A5068404213- Renal Transplantation Outcomes and Treatments
- Organ Transplantation Techniques and Outcomes
- Organ Donation and Transplantation
- Cytomegalovirus and herpesvirus research
- Polyomavirus and related diseases
- Cancer Genomics and Diagnostics
- Transplantation: Methods and Outcomes
- Renal and Vascular Pathologies
- Renal Diseases and Glomerulopathies
- Gut microbiota and health
- T-cell and B-cell Immunology
- Immune Cell Function and Interaction
- Parvovirus B19 Infection Studies
- COVID-19 Clinical Research Studies
- Single-cell and spatial transcriptomics
- Clostridium difficile and Clostridium perfringens research
- Dialysis and Renal Disease Management
- Blood groups and transfusion
- Pregnancy and Medication Impact
- Liver Disease and Transplantation
- Metabolism and Genetic Disorders
- Pharmacological Effects and Toxicity Studies
- SARS-CoV-2 and COVID-19 Research
- Healthcare Policy and Management
- Long-Term Effects of COVID-19
Weill Cornell Medicine
2016-2025
Cornell University
2016-2025
Presbyterian Hospital
2016-2025
New York Hospital Queens
2016-2025
NewYork–Presbyterian Hospital
2016-2025
Imperial College London
2024
The Rogosin Institute
2010-2023
Emory University
2023
Columbia University
2023
Creative Commons
2023
Solid organ transplant recipients may be at a high risk for SARS-CoV-2 infection and poor associated outcomes. We herein report our initial experience with solid two centers during the first 3 weeks of outbreak in New York City. Baseline characteristics, clinical presentation, antiviral immunosuppressive management were compared between patients mild/moderate severe disease (defined as ICU admission, intubation or death). Ninety analyzed median age 57 years. Forty-six kidney recipients, 17...
The outcome of renal transplantation after an episode acute rejection is difficult to predict, even with allograft biopsy.We studied urine specimens from 36 subjects rejection, 18 chronic nephropathy, and 29 normal biopsy results. Levels messenger RNA (mRNA) for FOXP3, a specification functional factor regulatory T lymphocytes, mRNA CD25, CD3epsilon, perforin, 18S ribosomal (rRNA) were measured kinetic, quantitative polymerase-chain-reaction assay. We examined associations levels reversal,...
The standard test for the diagnosis of acute rejection in kidney transplants is renal biopsy. Noninvasive tests would be preferable.
Immune rejection of organ transplants is a life-threatening complication and exemplified by alterations in the expression protein-encoding genes. Because microRNAs (miRNAs) regulate genes implicated adaptive immunity, we investigated whether acute (AR) associated with miRNA within allografts profiles are diagnostic AR predict allograft function. Seven 33 renal biopsies (12 21 normal) were profiled using microfluidic cards containing 365 mature human miRNAs (training set), subset...
A consensus conference on frailty in kidney, liver, heart, and lung transplantation sponsored by the American Society of Transplantation (AST) endorsed Nephrology (ASN), Transplant Surgeons (ASTS), Canadian (CST) took place February 11, 2018 Phoenix, Arizona. Input from transplant community through scheduled calls enabled wide discussion current concepts frailty, exploration best practices for risk assessment candidates management after transplant, development ideas future research....
Abstract The origin of most bacterial infections in the urinary tract is often presumed to be gut. Herein, we investigate relationship between gut microbiota and future development bacteriuria infection (UTI). We perform microbial profiling using 16S rRNA gene deep sequencing on 510 fecal specimens from 168 kidney transplant recipients metagenomic a subset urine supernatant specimens. report that 1% relative abundance Escherichia an independent risk factor for UTI Enterococcus bacteriuria....
Donor-derived cell-free DNA (dd-cfDNA) is an emerging noninvasive biomarker that has the potential to detect allograft injury. The capacity of dd-cfDNA kidney rejection and its added clinical value beyond standard care patient monitoring unclear. We enrolled 2,882 recipients from 14 transplantation centers in Europe United States observational population-based study. primary analysis included 1,134 patients. levels strongly correlated with rejection, including antibody-mediated (P < 0.0001),...
Key Points Posoleucel was generally safe, well tolerated, and associated with a greater reduction of BK viremia compared placebo. occurred coincident an increase in the circulating frequency virus–specific T cells posoleucel recipients. The presence persistence confirmed by T-cell receptor variable β sequencing. Background Kidney transplant recipients virus infection are at risk developing virus–associated nephropathy, allograft rejection, subsequent graft loss. There no approved treatments...
