A5025478304- Liver Disease and Transplantation
- Liver Disease Diagnosis and Treatment
- Organ Transplantation Techniques and Outcomes
- Renal Transplantation Outcomes and Treatments
- COVID-19 Clinical Research Studies
- Hepatitis C virus research
- Long-Term Effects of COVID-19
- Hepatocellular Carcinoma Treatment and Prognosis
- Acute Kidney Injury Research
- COVID-19 and healthcare impacts
- Hepatitis B Virus Studies
- HIV/AIDS drug development and treatment
- Pancreatic and Hepatic Oncology Research
- Renal Diseases and Glomerulopathies
- Colorectal Cancer Screening and Detection
- Respiratory Support and Mechanisms
- SARS-CoV-2 and COVID-19 Research
- Alcohol Consumption and Health Effects
- Drug-Induced Hepatotoxicity and Protection
- Chronic Kidney Disease and Diabetes
- Esophageal and GI Pathology
- Electrolyte and hormonal disorders
- HIV-related health complications and treatments
- SARS-CoV-2 detection and testing
- COVID-19 diagnosis using AI
University of Michigan
2016-2025
Baba Raghav Das Medical College
2024-2025
Michigan United
2019-2024
Massachusetts General Hospital
2024
Michigan Medicine
2010-2023
Tribhuvan University Teaching Hospital
2022-2023
VA Ann Arbor Healthcare System
2022-2023
E Ink (South Korea)
2023
A. Alfred Taubman Health Care Center
2013-2022
Tribhuvan University
2022
Abstract Background Severe coronavirus disease 2019 (COVID-19) can manifest in rapid decompensation and respiratory failure with elevated inflammatory markers, consistent cytokine release syndrome for which IL-6 blockade is an approved treatment. Methods We assessed effectiveness safety of tocilizumab a single-center cohort patients COVID-19 requiring mechanical ventilation. The primary endpoint was survival probability postintubation; secondary analyses included ordinal illness severity...
The vasoconstrictor terlipressin is used for type 1 hepatorenal syndrome (HRS-1) in many parts of the world and part clinical practice guidelines Europe.We conducted a phase 3 trial to confirm efficacy safety plus albumin adults with HRS-1. patients were randomly assigned 2:1 ratio receive or placebo up 14 days; both groups, concomitant use was strongly recommended. primary end point verified reversal HRS, defined as two consecutive serum creatinine measurements 1.5 mg per deciliter less at...
Abstract Background We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory emerging Infection Consortium (ISARIC) COVID-19 cohort, one of world's largest international, standardized data sets concerning hospitalized patients. Methods The set analysed includes patients between January 2020 2022 52 countries. investigated how symptoms on admission, co-morbidities, risk factors varied by age, sex other characteristics. used Cox...
The new allocation policy of the United Network Organ Sharing (UNOS) based on model for end-stage liver disease (MELD) gives candidates with stage T1 or T2 hepatocellular carcinoma (HCC) a priority MELD score beyond their degree hepatic decompensation. aim this study was to determine impact HCC before and after institution MELD. UNOS database reviewed all listed between July 1999 2002. were grouped by two time periods, date implementation February 27, Pre-MELD deceased donor transplantation...
Hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (OLT) is universal. We aimed to evaluate the efficacy and safety of pegylated interferon (PEG-IFN) ribavirin (RIB) in treatment post-OLT HCV recurrence.Thirty-seven patients with recurrent OLT were screened began treatment. Nineteen have completed therapy. PEG-IFN was started at a dose 0.5 microg/kg per week titrated toward maximum 1.5 week. RIB 400 mg day 1000 day, as tolerated. Therapy continued for 1 year...
The proportion of patients undergoing liver transplantation (LT) with renal insufficiency has significantly increased in the Model for End-Stage Liver Disease (MELD) era. This study was designed to determine incidence and predictors post-LT chronic failure (CRF) its effect on patient survival MELD Outcomes 221 adult LT recipients who had between February 2002 2007 were reviewed retrospectively. Patients listed as status 1, granted a exception, or living-donor, multiorgan excluded. Renal at...
