A5034063852- Renal Transplantation Outcomes and Treatments
- Organ Transplantation Techniques and Outcomes
- Liver Disease and Transplantation
- Organ Donation and Transplantation
- Transplantation: Methods and Outcomes
- Renal and Vascular Pathologies
- Liver Disease Diagnosis and Treatment
- Cytomegalovirus and herpesvirus research
- Surgical site infection prevention
- Polyomavirus and related diseases
- Pancreatic function and diabetes
- Frailty in Older Adults
- Organ and Tissue Transplantation Research
- Complement system in diseases
- Neurological Complications and Syndromes
- Dialysis and Renal Disease Management
- Healthcare Policy and Management
- Orthopedic Infections and Treatments
- Mycobacterium research and diagnosis
- Herpesvirus Infections and Treatments
- Wound Healing and Treatments
- Hepatitis B Virus Studies
- Nutrition and Health in Aging
- Appendicitis Diagnosis and Management
- Neuroscience of respiration and sleep
Thomas Jefferson University
2023-2024
Thomas Jefferson University Hospital
2024
University Hospitals of Cleveland
2021-2022
Case Western Reserve University
2021-2022
University of Florida
2013-2021
Florida College
2018-2021
Health Resources and Services Administration
2021
The Ohio State University
1998-2014
The Ohio State University Wexner Medical Center
2013
University of North Carolina at Chapel Hill
2002-2011
We propose a continuous kidney donor risk index (KDRI) for deceased kidneys, combining and transplant variables to quantify graft failure risk.By using national data from 1995 2005, we analyzed 69,440 first-time, kidney-only, adult transplants. Cox regression was used model the of death or loss, based on factors, adjusting recipient factors. The proposed KDRI includes 14 each found be independently associated with death: age, race, history hypertension, diabetes, serum creatinine,...
The importance of antibody-mediated rejection (AMR) in ABO-compatible liver transplantation is controversial. Here we report a prospective series recipients with preoperative positive crossmatch. To establish the diagnosis AMR recipients, criteria described for kidney allografts were adopted. In approximately 10% 197 transplants, observed T and B cell flow crossmatch before transplantation. Fifteen 19 patients converted to negative crossmatches early after displayed normal function while...
The transition from pediatric to adult health care is a vulnerable time for patients with chronic conditions. We need better understand the factors affecting of kidney transplant recipients during this transition.
Post-transplant anemia (PTA), a frequent complication during the first 3-6 months after transplant, is thought to be uncommon late post-transplant period. A study population of adults (> 18 years) transplanted 1995 at Stanford University (n = 88) and North Carolina 40) was selected. Data-collection points were 0, 1, 2, 3, 4 5 years post transplant. Anemia defined as hematocrit < 33 volume percentage. Thirty percent patients anemic some time The prevalence PTA increased over time; by 26%...
There are no accurate, noninvasive tests to diagnose BK polyomavirus nephropathy, a common infectious complication after renal transplantation. This study evaluated whether the qualitative detection of cast-like, three-dimensional aggregates ("Haufen") in urine accurately predicts nephropathy. Using negative-staining electron microscopy, we sought Haufen 194 samples from 139 control patients and 143 21 with was correlated pathology concomitant biopsies viruria (decoy cell shedding viral load...
In accordance with the National Organ Transplant Act and Department of Health Human Services’ Final Rule, Scientific Registry Recipients (SRTR) publicly releases biannual program-specific reports that include analyses transplant centers’ risk-adjusted waitlist mortality, organ acceptance ratios, rates, graft patient survival. Since inception these center metrics, 1-year posttransplant survival have improved, variation has decreased, casting uncertainty on their clinical relevance. The SRTR...
Islet allotransplantation in the United States (US) is facing an imminent demise. Despite nearly three decades of progress field, archaic regulatory framework has stymied US clinical practice. Current regulations do not reflect state-of-the-art or technical practices. In US, islets are considered biologic drugs and "more than minimally manipulated" human cell tissue products (HCT/Ps). contrast, across world, appropriately defined as "minimally manipulated tissue" regulated a drug, which led...
