Gregory Hare

MD, PhD

Investigator

Biography

Dr. Gregory Hare is a Staff Anesthesiologist at St. Michael’s Hospital and a Professor in the Department of Anesthesia at the University of Toronto. His clinical focus is to develop multimodal and inter-professional approaches to optimize patient outcomes through patient blood management strategies. His long term research goal is to define mechanisms of anemia-induced morbidity and mortality; and to design novel treatment strategies to prevent these adverse outcomes.

Dr. Hare’s research is focused on defining adaptive, and maladaptive, cardiovascular mechanisms in experimental models of acute anemia using integrative whole animal models. These translational studies have defined mechanism of anemia-induced tissue hypoxia and mortality. His laboratory has identified integrative adaptive cellular (nNOS and HIF) and physiological mechanisms which promote organism survival during acute anemia. In addition, their laboratory has demonstrated that acute beta-blockade interferes with adaptive cardiovascular mechanisms, which sustain cerebral oxygen delivery during anemia. This could possibly explain the negative interaction between acute anemia and beta-blockade and the increased incidence of stroke in perioperative patients.

The laboratory is currently focused on translational approaches to identify patient specific biomarkers of anemia-induced tissue hypoxia in order to identify when patients are at risk of anemia induced morbidity and mortality; and to derive patient specific therapies which can reduce morbidity and mortality associated with both anemia and red blood cell transfusion. The overall clinical goal is to reduce morbidity and mortality associated with acute and chronic anemia in perioperative patients.

Recent Publications

  1. Mistry, N, Mazer, CD, Sivaswamy, A, Haldenby, O, Austin, PC, Sud, M et al.. Transfusion in Anemic Patients with Acute Coronary Syndromes: A Population-Based Cohort Study. Can J Cardiol. 2024; :. doi: 10.1016/j.cjca.2024.10.012. PubMed PMID:39427842 .
  2. Marrow, JP, Alshamali, R, Edgett, BA, Allwood, MA, Cochrane, KLS, Al-Sabbag, S et al.. Cardiomyocyte crosstalk with endothelium modulates cardiac structure, function, and ischemia-reperfusion injury susceptibility through erythropoietin. Front Physiol. 2024;15 :1397049. doi: 10.3389/fphys.2024.1397049. PubMed PMID:39011088 PubMed Central PMC11246973.
  3. Costa, LGVD, Papa, FV, Hare, GMT, Salgado-Filho, MF, Lineburger, EB, Schmidt, AP et al.. Anemia and outcomes in cardiac surgery. Braz J Anesthesiol. 2024;74 (3):844504. doi: 10.1016/j.bjane.2024.844504. PubMed PMID:38677651 PubMed Central PMC11081777.
  4. Chin, K, Jiang, H, Steinberg, BE, Goldenberg, NM, Desjardins, JF, Kabir, G et al.. Bilateral nephrectomy impairs cardiovascular function and cerebral perfusion in a rat model of acute hemodilutional anemia. J Appl Physiol (1985). 2024;136 (5):1245-1259. doi: 10.1152/japplphysiol.00858.2023. PubMed PMID:38385183 .
  5. Allwood, MA, Edgett, BA, Platt, MJ, Marrow, JP, Coyle-Asbil, B, Holjak, EJB et al.. Novel roles of cardiac-derived erythropoietin in cardiac development and function. J Mol Cell Cardiol. 2024;188 :90-104. doi: 10.1016/j.yjmcc.2024.01.006. PubMed PMID:38382296 .
  6. Jiang, H, Hare, GMT, Mazer, CD. Effect of different red cell transfusion thresholds on quality of life: An important question with no clear answer yet. Transfusion. 2023;63 (11):2013-2016. doi: 10.1111/trf.17586. PubMed PMID:37965701 .
  7. Hibino, M, Peterson, MD, Tachibana, R, Chu, MWA, Bozinovski, J, Dagenais, F et al.. Association of Cerebral Oximetry With Brain Ischemic Lesions and Functional Outcomes in Arch Repair. Ann Thorac Surg. 2024;117 (3):627-633. doi: 10.1016/j.athoracsur.2023.09.026. PubMed PMID:37777147 .
  8. Mistry, N, Jiang, H, Chin, K, Hare, GMT, Verma, S, Mazer, CD et al.. Transfusion thresholds in acute coronary syndromes. Curr Opin Cardiol. 2023;38 (6):533-538. doi: 10.1097/HCO.0000000000001085. PubMed PMID:37610413 .
  9. Mistry, N, Hare, GMT, Shehata, N, Kramer, RS, Fawzy, HF, Baker, RA et al.. Methemoglobin as a marker of acute anemic stress in cardiac surgery. iScience. 2023;26 (8):107429. doi: 10.1016/j.isci.2023.107429. PubMed PMID:37575193 PubMed Central PMC10415918.
  10. Mistry, N, Hare, GMT, Shehata, N, Belley-Cote, E, Papa, F, Kramer, RS et al.. Transfusion Thresholds for Acute Coronary Syndromes-Insights From the TRICS-III Randomized Controlled Trial, Systematic Review, and Meta-Analysis. J Am Heart Assoc. 2023;12 (1):e028497. doi: 10.1161/JAHA.122.028497. PubMed PMID:36565203 PubMed Central PMC9973586.
Search PubMed

Affiliations & Other Activities

 

  • Staff Anesthesiologist, Department of Anesthesia, St. Michael’s Hospital
  • Professor, Department of Anesthesia, University of Toronto
  • Professor, Physiology, University of Toronto
  • Associate Member, Institute of Medical Science, University of Toronto