prison a micro elimination project will take place whereby all existing inmates are screened through a mass screening methodology. Screening will be carried out by a CNM prisons liaison nurse using mobile point of care HCV quantitative RNA technology using a finger stick blood sample.The CNM will link all HCV positive prisoners to care for continuation or initiation of treatment prior to transfer or release to the community. Methodology Screening . All new inmates on remand in Cloverhill prison will be screened by the CNM working for 3of 4 weeks in this location. As the service is developed screening at Castlerea prison will be advanced. . A mobile point of care HCV quantitative RNA technology using a finger stick blood sample which negates the need for phlebotomy services, with a 60 minute turnaround time for results which will enable rapid engagement into care. . A micro elimination program will commence in the Midlands and Portlaois prisons whereby all existing inmates will be screened by the CNM through mass screening methodology using the same POC RNA technology . Prisoners will be educated on liver health, risk factors for fibrosis progression and DAA treatment for Hepatitis C by the Red Cross and the HCV prison Liaison CNM. . Those prisoners found to have active replicating HCV will have an assessment of their fibrosis/cirrhosis stage using a mobile Fibroscan or biomarkers such as APRI/FIB-4. . The IPS health records will be updated with the results. . In the remand prisons HCV positive patients will be offered treatment on-site by the CNM if the duration of their incarceration from the point of engagement is 8 weeks or more . If a prisoner on remand chooses not to be treated whilst on remand and does not get a custodial sentence they will be referred for treatment in the community . If they are committed under sentence and are awaiting treatment or have already commenced treatment on remand the HCV liaison CMN will link in with the prison that the patient is being transferred to. . Patients who refuse treatment or cannot be treated at this point will be linked to care with community services. . On-site treatment will then continue for all new committals from the remand prisons. Governance . This project will be led by Prof McKiernan, the IPS and NHCTP and all decisions with regard to the screening methodology and treatment will be made by these bodies. . The support from AbbVie will be limited strictly to initial funding for equipment & screening only in each prison. . Abbvie will fund in stages two POC RNA machines and the number of test kits based on the operational capacity of each prison at commencement of the project , 1 for use in the 3 remand prisons and 1 to be used in the Midlands and Portlaoise the initial microelimination sites which could then be transferred to other prisons in the future. . Abbvie will also fund 2 fibroscans, 1 for the 3 remand prisons and one for the micro elimination sites which could then be transferred to other prisons. as part of NHCTP & IPS screen to treat elimination program . All other resource requirements such as funding for the HCV prison liaison CNM headcount will be determined and funded by the NHCTP or IPS as appropriate . The funding provided is in alignment with the rollout of the planned NHCTP/ IPS on-site screen to treat program, specifically that the infrastructure and resources will be in place to roll out the project in the same timescale.
- Funding Agency
- Abbvie Ltd
- Date From
- 01/06/2019
- Date To
- 12mo
- Title
- Helicobacter Pylori Resistance Pattern Over Last 14 Years In A University Teaching Hospital
- Summary
- Introduction Helicobacter Pylori (H.Pylori) infection is a recognized cause for chronic gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa associated lymphoid tissue lymphoma. There has been an increase in the prevalence of antibiotic-resistant bacteria. The Irish Helicobacter Pylori Working Group Consensus has stated that standard triple therapy for 7 days' duration can no longer be recommended. Aim To investigate H.Pylori resistance patterns in patients having gastroscopy with culture & sensitivity(C&S) at St. James's Hospital, over last 14 years. Methods This is a retrospective study, evaluating H.Pylori C&S sent over the last 14 years. Resistance patterns were analysed for the positive C&S. Results Out of a total of 1228 C&S sent for H.pylori, 643 (52.36%) were positive while, 585 (47.64%) were negative for the bacteria. Within positive C&S, 402(62.52%) were female, with the mean age of 42.69 years. The sensitivity testing for amoxicillin and metronidazole were discontinued after 2010. Resistance rate for clarithromycin and metronidazole were 78.08% and 66.37% respectively. Comparing the period from 2004-2009 to 2010-2017, the resistance rate for clarithromycin was rising from 69.27% to 81.51%. Resistance rate for amoxicillin, tetracycline, and rifampicin were 3.44%, 0.31% and 1.09% respectively. 35.87% were resistant while 3.26% were intermediate sensitivity to levofloxacin. Conclusion In the cohort of patients with previous H Pylori eradication failure, resistance to Clarithromycin and Metronidazole is common, with increasing resistance rate to clarithromycin over the years. Resistance pattern to levofloxacin is also on the rise. This further validates the use of H Pylori C&S to guide the antibiotic regimen in this cohort.
- Funding Agency
- nil
- Date From
- 2017
- Date To
- 2017
Recognition
Representations
National Hepatitis C strategy 2011-2014
ICORN - clinical advisory group
National Hepatitis C treatment programme
Irish Society of Gastroenterolgy board member
Gastroenterology Registrars training group - founding ( revival) member
Irish Society of Gastroenterology - NCHD member
Awards and Honours
Fellow of Royal College of Physicians, London
Fellow Royal College of Physicians, Ireland
Memberships
Royal College of Physicians London
Royal College of Physicians, Ireland
European Crohns and Colitis Organisation
American Gastroenterolgy Association
Irish Hepatitis C Outcomes Research Network
Irish Society of Gastroenterolgy
European Association for the study of Liver Disease
National Hepatitis C Treatment Programme clinical advisory group