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Magali Fontaine, MD, PhD

Academic Title:

Professor

Primary Appointment:

Pathology

Secondary Appointment(s):

Medicine

Location:

UMMC N2W50A

Phone (Primary):

410-328-3834

Fax:

443-462-3248

Education and Training

Education

1981                                        Lycee Hoche-Versailles, BA (Baccalaureate)

1989                                        University René Descartes Paris, Cochin Port-Royal Medical School, MD

2000                                        University of Illinois at Chicago, Ph.D. in Transplant Pathology

 Post Graduate Education and Training    

1990 - 1991                             Surgical Research Fellow, Oncology Division

                                                Adoptive Immunotherapy Using Tumor Infiltrating Lymphocytes

                                                Brigham & Women's Hospital, Boston, Harvard Medical School

1991 - 1993                             Surgical Research Fellow, Transplantation Division, Tissue Engineering,

                                                The Children's Hospital, Boston, Harvard Medical School

1993 - 1994                             Internship in General Surgery, University of Illinois, Chicago         

1994 - 1995                             PGY II in General Surgery

                                                Metropolitan Group Hospitals Residency, Chicago

1995 - 1999                             Residency in Pathology (AP, CP)

                                                University of Illinois College of Medicine

1999 - 2000                             Fellowship in Transfusion Medicine, Mayo Clinic, Rochester

Biosketch

NAME Magali J. Fontaine, M.D., Ph.D. POSITION TITLE Associate Professor
eRA COMMONS USER NAME
FONTAINE.MAGALI
EDUCATION/TRAINING
INSTITUTION AND LOCATION DEGREE (if applicable) YEAR(s) FIELD OF STUDY
Lycee Hoche, Versailles, France B.A. 1981 Math / Physics
University Paris V, Paris, France M.D. 1989 Medicine
University of Illinois at Chicago Ph.D. 2000 Cell Transplantation

 A. Personal Statement

 

Dr Magali Fontaine has a broad background in transfusion medicine.  She completed her clinical Fellowship in Transfusion Medicine at the Mayo Clinic. Her contributions to the field of transfusion medicine are focused on the management of the blood supply chain and prevention of transfusion adverse events. She previously served as the Associate Director of the Transfusion Service at Stanford University Medical Center and currently serves as the Medical Director of the Transfusion Service at the University of Maryland Medical Center, which holds one of the busiest Shock Trauma Center in the United States in addition to serving the full spectrum of hospitalized adult and pediatric patients including bone marrow and solid organ transplantation programs, large labor and delivery service, busy cardiovascular and oncologic surgery services. She has authored over 50 publications specifically related to the safe practice of transfusion medicine by limiting associated adverse events.

Cellular Therapy:

  1. Fontaine MJ, Winters JL, Moore SB, McGregor CGA, Santrach PJ. Frozen preoperative autologous blood donation for heart transplantation at the Mayo Clinic from 1988 to 1999. Transfusion 2003;43:476-480. PMID: 12662280

  2. Butwick A, Aleshi P, Fontaine MJ, Riley E, Goodnough LT. Retrospective analysis of transfusion outcomes in pregnant patients at a tertiary obstetric center. International Journal of Obstetric Anesthesia 2009; 18(4): 302-8. PMID: 19628384

  3. Fontaine MJ, Chung YT, Erhun F,Goodnough LT. Age of blood as a limitation for transfusion: Potential impact on blood inventory and availability. Transfusion 2010; 50(10):2233-9. PMID: 20497519

  4. Atkinson MP*, Fontaine MJ, Goodnough LT, Wein LM. A Novel Allocation Strategy for Blood Transfusions: Investigating the Tradeoff between the Age and Availability of Transfused Blood. Transfusion 2012; 52(1):108-17. PMID: 21756261

  5. Novak DJ, Bai Y, Cooke RK, Marques M, Fontaine MJ, Gottschall J, Carey P, Scanlan M, Feibig E, Shulman I, Nelson J, Flax S, Daniel-Johnson J, Callum J, Hess JR and the PROPPR Study Group. Making thawed universal donor plasma available rapidly for massively bleeding trauma patients: the experience of the PROPPR trial centers. Transfusion 2015. 55(6):1331-9. PMID: 25823522

 

B.  Positions and Honors

 

Positions and Employment

1990 - 1991                 Fellow, Immunology/Oncology Division, Brigham & Women’s Hospital,  Harvard Medical School, Boston, MA

