A5066036858- Renal Transplantation Outcomes and Treatments
- Organ Donation and Transplantation
- Organ Transplantation Techniques and Outcomes
- Renal and Vascular Pathologies
- Neurological Complications and Syndromes
- Transplantation: Methods and Outcomes
- Pharmacological Effects and Toxicity Studies
- Polyomavirus and related diseases
- Cytomegalovirus and herpesvirus research
- Liver Disease and Transplantation
- Pediatric Urology and Nephrology Studies
- Renal Diseases and Glomerulopathies
- Pregnancy and Medication Impact
- Organ and Tissue Transplantation Research
- Ureteral procedures and complications
- Parvovirus B19 Infection Studies
- Trauma and Emergency Care Studies
- Oral and gingival health research
- Urological Disorders and Treatments
- Appendicitis Diagnosis and Management
- Nosocomial Infections in ICU
- Traumatic Brain Injury and Neurovascular Disturbances
- Hemodynamic Monitoring and Therapy
- Intensive Care Unit Cognitive Disorders
- Renal cell carcinoma treatment
Cleveland Clinic Lerner College of Medicine
2011-2023
Cleveland Clinic
2012-2022
Mount Sinai Hospital
2022
Ospedale regionale di Lugano
2019-2020
Medical University of Vienna
2016-2020
University Hospital Frankfurt
2016-2019
Goethe University Frankfurt
2016-2019
Case Western Reserve University
2012-2018
Beilstein-Institut
2018
Collaborative Group (United States)
2014-2016
Progressive nephrotoxicity caused by calcineurin inhibitor drugs contributes to the long-term decline in renal function kidney transplant patients.We conducted a randomized, prospective trial of drug avoidance 61 adult primary recipients. Each patient received induction therapy with 20 mg basiliximab on days 0 and 4, maintenance mycophenolate mofetil 1 g two times per day steroids. Thirty-one patients sirolimus, 5 daily after 15-mg loading dose. Doses were then concentration-controlled keep...
We performed a randomized prospective trial comparing calcineurin inhibitor (CNI)-free to CNI-based immunosuppression determine the impact on renal function, structure and gene expression. Sixty-one kidney recipients treated with basiliximab mycophenolate mofetil (MMF) prednisone (P) were randomly assigned concentration-controlled sirolimus or cyclosporine. Two years post-transplant 55 patients underwent function studies, 48 (87%) transplant biopsies; all classified by Banff scoring 41 DNA...
No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Dec 2001RENAL OUTCOME 25 YEARS AFTER DONOR NEPHRECTOMY DAVID A. GOLDFARB, SURENA F. MATIN, WILLIAM E. BRAUN, MARTIN J. SCHREIBER, BARBARA MASTROIANNI, DOREEN PAPAJCIK, HENRY ROLIN, STUART FLECHNER, MARLENE GOORMASTIC, and ANDREW C. NOVICK GOLDFARBDAVID GOLDFARB , MATINSURENA MATIN BRAUNWILLIAM BRAUN SCHREIBERMARTIN SCHREIBER MASTROIANNIBARBARA MASTROIANNI PAPAJCIKDOREEN PAPAJCIK ROLINHENRY ROLIN FLECHNERSTUART FLECHNER...
Two hundred twenty-eight patients from a total of 466 (49%) receiving renal allografts under cyclosporine/prednisone (CsA/Pred) immunosuppression experienced at least one episode posttransplant hepatotoxicity. All were documented to have normal serum bilirubin, glutamic oxaloacetic transaminase (SGOT), pyruvate (SGPT), lactic acid dehydrogenase (LDH), and alkaline phosphatase (AP), as well negative results biliary ultrasound upper gastrointestinal contrast examinations prior transplantation....
The therapeutic efficacy of cyclosporine (CsA) as an immunosuppressive agent was complemented by a modest, long-term incidence toxic complications in 402 renal allograft recipients engrafted one to five years prior analysis. overall patient and graft survivals at year were 97% 84% (actual), 92% 67% (actuarial). index excellent: only 12% allografts lost from rejection, with 5% patients succumbing infection. While infections common, tending emanate the urinary tract or be viral etiology, they...
Background. We report the 5-year outcomes from a randomized prospective trial in primary adult renal allograft recipients, designed to evaluate calcineurin inhibitor (CNI)-free immunosuppression on kidney transplant function. Methods. Sixty-one patients were either sirolimus (n=31) or cyclosporine (n=30) after basiliximab induction and mycophenolate mofetil (MMF) with steroids. Sirolimus was concentration controlled at 10–12 ng/mL for least 6 months. Results. After 5 years,...
Report cards evaluating transplant center performance have received significant attention in recent years corresponding with the Centers for Medicare and Medicaid Services issue of 2007 Conditions Participation. Our primary aim was to evaluate association report card evaluations volume. We utilized data from Scientific Registry Transplant Recipients (SRTR) along six consecutive program-specific reports January July 2009 adult kidney centers. Among 203 centers, 46 (23%) were low performing...
