A5028141797- Renal Transplantation Outcomes and Treatments
- Organ Transplantation Techniques and Outcomes
- Organ Donation and Transplantation
- Renal and Vascular Pathologies
- Pain Management and Opioid Use
- Opioid Use Disorder Treatment
- Anesthesia and Pain Management
- Long-Term Effects of COVID-19
- Transplantation: Methods and Outcomes
- COVID-19 Clinical Research Studies
- Migration, Health and Trauma
- Cytomegalovirus and herpesvirus research
- Hepatitis C virus research
- COVID-19 Impact on Reproduction
- Neurological Complications and Syndromes
- Reproductive System and Pregnancy
- Infectious Encephalopathies and Encephalitis
- Pregnancy and Medication Impact
- Hepatitis B Virus Studies
- Dialysis and Renal Disease Management
- Metabolism and Genetic Disorders
- Liver Disease Diagnosis and Treatment
- Geriatric Care and Nursing Homes
- Viral Infections and Immunology Research
- Herpesvirus Infections and Treatments
Yale New Haven Hospital
2023
Hartford Hospital
2018-2022
Hartford Financial Services (United States)
2019-2022
University of Connecticut
2016-2020
The widespread transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to propagate the disease 2019 (COVID-19) pandemic with solid organ transplant (SOT) recipients being an exceptionally vulnerable population for poor outcomes. Treatments COVID-19 are limited; however, monoclonal antibodies emerging as a potential therapeutic option change trajectory high-risk patients. This retrospective single center cohort study evaluated outcomes SOT mild moderate who...
Nonopioid strategies to optimize pain management in patients after liver transplantation remain underexplored. The purpose of this study was evaluate whether the use a multimodal (MPM) order set would reduce postoperative opioid adult transplantation.Retrospective pre- and post-order implementation study.Large academic tertiary care hospital.Thirty-one adults who underwent were included; these, 18 received provider-managed regimens (pre-MPM group: August 20, 2016-January 17, 2018), 13 MPM...
Historically, there is perceived pressure to achieve therapeutic levels of tacrolimus quickly after heart transplant (HT). We evaluated the association between time within range and trough rejection in 30 days following HT.This a single-center retrospective cohort study consecutive adult HT patients receiving immunosuppression. Goal were 10-15 ng/ml. Surveillance endomyocardial biopsies performed weekly for 4 weeks. Outcomes included effect time-in-therapeutic (Rosendaal method) on 30-day...
The prevalence of substance use disorder in the liver transplantation (LT) population makes postoperative pain management challenging. We report our initial experience with a novel, comprehensive, multidisciplinary opioid avoidance pathway 13 LT recipients between January 2018 and September 2019. Patients received comprehensive pre‐LT education on by surgeon, pharmacist, psychologist at time listing. Immediately after LT, patients continuous incisional ropivacaine infusion, ketamine,...
Abstract Noncirrhotic hyperammonemia (NCH) is a rare but often fatal complication of solid organ transplantation. We present case wherein an infectious cause NCH was suspected following kidney transplantation (KT) and the patient promptly started on empirical antibiotic treatment which proved to be lifesaving. A 56‐year‐old Chinese woman with past medical history end‐stage renal disease secondary ischemic nephropathy cerebrovascular accident received from 52‐year‐old brain‐dead donor Kidney...
Pregnancy in solid organ transplant recipients carries numerous risks to the mother such as increased risk of rejection, gestational diabetes mellitus, and preeclampsia. The developing fetus is subjected birth defects, preterm delivery, low weight. Typically, these can be managed through intensive, multidisciplinary prenatal care a proper immunosuppressive regimen. In setting however, little data are available suggest safe effective treatment acute cellular antibody-mediated or mixed...
Abstract The clinical course and outcomes of immunocompromised patients, such as transplant recipients, with COVID‐19 remain unclear. It has been postulated that a substantial portion the disease burden seems to be mediated by host immune activation severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Herein, we present simultaneous heart‐kidney (SHKT) recipient who was hospitalized for management failure from volume overload complicated thrive, multiple opportunistic infections,...
To the Editor: Our knowledge about effects of COVID-19 on solid organ transplant (SOT) population is characterized by remarkable heterogeneity in treatment and outcomes SOT recipients infected with SARS-CoV-2. As one earliest hotspots United States, we present our 16 (13 kidney, 2 liver, 1 simultaneous heart-kidney) between March 30, 2020, May 7, at center (Institutional Review Board-approved database, HHC-2020-0124). Table provides case summaries study population. Ten patients were alive...
Utilization of Hepatitis B virus (HBV)-infected kidney allografts represents an opportunity to bridge the gap between organ supply and demand. Highly efficacious vaccines antiviral therapies allow these be transplanted with negligible risk recipient. The purpose this study was describe prophylactic strategies related clinical outcomes transplant recipients who received a from HBV viremic donor. Eight patients allograft deceased donor January 1, 2017 December 4, 2020. All were immune...
Postoperative pain is a significant source of morbidity in patients undergoing living donor nephrectomy (LDN) and deterrent for candidates. We implemented standardized multimodal analgesic regimen, which consists pharmacist-led pre-procedure management education, combination transversus abdominis plane rectus sheath block performed by the regional anesthesia team, scheduled acetaminophen gabapentin, as-needed opioids. This single-center retrospective study evaluated outcomes between LDN who...
Abstract Cytomegalovirus (CMV) is a significant cause of morbidity in kidney transplant recipients (KTR). Historically at our institution, KTR with low and intermediate CMV risk received 6 months valganciclovir if they lymphocyte depleting induction therapy. This study evaluates choice duration prophylaxis based on donor (D) recipient (R) serostatus the incidence post‐transplant viremia (D‐/R‐) (R+) receiving lymphocyte‐depleting A protocol utilizing valacyclovir for 3 D‐/R‐ R+ was...
Post-transplant lymphoproliferative disorder (PTLD) is an uncommon, but well-described complication after liver transplantation. Most recently, Hepatitis C virus (HCV) has been implicated in the development of PTLD. A HCV-negative 62-year-old man with autoimmune hepatitis received a HCV nucleic acid amplification test-positive graft from 73-year-old brain-dead donor (D+/R-). After his recovery operation, patient was treated for and achieved undetectable viral load. He readmitted 6 months...
Purpose: Compared to non-Hispanic whites (NHW), Hispanics in the United States (U.S.) suffer from disproportionally higher rates of obesity, hypertension, diabetes, and ultimately, end-stage renal disease. Moreover, are less likely be referred for dialysis, evaluated kidney transplantation (KT), placed on KT wait list, or receive a KT. Interestingly, some reports suggest that if transplanted, enjoy longer graft patient survival after Methodology: We data U.S. Scientific Registry Transplant...
Purpose: Despite having greater severity of alcoholic liver disease, higher incidence hepatocellular carcinoma and non-alcoholic fatty mortality from hepatitis B C infection, ethnic minorities in the United States (U.S.) have a lower number referrals for transplantation (LT) compared to non-Hispanic Whites (NHW). We sought identify factors associated with graft failure how they differ by race/ethnicity. Methodology: evaluated data U.S. Scientific Registry Transplant Recipients (SRTR) all...
Purpose: Disparities in children undergoing liver transplantation (LT) exist and have been attributed to a combination of racial socioeconomic circumstances. We sought evaluate the influence those barriers access LT on graft patient survival. Methodology: evaluated data from U.S. Scientific Registry Transplant Recipients (SRTR) all pediatric (<18 years old) recipients 1999 2014 compared outcomes by race or ethnicity: Hispanic, non-Hispanic White (NHW), Blacks (NHB). assessed 1- 5-year...