1991 - 1993                 Fellow, Tissue Engineering Division, Children's Hospital, Harvard Medical School,

1993 - 1995                 Internship, Department of Surgery, University of Illinois at Chicago (UIC), Chicago, IL

1995 - 1999                 Pathology Residency/Ph.D. Studies in Cell Transplantation

                                    Clinical Instructor, Department of Pathology, UIC, Chicago, IL

1999 - 2000                 Fellow, Transfusion Medicine Division, Mayo Clinic, Rochester, MN

2000 - 2003                 Clinical Instructor, Department of Pathology, Transfusion Medicine Division, Medical University of South Carolina (MUSC), Charleston, SC

2003 - 2004                 Assistant Professor of Pathology, MUSC, Charleston, SC

2004 - 2013                 Assistant Professor of Pathology, Stanford University, Stanford, CA

                                    Associate Director Transfusion Service, Assistant Director of the Blood Center

2013 – present                        Associate Professor of Pathology and Medicine

                                    Medical Director of Transfusion Services and Cellular Therapy Processing Laboratory

                                    University of Maryland School of Medicine

 

Honors and Awards

  1. Graduated in Medicine with Honors (06/28/1989) Summa cum Laude

1998        Warren and Clara Cole Foundation Grant Award. University of Illinois at Chicago

2008      Excellence in Teaching Award, Pathology, Stanford University School of Medicine

2009      Faculty Mentor Award for Post Doctoral Fellows in Immunology, Stanford University

2010      Chair of National Committee on Standards for Cellular Therapies – American Association of Blood Banks (Bethesda, Maryland)

 

 

C.  Contribution to Science

Cellular Therapy

Her contributions to the field of cellular therapy are a continuation of her post-doctoral training spent at Harvard Medical School, where she was mentored by pioneers in tissue engineering, Drs. Langer and Vacanti, optimizing new techniques of hepatocyte transplantation for end stage liver diseases in neonates. She then moved to the University of Illinois in Chicago (UIC) to complete a combined residency in surgery and clinical pathology with a PhD degree in pancreatic islet transplantation for patients with type 1 diabetes and contributed to the development of the islet cell transplant program at UIC.  Following a Fellowship in Transfusion Medicine at the Mayo Clinic in Rochester, MN, she moved to the Medical University of South Carolina in Charleston where she was integral in starting their islet cell transplant program. Thereafter, she held the title of Associate Director of the Blood Bank at Stanford University School of Medicine and served as Chair of the National Committee on Standards for Cellular Therapies for the American Association of Blood Banks (AABB). She currently serves as the co-Chair on the Novel Cellular Therapies and Product Development Subsection for the AABB.  She also serves as chair of the recently developed AABB Cellular Therapy Education Program Unit. Her experience from serving on these committees has helped her to identify knowledge and regulatory gaps that need to be filled for novel cellular therapies to succeed.

 

  1. Fontaine M, Hansen LK, Thompson S, Uyama S, Ingber DE, Langer R, Vacanti JP. Transplantation of genetically altered hepatocytes using cell-polymer-constructs. Transplantation Proceedings 25:1102-1104, 1993.  PMID:8442022

  2. Fontaine M, Schloo B, Jenkins R, Uyama S, Hansen L, Vacanti JP. Human hepatocyte isolation and transplantation into an athymic rat, using prevascularized cell polymer constructs. J.  Pediatric Surg.  30:56-60, 1995. PMID: 7722831

  3. DavisNE, Rothkopf  LN, Mirsoian A, Kojic N, Kaplan D, BarronAE, FontaineMJ. Enhanced function of pancreatic islets co-encapsulated with ECM proteins and mesenchymal stromal cells in a silk scaffold. Biomaterials 33(28):6691-6697, 2012. PMID: 22766242

  4. Hamilton D, Shih H, Schubert RA, Michie SA, Kaplan D, Fontaine MJ. A silk-based encapsulation platform for pancreatic islet transplantation improves islet function in vivo. Tissue Engineering and Regenerative Medicine. (in press). PMID:25619945

 

