A5069741073- Organ Transplantation Techniques and Outcomes
- Renal Transplantation Outcomes and Treatments
- Liver Disease and Transplantation
- Liver Disease Diagnosis and Treatment
- Organ Donation and Transplantation
- Hepatocellular Carcinoma Treatment and Prognosis
- Nutrition and Health in Aging
- Renal and Vascular Pathologies
- Transplantation: Methods and Outcomes
- Liver physiology and pathology
- Cholangiocarcinoma and Gallbladder Cancer Studies
- Hepatitis C virus research
- Surgical Simulation and Training
- Renal Diseases and Glomerulopathies
- Innovations in Medical Education
- Dialysis and Renal Disease Management
- Neurological Complications and Syndromes
- Diversity and Career in Medicine
- Complement system in diseases
- Pancreatic and Hepatic Oncology Research
- Frailty in Older Adults
- Cytomegalovirus and herpesvirus research
- Pregnancy and Medication Impact
- Clinical Nutrition and Gastroenterology
- Hernia repair and management
University of Pittsburgh
2016-2025
University of Pittsburgh Medical Center
2016-2025
Children's Hospital of Pittsburgh
2022-2024
University of California, Los Angeles
2023
University of California, San Francisco
2023
UPMC Health System
2023
CHRISTUS Transplant Institute
2022
American College of Surgeons
2022
Directorate-General for Interpretation
2022
Wuhan University
2021
Background. Current antihumoral therapies in transplantation and autoimmune disease do not target the mature antibody-producing plasma cell. Bortezomib is a first class proteosomal inhibitor, that Food Drug Administration approved, for treatment of cell-derived tumors multiple myeloma. We report clinical experience with cell-targeted therapy (bortezomib) as an antirejection strategy. Methods. Eight episodes mixed antibody-mediated rejection (AMR) acute cellular (ACR) six transplant...
Transplant recipients are at increased risk of malignancy; however, the influence transplantation on cancer outcomes has not been rigorously defined. The purpose this study was to examine individual cancers.De novo nonsmall cell lung cancer, colon breast prostate bladder renal (RCC), and malignant melanoma data in 635 adult (>18 years age) transplant (from Israel Penn International Tumor Registry) were compared with from 1,282,984 adults general population Surveillance, Epidemiology, End...
To evaluate the effect of pretransplant bridging locoregional therapy (LRT) on hepatocellular carcinoma (HCC) recurrence and survival after liver transplantation (LT) in patients meeting Milan criteria (MC).Pre-LT LRT mitigates tumor progression waitlist dropout HCC within MC, but data its impact post-LT remain limited.Recurrence-free were compared among 3601 MC with without utilizing competing risk Cox regression consecutive from 20 US centers (2002-2013).Compared 747 LT recipients not...
The efficacy of plasma cell targeted therapies for antibody-mediated rejection (AMR) has not been defined in detail. purpose this study was to compare early and late acute AMR terms immunologic characteristics responses with proteasome inhibitor (PI) therapy.Renal transplant recipients were treated PI-based regimens. Early as occurring within 6 months posttransplant. Immunodominant donor-specific antibody (iDSA) the DSA highest level.Results are expressed or AMR. Thirty episodes (13 early,...
Frailty is a known risk factor for major life-threatening liver transplant complications, deaths, and waitlist attrition. Whether frailty indicates adverse outcomes in cirrhosis short of lethality not well defined. We hypothesized that clinical measurements using gait speed grip strength would indicate the subsequent hospitalization complications cirrhosis.We assessed as 1-year prospective study 373 cirrhotic patients evaluated or awaiting transplantation. determined its association with...
The aim of this study was to compare outcomes between living donor liver transplant (LDLT) and deceased (DDLT) at a single center demonstrate the advantages LDLT provide justification for increased utilization application procedure.LDLT comprises very small percentage all transplants performed in United States, despite its shortage availability organs.A retrospective review adult (n = 245) DDLT 592) over 10 years (2009-2019), comparing survival by Kaplan-Meier analysis other measures outcome...
The purpose of the present study was to determine effects interleukin-37 (IL-37) on liver cells and inflammation induced by hepatic ischemia/reperfusion (I/R).Mice were subjected I/R. Some mice received recombinant IL-37 at time reperfusion. Serum levels alanine aminotransferase, myeloperoxidase content assessed. tumor necrosis factor-α (TNF-α), macrophage inflammatory protein-2 (MIP-2) keratinocyte chemokine (KC) also Hepatic reactive oxygen species (ROS) For in vitro experiments, isolated...
Background and Aims The Organ Procurement Transplantation Network recently approved liver transplant (LT) prioritization for patients with hepatocellular carcinoma (HCC) beyond Milan Criteria (MC) who are down‐staged (DS) locoregional therapy (LRT). We evaluated post‐LT outcomes, predictors of down‐staging, the impact LRT in beyond‐MC HCC from U.S. Multicenter Transplant Consortium (20 centers, 2002‐2013). Approach Results Clinicopathologic characteristics, overall survival (OS),...