Antibody-mediated rejection (AMR) after liver transplantation is recognized in ABO incompatible and xeno-transplantation, but its role compatible controversial. We report a case of that demonstrated clinical, serological histological signs AMR without evidence concurrent acute cellular rejection. with persistently high titers circulating donor specific antibodies resulted graft injury initial centrilobular hepatocyte necrosis, fibroedematous portal expansion mimicking biliary tract outflow...
There is a paucity of data concerning the correlation complement component 4d (C4d) staining in liver allografts and antibody-mediated rejection. Data about location character C4d deposits native allograft tissues are inconsistent. We performed immunofluorescence (IF) on 141 fresh-frozen biopsy samples livers, documented pattern IF staining, correlated findings with presence donor-specific alloantibodies (DSAs). A linear/granular sinusoidal was noted 18 28 obtained after transplantation from...
Recurrent glomerulonephritis is an important cause of kidney allograft failure. The effect immunosuppression on recurrent IgA nephropathy (IgAN) unclear. We analyzed the impact steroids and other risk IgAN post-kidney transplantation. Between June 1989 November 2008, 3311 transplants were performed at our center. was primary disease in 124 patients; these, 75 (60.5%) patients received steroid-based (15 undergoing late steroid withdrawal), 49 (39.5%) maintained steroid-free immunosuppression....
The use of digital subtraction angiography (DSA) versus helical CT (CTA) or MR (MRA) for live renal donor evaluation is still controversial. Although CTA and MRA can detect some proximal moderate to severe arterial changes caused by fibromuscular dysplasia (FMD), mild distal FMD are not detected well without angiography.This a retrospective chart review all potential, normotensive donors at our center from July 1995 June 2001. One hundred fifty-nine patients completed the process underwent...
Background/Aims: Both hemorrhagic and cardiogenic shock are associated with hepatic gene expression at resuscitation.This study investigated the potential role of intravascular superoxide anion as a proximal trigger heat protein expression.Methods: Preanesthetized pigs were subjected to 120 m total warm iscbemia.The survival model consisted warm, ischemia reperfusion (with activt~ portal-systemic bypass) followed by for 3 days.Serial biopsy samples evaluated 72 (HSP-72) messenger RNA (mRNA)...
Obstructive sleep apnea (OSA) acutely increases systemic (Psa) and pulmonary (Ppa) arterial pressures decreases ventricular stroke volume (SV). In this study, we used a canine model of OSA ( n = 6) to examine the role hypoxia autonomic nervous system (ANS) in mediating these cardiovascular responses. Hyperoxia (40% oxygen) completely blocked any increase Ppa response obstructive but only attenuated Psa. contrast, after blockade ANS (20 mg/kg iv hexamethonium), produced decrease Psa (−5.9...
Abstract Background The impact of parathyroidectomy on allograft function in kidney transplant patients is unclear. Methods We conducted a retrospective, observational study all recipients from 1988 to 2008 who underwent for uncontrolled hyperparathyroidism (n = 32). Post‐parathyroidectomy, changes estimated glomerular filtration rate (e GFR ) and graft loss were recorded. Cross‐sectional associations at baseline between e serum calcium, phosphate, parathyroid hormone ( PTH ), their within...
A plasmapheresis-free protocol for desensitization of donor kidney transplant candidates with high Calculated Panel Reactive Antibody (CPRA) was initiated at our center. The adopted from previously published work by Vo, Jordan et al.Five patients CPRA 94 ± 18%, awaiting living or deceased donors received rituximab (1 g × 2 doses) and intravenous immunoglobulin (IVIG g/kg without plasmapheresis. Levels specific antibodies (DSA) T/B cell crossmatches were followed using solid phase flow...
Scientific Registry of Transplant Recipients report cards US organ transplant center performance are publicly available and used for quality oversight. Low (LP) evaluations associated with changes in practice including reduced rates increased waitlist removals. In 2014, implemented new Bayesian methodology to evaluate which was not adopted by Center Medicare Medicaid Services (CMS). May 2016, CMS altered their criteria, reducing the likelihood LP evaluations.Our aims were incidence, survival...