ABSTRACT Background Severe COVID-19 can manifest in rapid decompensation and respiratory failure with elevated inflammatory markers. This presentation is consistent cytokine release syndrome chimeric antigen receptor T cell therapy, for which IL-6 blockade approved treatment. Methods We assessed effectiveness safety of tocilizumab a single-center cohort patients requiring mechanical ventilation. The primary endpoint was survival probability post-intubation; secondary analyses included an...
Background. Solid organ transplant (SOT) recipients are considered to be “vulnerable” COVID-19 infection due immunosuppression. To date, there no studies that compared the disease severity of in SOT with nontransplant patients. Methods. In this case-control study, we outcomes between and their matched controls. The cases were all adult (N = 41) from our academic health center who diagnosed March 10, 2020 May 15, using positive reverse transcriptase polymerase chain reaction for SARS-CoV2....
Obstructive sleep apnea and other disorders overlap with comorbidities associated poor outcomes related to severe acute respiratory syndrome coronavirus 2 infection. However, the prevalence of obstructive among patients hospitalized for COVID-19 relationship is poorly characterized, relevance remains unknown. The objective this study was identify pre-existing association illness.Patients infection admitted University Michigan Hospital System were included. Electronic medical records queried...
Candidates with fulminant hepatic failure (Status–1A) receive the highest priority for liver transplantation (LT) in United States. However, no studies have compared wait–list mortality risk among end–stage disease (ESLD) candidates high Model End–Stage Liver Disease (MELD) scores to those listed as Status–1A. We aimed determine if there are MELD ESLD at which their is higher than that of Status–1A, and identify factors predicting who Data were obtained from Scientific Registry Transplant...
Candidates with AKI including hepatorenal syndrome often recover renal function after successful liver transplantation (LT). This study examined the incidence and risk factors associated nonrecovery within 6 months of LT alone among those receiving acute replacement therapy (RRT) before LT.Scientific Registry Transplant Recipients data were linked Centers for Medicare Medicaid Services ESRD 2112 adult deceased-donor LT-alone recipients who received RRT ≤90 days (February 28, 2002 to August...
The survival benefit of simultaneous liver‐kidney transplantation (SLKT) over liver alone (LTA) is unclear from the current literature. Additionally, role donor kidney quality, measured by risk index (KDRI), in SLKT not studied. We compared after and LTA among recipients with similar pretransplant renal dysfunction using novel methodology, specifically respect to probability area under curve dialysis status KDRI. Data were obtained Scientific Registry Transplant Recipients. study cohort...
Hepatocellular carcinoma (HCC) is a common indication for liver transplantation (LT). Recent data suggest that body composition features strongly affect post-LT mortality. We examined the impact of on mortality in patients with HCC. Data adult LT recipients who received Model End-Stage Liver Disease exception HCC between February 29, 2002, and December 31, 2013, had computed tomography (CT) scan any time 6 months prior to were reviewed (n = 118). All available CT Digital Imaging...
Sustained virologic response (SVR) after antiviral therapy for recurrent hepatitis C virus (HCV) infection in liver transplant (LT) recipients is consistently lower than that achieved non-LT patients. We evaluated efficacy and safety of pegylated interferon (IFN) ribavirin (RBV) LT with HCV factors associated SVR. All subjects histologic evidence were intended to be treated 48 weeks full-dose IFN; target dose RBV was 800 mg/day. Thirty-five HCV, median age 48.5 years, 77% genotype 1,...
Incident ESRD after liver transplantation (LT) is associated with high post-transplant mortality. We constructed and validated a continuous renal risk index (RRI) to predict post-LT ESRD. Data for 43,514 adult recipients of deceased donor LT alone (February 28, 2002 December 31, 2010) were linked from the Scientific Registry Transplant Recipients Centers Medicare Medicaid Services Program. An adjusted Cox regression model time was fitted, resulting equation used calculate an RRI each...