There are no minimally invasive diagnostic metrics for acute kidney transplant rejection (AR), especially in the setting of common confounding diagnosis, dysfunction with (ADNR). Thus, though biopsies remain gold standard, they invasive, have substantial risks, sampling error issues and significant costs not suitable serial monitoring. Global gene expression profiles 148 peripheral blood samples from patients excellent function normal histology (TX; n = 46), AR (n 63) ADNR 39), two...
Interstitial fibrosis and tubular atrophy (IFTA) is found in approximately 25% of 1-year biopsies posttransplant. It known that IFTA correlates with decreased graft survival when histological evidence inflammation present. Identifying the mechanistic etiology important to understanding why long-term has not changed as expected despite improved immunosuppression dramatically reduced rates clinical acute rejection (AR) (Services UDoHaH....
The aim of this study was to determine whether there has been an increase in the incidence or severity wound-healing complications that can be attributed introduction newer immunosuppressive drugs.Consecutive series adult kidney-only transplant recipients were selected from our Unified Transplant Database backward September 2002. There 513 patients divided into groups on basis their maintenance immunosuppression given for at least first 30 days posttransplant. Group I (152) sirolimus,...
Background. The results of renal transplantation in obese recipients have been controversial, with some reports finding increased morbidity prohibitive and others acceptable. We attempted to determine whether patients extreme excess their ideal body weight should undergo transplantation. Methods. study population included 127 (body mass index >30 kg/m2) who were compared a matched nonobese control group <27 similar demographics. There no significant differences between the groups according...
We report our initial experience in using the proteasome inhibitor, bortezomib, to treat established antibody-mediated rejection (AMR) 20 patients.There were 16 kidney-only and 4 kidney-combined organ recipients with de novo donor-specific antibody (DSA) histologic evidence of AMR peritubular capillaries C4d deposition. was diagnosed 19.8 months (range 1-71 months) posttransplant. Patients received intravenous corticosteroids followed by a 2-week cycle on days 1-4-8-11 plasmapheresis 1.3...
Despite the benefits of kidney transplantation, total number transplants performed in United States has stagnated since 2006. Transplant center quality metrics have been associated with a decline transplant volume among low-performing centers. There are concerns that regulatory oversight may lead to risk aversion and lack transplantation growth.A retrospective cohort study adults (age≥18 years) wait-listed for from 2003 2010 using Scientific Registry Recipients was conducted. The primary aim...
The practice of kidney paired donation (KPD) is expanding annually, offering the opportunity for live donor transplant to more patients. We sought identify if voluntary KPD networks such as National Kidney Registry (NKR) were selecting or attracting a narrower group donors recipients compared with national registries. For this purpose, we merged data from NKR database Scientific Transplant Recipients (SRTR) database, February 14, 2008, 2017, encompassing first 9 years NKR. Compared all...
Background and objectives The objective was to study the long-term impact of transient versus persistent BK viremia on kidney transplant outcomes. Design, setting, participants, & measurements In total, 609 recipients who underwent from 2007 2011 were screened at months 1–12 for occurrence polyomavirus viremia; 130 patients (21.7%) developed during first year post-transplant. classified according duration infection (more or less than 3 months), viral loads 10,000 copies/ml) as low (n=42),...
Approximately 59 000 kidney transplant candidates have been removed from the waiting list since 2000 for reasons other than transplantation, death, or transfers. Prior studies indicate that low-performance (LP) center evaluations by Scientific Registry of Transplant Recipients (SRTR) are associated with reductions in volume. There is limited information to determine whether performance oversight impacts waitlist management. We used national SRTR data evaluate outcomes 315 796 on (2007–2014)....
We analyzed the development of chronic rejection in 511 kidney-only renal transplants 507 patients between July 1987 and November 1994. A database was established for recipients ≥18 years old who received cyclosporine-based immunosuppression demonstrated graft survival a minimum 12 months. The 347 cadaver (67.9%) 164 live donor (32.1%) were followed to 102 months (mean 51 months). Chronic diagnosed 124 transplants(24%), with mean time diagnosis 23±18 (range 3-92). Risk factors identified...
No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 May 2004The Influence Various Maintenance Immunosuppressive Drugs on Lymphocele Formation and Treatment After Kidney Transplantation MAHESH GOEL, STUART M. FLECHNER, LINGME ZHOU, BARBARA MASTROIANNI, KATHY SAVAS, ITHAAR DERWEESH, PRATIK PATEL, CHARLES MODLIN, DAVID GOLDFARB, ANDREW C. NOVICK GOELMAHESH GOEL More articles by this author , FLECHNERSTUART FLECHNER ZHOULINGME ZHOU MASTROIANNIBARBARA MASTROIANNI SAVASKATHY SAVAS...
We performed a pilot study in which 22 kidney recipients (14 LD: 8 DCD) were given alemtuzumab induction (30 mg day 0 and 1), steroids (500 mp 1, none thereafter), mycophenolate mofetil (MMF) maintenance b.i.d) sirolimus (concentration controlled 8-12 ng/mL). With mean follow-up of 15.9 months, patient survival is (21/22) 96% graft (19/22) 87%. Acute rejections occurred (8) 36.3% (two humoral). Of 19 surviving grafts, 18 (95%) remain steroid 15 (79%) CNI-free. At 1 year, creatinine was 1.43...