Blood Supply Chain

Her contributions to the field of transfusion medicine are associated with her interest in management of the blood supply chain and prevention of transfusion adverse events. She implemented several innovative new tests and approaches that are important for patient safety and inventory management: First, she designed and implemented an algorithm for platelet selection and inventory management based on a comprehensive data analysis of the platelet supply chain between the blood center and the hospital based transfusion service; this model was developed through a collaboration between the Stanford Hospital Transfusion Service, Stanford Blood Center and the Department of Management Science and Engineering. This effort significantly improved efficiency and reduced the outdate rate of platelet products on the shelf. Second, she improved the platelet transfusion support for refractory, HLA allo-sensitized patients; she refined the platelet transfusion management algorithm based on a new assay developed in the Stanford HLA lab that detects only HLA antibodies capable of binding the first complement component (C1q). Lastly, she analyzed the patient needs for cytomegalovirus (CMV) sero-negative blood products and implemented a reflex test to allocate the CMV sero-negative blood products to the patients who truly needed it. This assay is now being implemented at University of Maryland Medical Center.

 

  1. FontaineMJ*, ChungYT, RogersWM, SussmannHD, QuachP, GalelSA, Goodnough LT, and F Erhun#.  Improving Platelet Supply Chains through Collaborations between Blood Centers and Transfusion Services. Transfusion 2009; 49(10):2040-2047. PMID: 19538430

  2. Fontaine MJ*, Jurado C, Miller E, Viele M, Goodnough LT#. Impact of CMV antibody reflex testing on management of blood inventory for patients requiring CMV compatible blood. Transfusion2010; 50(8):1685-1689. PMID: 20412530

  3. Fontaine MJ*, Kuo JK, Miller E, Chen Ge, Vayntrub T, Galel S, Viele M, Goodnough LT, Tyan D#. Complement fixing solid phase screening for HLA antibodies increases the availability of compatible platelet components for refractory patients. Transfusion 2011;51(12):2611-8. PMID: 21615749

     

Platelet Inventory management to mitigate the risk of hemolysis

While pursuing her quest in improving the safe practice of transfusion medicine, she focused m her efforts on reducing the risk of hemolysis associated with transfusion of platelets containing ABO incompatible plasma with the patient red blood cells. Plateletpheresis blood products are suspended in plasma that may contain ABO antibodies. It has been recommended to avoid transfusion of these platelet products if they contain ABO incompatible plasma with high-titer ABO antibody against the recipient red blood cells. She help develop a high-titer screen on all platelet donations before release to the Hospital Transfusion Service. Through a large analysis of about 1,900 platelet donations, donor characteristics were associated with high-titer screen results such as group O, female gender and age less than 30 years old. These characteristics will be informative to other blood collection centers interested in developing mitigation strategies against hemolysis associated with transfusion of platelet containing ABO incompatible plasma.

 

  1. Fontaine MJ, Mills AM, Weiss S, HongWJ, FerrerZ, DunlapM, GonzalezC, VieleM, GoodnoughLT. How we treat: risk mitigation for ABO-incompatible plasma in plateletpheresis products.Transfusion 2012; 52(10):2081-5. PMID: 22414003

  2. Goodnough LT*, Viele M, Fontaine MJ, Chua L, Ferrer Z, Jurado C, Quach P, Dunlap M, and Arber DA. Quality Management in the Transfusion Service: Case Studies in Process Improvement. Transfusion 2011; 51 (3):600-9. PMID: 20738826

  3. Fontaine MJ, Webster J, Gomez S, Pham TD, Goodnough LT and Galel S. How do I implement an automated screen for high-titer ABO antibody as an inventory management tool for ABO plasma-incompatible platelets.Transfusion (in press)

     

Highlighted Publications

Hamilton D, Shih H, Schubert RA, Michie SA, Kaplan D, Fontaine MJ.A silk-based encapsulation platform for pancreatic islet transplantation improves islet function in vivo. Tissue Engineering and Regenerative Medicine. (in press)

Yabu JM, Fontaine MJ. ABO-Incompatible Living Donor Kidney Transplantation without Post-Transplant Therapeutic Plasma Exchange. Journal of Clinical Apheresis. 2015. 30(6):340-6

Fontaine MJ, Webster J, Gomez S, Pham TD, Goodnough LT, Galel SA. How do I implement an automated screen for high-titer ABO antibody as an inventory management tool for ABO plasma-incompatible platelets? Transfusion 2015. 55(12):2783-9

Fontaine MJ, Shih H, Schaefer R, Pittenger M. Unraveling the mesenchymal stromal cells’ paracrine immunomodulatory effects. Transfusion Medicine Review 2016. 30(1):37-43

Peng Z, Pati S, Fontaine MJ, Kozar R. Lack of Species Specific Difference in Pulmonary Function When Using Mouse Versus Human Plasma in a Mouse Model of Hemorrhagic Shock. Journal of Trauma. 2016 (in press)

Additional Publication Citations

Fontaine MJ, Thompson S, Hansen LK, Mulligan RC, Vacanti JP Optimization studies on retroviral mediated gene transfer into rat hepatocytes: Implications for gene therapy. Annual Meeting of the Society of University Surgeons Residents' Program, Cincinnati, Ohio, February 15, 1992.