Tacrolimus dosing to establish therapeutic levels in recipients of organ transplants is a challenging task because much interpatient and intrapatient variability drug absorption, metabolism, disposition. In view the reported impact gut microbial species on we investigated relationship between microbiota tacrolimus requirements this pilot study adult kidney transplant recipients. Serial fecal specimens were collected during first month transplantation from 19 who either required 50% increase...
The gut microbiome plays a role in the regulation of immune system.We prospectively enrolled 26 kidney transplant recipients and collected serial fecal specimens (N=85) during first three months transplantation. We characterized bacterial composition by polymerase chain reaction amplification 16S rRNA V4-V5 variable region deep sequencing using Illumina MiSeq platform.An increase relative abundance Proteobacteria was observed posttransplantation compared to pretransplantation (P=0.04,...
Polyomavirus nephropathy (PVN) is a common viral infection of renal allografts, with biopsy-proven incidence approximately 5%. A generally accepted morphologic classification definitive PVN that groups histologic changes, reflects clinical presentation, and facilitates comparative outcome analyses lacking. Here, we report scheme for from the Banff Working Group on Nephropathy, comprising nine transplant centers in United States Europe. This study represents largest systematic analysis...
Urinary tract infections are one of the most common in humans. Here we tested utility urinary cell-free DNA (cfDNA) to comprehensively monitor host and pathogen dynamics bacterial viral infections. We isolated cfDNA from 141 urine samples a cohort 82 kidney transplant recipients performed next-generation sequencing. found that is highly informative about composition microbiome, antimicrobial susceptibility, growth dynamics, allograft injury, response infection. These different layers...
Urinary tract infection (UTI) is a frequent, serious complication in kidney allograft recipients.
De novo donor-specific antibody (dnDSA) is associated with antibody-mediated rejection (AMR) and allograft loss, yet the histology dnDSA remains unclear. The aim of this study was to examine in patients serial surveillance biopsies. We retrospectively studied adult conventional solitary kidney transplant recipients from October 2007 May 2014. definition new (DSA) mean fluorescence intensity (MFI) >1000. incidence 7.0% (54 771) over follow-up 4.2 ± 1.9 years. Patients had reduced...
Posttransplant diarrhea is associated with kidney allograft failure and death, but its etiology remains unknown in the majority of cases. Because altered gut microbial ecology a potential basis for diarrhea, we investigated whether posttransplant dysbiosis. We enrolled 71 recipients serial fecal specimen collections first 3 months transplantation profiled microbiota using 16S ribosomal RNA (rRNA) gene V4-V5 deep sequencing. The Shannon diversity index was significantly lower 28 diarrheal...
The COVID-19 pandemic has brought unprecedented challenges to the transplant community. reduction in transplantation volume during this time is partly due concerns over potentially increased susceptibility and worsened outcomes of immunosuppressed recipients. consequences on patients waitlisted for kidney transplantation, however, have not previously been characterized. We studied 56 80 recipients diagnosed with between March 13 May 20, 2020. Despite similar demographics burden comorbidities...
Much of the higher risk for end-stage kidney disease (ESKD) in African American individuals relates to ancestry-specific variation apolipoprotein L1 gene (
Kidney graft recipients receiving immunosuppressive therapy may be at heightened risk for coronavirus disease 2019 (Covid-19) and adverse outcomes. It is therefore important to characterize the clinical course outcome of Covid-19 in this population identify safe therapeutic strategies.We performed a retrospective chart review 73 adult kidney evaluated from 13 March 20 April 2020. Primary outcomes included recovery symptoms, acute injury, failure case fatality rate.Of patients screened, 54...
Given the potential utility of frailty, a clinical phenotype decreased physiologic reserve and resistance to stressors, predict postkidney transplant (KT) outcomes, we sought understand perceptions practices regarding frailty measurement in US KT programs.
High-throughput metagenomic sequencing offers an unbiased approach to identify pathogens in clinical samples. Conventional sequencing, however, does not integrate information about the host, which is often critical distinguish infection from infectious disease, and assess severity of disease. Here, we explore utility high-throughput cell-free DNA (cfDNA) after bisulfite conversion map tissue cell types origin host-derived cfDNA, profile bacterial viral metagenome. We applied this assay 51...
Simultaneous heart-kidney transplant (sHK) has enabled the successful transplantation of patients with end-stage heart disease and concomitant kidney disease, non-inferior outcomes to (HT) alone. The decision for sHK is challenged by difficulties in differentiating those a significant component reversible injury due cardiorenal syndrome who may recover function after HT, from intrinsic advanced would benefit most sHK. A consensus conference on took place June 1, 2019 Boston, Massachusetts....