The aim of the study was to determine rate, predictors, and impact complete pathologic response (cPR) pretransplant locoregional therapy (LRT) in a large, multicenter cohort hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT).LRT is used mitigate waitlist dropout for with HCC awaiting LT. Degree tumor necrosis found on explant has been associated recurrence overall survival, but not evaluated study.Comparisons were made among receiving pre-LT LRT (n = 802) without...
Frailty with sarcopenia in cirrhosis causes liver transplant wait-list attrition and deaths. Regular physical activity is needed to protect patients from frailty. We subjectively assess performance selecting for listing, but we do not know whether clinical assessments reflect the extent of actually perform. To investigate this question, 53 wait-listed self-assessed their ordinary tasks using Rosow-Breslau survey, clinicians assessed status Karnofsky index. compared these actual measured an...
Frailty is a predictor of morbidity and mortality in cirrhosis. Although evidence for prehabilitation promising, the data liver transplant (LT) candidates are limited. The primary aim this study was to evaluate effect novel strategy on changes frailty metrics survival LT candidates. secondary determine liver-related extrahepatic conditions associated with frailty.In ambispective cohort study, all patients underwent assessment using index (LFI), 6-minute walk test, gait speed test performed...
Interleukin (IL)-33 is a recently identified member of the IL-1 family that binds to receptor, ST2L. In current study, we sought determine whether IL-33 an important regulator in hepatic response ischemia/reperfusion (I/R). Male C57BL/6 mice were subjected 90 minutes partial ischemia, followed by up 8 hours reperfusion. Some received recombinant (IL-33) intraperitoneally (IP) before surgery or anti-ST2 antibody IP at time Primary hepatocytes and Kupffer cells isolated treated with assess...
In March 2021, the United States implemented a new kidney allocation system (KAS250) for deceased donor transplantation (DDKT), which eliminated donation service area-based and replaced it with on basis of distance from hospital to transplant center within/outside radius 250 nautical miles. The effect this policy discards logistics is unknown.
HCC recurrence following liver transplantation (LT) is highly morbid and occurs despite strict patient selection criteria. Individualized prediction of post-LT risk remains an important need. Clinico-radiologic pathologic data 4981 patients with undergoing LT from the US Multicenter Transplant Consortium (UMHTC) were analyzed to develop a REcurrent Liver cAncer Prediction ScorE (RELAPSE). Multivariable Fine Gray competing analysis machine learning algorithms (Random Survival Forest...
The impact of subclinical inflammation (SCI) noted on early kidney allograft biopsies remains unclear. This study evaluated the outcome SCI 3-month biopsy. A total 273/363 (75%) transplant recipients with a functioning underwent 3-months posttransplant. Among those stable function at 3 months, 200 that did not meet Banff criteria for acute rejection were identified. These Group I: No Inflammation (NI, n = 71) and II: Subclinical (SCI, 129). We differences in 24-months histology score...
Preserved physical function is key for successful liver transplantation (LT); however, prehabilitation strategies are underdeveloped. We created a smartphone application (app), EL‐FIT (Exercise and Liver FITness), to facilitate exercise training in end‐stage disease (ESLD). In this feasibility study, we tested app usage the accuracy of activity data transfer obtained feedback from initial users. A total 28 participants used wore tracker 38 ± 12 days (age, 60 8 years; 57% males; Model...
Early immunological biomarkers that predict rejection and chronic allograft loss are needed to inform preemptive therapy improve long-term outcomes. Here, we prospectively examined the ratio of interleukin-10 (IL-10) tumor necrosis factor-α (TNFα) produced by transitional-1 B cells (T1B) 3 months after transplantation as a predictive biomarker for clinical subclinical renal subsequent course. In both Training (n = 162) Internal Validation 82) Sets, T1B IL-10/TNFα predicted anytime in first...
The transcription factor nuclear kappaB (NF-κB) plays diverse roles in the acute injury response to hepatic ischemia/reperfusion (I/R). Activation of NF-κB Kupffer cells promotes inflammation through cytokine expression, whereas activation hepatocytes may be cell protective. interaction receptor activator (RANK) and its ligand (RANKL) activation; however, this ligand-receptor system has not been studied liver injury. In current study, we sought determine if RANK RANKL were important I/R....
Background. There are no instruments that can identify patients at an increased risk of poor outcomes after liver transplantation (LT) based only on their preoperative characteristics. The primary aim this study was to develop such a scoring system. Secondary were assess the discriminative performance predictive model for 90-day mortality, 1-year and 5-year patient survival. Methods. population represented by 30 458 adults who underwent LT in United States between January 2002 June 2013....
We investigated the effect of clinical and subclinical T cell-mediated rejection (C-TCMR SC-TCMR) on allograft histology, function, progression.Adult kidney recipients with 2 protocol biopsies were divided into No-TCMR (n = 104), SC-TCMR 56), C-TCMR 32) in at least 1 biopsy. Chronicity (ci + ct cg cv) scores, renal burden disease measured by area under curve (serum creatinine, mg mo/dL) compared.Baseline characteristics similar except for mean donor age Kidney Donor Profile index scores....