Fontaine MJ, Hansen LK, Thompson S, Uyama S, Ingber DE, Mulligan R, Langer R, Vacanti JP Transplantation of genetically altered hepatocytes using cell-polymer-constructs. XIVth International Congress of the Transplantation Society in Paris, France, August 16-21, 1992.

Fontaine MJ, Schloo B, Jenkins R, Uyama S, Hansen L, Vacanti JP. Human hepatocyte transplantation using cell polymer constructs. American Pediatric Surgical Association, Hilton Head, South Carolina, May 1993.

Benedetti E, Kirby J, Blanchard J, Ward MG, Williams R, Hewitt T, Fontaine MJ, Pollak R. A large animal model for hepatocyte transplantation preliminary results in dalmatian dogs. American Society of Transplant Surgeons, Dallas, Texas, May 29-31, 1996.

Kirby J, Mihalov M, Benedetti E, Johnson MT, Mangen MS, Fontaine MJ, Pollak R. The value of PCR for CMV in asymptomatic transplant patients in predicting current or future CMV disease. American Society of Transplant Physicians, Dallas, Texas, May 26-29, 1996.

Research Interests

Dr. Fontaine's research interest in cellular therapy is focused on improving the success of islet cell transplantation for patients with T1D, significant challenges remain to be addressed including improved preservation of islet cells during isolation, revascularization of islets after implantation, and prevention of inflammation/rejection and autoimmune destruction of the islet graft. To address these issues, her laboratory is testing bio-encapsulation platforms using materials such as silk-based hydrogel containing mesenchymal stromal cells to enhance islet cell survival and function while preventing or minimizing immune mediated cell damage in vivo.

Clinical Specialty Details

Dr. Fontaine's contributions to the field of transfusion medicine are associated with her interest in management of the blood supply chain and prevention of transfusion adverse events.

Awards and Affiliations

2008                                        Excellence in Teaching, Stanford University School of Medicine

2009                                        Faculty Mentor Award for Postdoctoral Fellows in Immunology, Stanford University

2010                                        Chair of National Committee on Standards for Cellular Therapies American Association of Blood Banks (AABB)

2010                                        Stanford Leadership Development Program (nominated)

2011                                        President of the Association of Clinical Scientists

2011                                        Excellence in Teaching, Stanford University School of Medicine

2012                                        Stanford Leadership Development Advanced Program (nominated)

Grants and Contracts

Active Grants

07/2016 - 06/2017       (PI, 5%) “Silk-based encapsulation system to improved pancreatic isle function”

Living Legacy Foundation of Maryland Grant Program

The goal of this study is to develop an islet cell in vivo delivery platform using silk-based biomaterial to enhance islet cell engraftment.

Total Direct Costs: $60,000

07/2016 - 06/2019                               (PI, 7%)

“PIPER Study”

Cerus Corporation

A Prospective, Open Label, Post Marketing Surveillance Study Following Transfusion of INTERCEPT Platelet Components.

Total Direct Costs: $280,000

 

Completed Grants

1998 - 2000                 (Co-Investigator) PI: Benedetti

Warren and Clara Cole Foundation Grant Award

University of Illinois at Chicago

“Islet Cell transplantation in the gastric mucosa of mongrel dogs”

 

2002 - 2004                 (PI)

MUSC Research Committee for Institutional Support

“Improving survival of pancreatic cells for transplantation”

 

2002 - 2004                 (Co-Investigator)       

V.I. Technologies, Inc. (VITEX)

A phase III study to evaluate Pen 110-0101-treated red blood cells in chronically transfused patients

 

2003 - 2004                             (Co-Investigator)                    PI: Kex

Merck, Inc.

Preventing Diabetes in NOD mice using the drug statin

 

2003 - 2008                             (Principal Investigator)

Stanford University

“Preserving islet cell mass and function”      

 

2006 - 2007                             (PI)

Stanford University School of Medicine

Dean`s postdoctoral fellowship for postdoctoral fellow Manana Kvezereli

Protective Role of TNF-Alpha Stimulating Gene 6 in Pancreatic                             Islets”

The goal of this study is to characterize the expression and the anti-inflammatory role of TSG-6 in pancreatic islets during the onset of type 1 diabetes.

                        (PI)

Kai Pharmaceutical

“PKC Epsilon activation to improve pancreatic islet cell graft viability and function”                     

                        (PI)

NIH- 5T32AI007290-25 - Stanford Immunology Program Training grant. Steinman

Postdoctoral Fellow Nicolynn Davis Ph.D.

“A novel approach to pancreatic islet encapsulation”

11/2010 - 10/2014                   (Co-Investigator, 5%)             PI: Butcher

A Novel Tolerogenic Dendritic Cell: “Biology & therapeutic potential”

NIH - R01 DK084647-01A1            

The goal of this study is to define the cellular and molecular mechanisms that novel tolerogenic dendritic cells employ to regulate T cell immunity; and to test their therapeutic potential in models of transplantation.

 

12/2010 - 6/2013                     (PI, 2%)

BIO-X Stanford Interdisciplinary Initiatives Program.                                                         
Novel silk scaffolds for pancreatic islet encapsulation”
                                                       
The goal of this study is to develop a novel scaffold to encapsulate             islet cells for transplantation that will enhance cell survival and function and minimize immune-mediated destruction in vivo.

 

12/2010 - 11/2013                   (Co-Investigator, 5%)             PI: Shizuru

“Purified allogeneic hematopoietic stem cells as a platform for tolerance induction”

California Institute for Regenerative Medicine RFA0903

The goal of this study to develop conditioning regimens that will permit the safe translation of HSC transplants to induce tolerance to transplanted adult tissues and progenitor cells, and block the pathology of autoimmune disease.

 

2011 - 2013                             (PI, 2%)

Sanofi Pharmaceutical

“Silk scaffolds for pancreatic islet encapsulation”

 

2012 - 2013                             (PI, 2%)

Children Research Institute (CHRI), Stanford, CA

“Preventing allergic transfusion reactions”

The objective is to define peripheral blood markers, specifically on leukocytes (eosinophils, basophils, neutrophils), which are activated in chronically transfused patients presenting with recurrent allergic transfusion reactions.

 

2013 - 2014                             (Co-Investigator, 2%)             PI: Scalea

PROPPR

PROPPR is a multicenter, randomized trial which will compare different ratios of blood products given to trauma patients who are predicted to require massive transfusions.

 

05/2014 - 04/2016                               (PI, 4%)

Controlled expansion of human mesenchymal stromal/stem cells by microRNAs to improve pancreatic islet function after transplantation” 

Living Legacy Foundation of Maryland Grant Program

The goal of this study is to to identify miRs capable of promoting hMSC expansion and evaluate the immunoregulatory function of microRNA-expanded hMSCs in the context of islet transplantation to treat patients with T1D

 

06/2014 - 06/2015                               (PI, 2%)

Enterprise Inc.

Portable point of care testing to assess coagulation in the field”

In collaboration with Enterprise and U Maryland College Park, current instrumentation available for POCT coagulation testing such thromboelastogram (i.e. TEG versus ROTEM) is evaluated for development of more efficient and portable platforms.

Lab Techniques and Equipment

Recently, Dr. Fontaine implemented several innovative new tests and approaches that are important for patient safety and inventory management:

  • Established a model for management of red blood cell and platelet inventories; this model was developed through a collaboration between the Stanford Hospital Transfusion Service, Stanford Blood Center and the Department of Management Science and Engineering (MS&E).

  • Improved the platelet transfusion support for refractory, HLA allosensitized patients: Stanford Hospital Transfusion Service implemented a platelet transfusion management algorithm based on a new assay developed in the Stanford HLA lab that detects only HLA antibodies capable of binding the first complement component (C1q).

  • Participated in the development of a guideline for massive transfusion: this promptly and adequately supports patients with acute and severe bleeding.

  • Participated in the implementation of a two specimen requirement for verification of ABO/Rh type for blood transfusion.

  • Developed novel red blood cell inventory management strategies to meet the higher demand for fresher blood