A5014914376- Renal Transplantation Outcomes and Treatments
- Organ Donation and Transplantation
- Acute Kidney Injury Research
- Organ Transplantation Techniques and Outcomes
- Renal and Vascular Pathologies
- Chronic Kidney Disease and Diabetes
- Neurological Complications and Syndromes
- Dialysis and Renal Disease Management
- Liver Disease and Transplantation
- Hepatitis C virus research
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Hemodynamic Monitoring and Therapy
- Cardiac, Anesthesia and Surgical Outcomes
- Polyomavirus and related diseases
- Transplantation: Methods and Outcomes
- Renal Diseases and Glomerulopathies
- Infectious Aortic and Vascular Conditions
- HIV/AIDS drug development and treatment
- Cytomegalovirus and herpesvirus research
- Pneumocystis jirovecii pneumonia detection and treatment
- Kidney Stones and Urolithiasis Treatments
- Studies on Chitinases and Chitosanases
- COVID-19 Clinical Research Studies
- Viral-associated cancers and disorders
- Antibiotics Pharmacokinetics and Efficacy
University of Utah
2016-2025
Konkuk University
2021
Brigham Young University
2021
University of Lethbridge
2021
University of Utah Hospital
2018-2020
University of Birmingham
2020
Yale University
2009-2017
University of Connecticut
2017
Massachusetts General Hospital
2017
Creative Research Enterprises (United States)
2017
Current methods for predicting graft recovery after kidney transplantation are not reliable. We performed a prospective, multicenter, observational cohort study of deceased-donor transplant patients to evaluate urinary neutrophil gelatinase-associated lipocalin (NGAL), IL-18, and injury molecule-1 (KIM-1) as biomarkers dialysis within 1 wk subsequent recovery. collected serial urine samples 3 d analyzed levels these putative biomarkers. classified delayed function (DGF), slow (SGF), or...
Background and objectives: Serum creatinine concentration at the time of nephrology consultation is not necessarily indicative severity acute kidney injury (AKI). Although urine microscopy useful to differentiate AKI, its role in predicting adverse clinical outcomes has been well described. Design, setting, participants, & measurements: The relationship between findings for AKI was evaluated prospectively. A urinary sediment scoring system created on basis number renal tubular epithelial...
Studies have evaluated acute kidney injury (AKI) using biomarkers in various settings, but their prognostic utility within current practice is unclear. Thus, we sought to determine the of newer or traditional markers (fractional excretion sodium [FeNa] and urea [FeUrea] microscopy) over clinical assessment alone.This a prospective cohort study adults on first day meeting AKI criteria. We measured urine concentrations neutrophil gelatinase-associated lipocalin (NGAL), molecule-1 (KIM-1),...
Kidney hypoperfusion during episodes of systemic hypotension or after surgical procurement for transplantation can lead to tubular cell death via necrosis and apoptosis, which trigger a series responses that promote repair. The factors contribute the repair phase kidney injury are not well understood. Using urine proteomic screen in mice, we identified macrophage-secreted chitinase-like protein Brp-39, murine product chitinase 3-like 1 gene, as critical component this reparative response...
Assessment of deceased-donor organ quality is integral to transplant allocation practices, but tools more precisely measure donor kidney injury and better predict outcomes are needed. In this study, we assessed associations between biomarkers in urine the following outcomes: AKI (stage 2 or greater), recipient delayed graft function (defined as dialysis first week post-transplant), 6-month eGFR. We measured urinary concentrations microalbumin, neutrophil gelatinase–associated lipocalin...
Hypothermic machine perfusion (HMP) is increasingly used in deceased donor kidney transplantation, but controversy exists regarding the value of biomarkers and pump parameters for assessing organ quality. We prospectively determined associations between perfusate (neutrophil gelatinase–associated lipocalin [NGAL], injury molecule 1, IL-18 liver-type fatty acid–binding protein [L-FABP]) (resistance flow) with outcomes delayed graft function (DGF) 6-mo estimated GFR (eGFR). DGF occurred 230...
Biopsies taken at deceased donor kidney procurement continue to be cited as a leading reason for discard; however, the reproducibility and prognostic capability of these biopsies are controversial.We compiled retrospective, single-institution, continuous cohort transplants performed from 2006 2009. Procurement biopsy information-percentage glomerulosclerosis, interstitial fibrosis/tubular atrophy, vascular disease-was obtained national transplant database. Using univariable, multivariable,...
<h3>Importance</h3> The shortage of deceased donor kidneys for transplants is an ongoing concern. Prior studies support transplanting from donors with acute kidney injury (AKI), but those investigations have been subject to selection bias and small sample sizes. Current allocation practices AKI in the United States are not well characterized. <h3>Objectives</h3> To evaluate association recipient graft survival characterize recovery discard by organ procurement organizations. <h3>Design,...
Background Acute kidney injury (AKI) is a common complication of cardiac surgery. An intraoperative monitor perfusion needed to identify patients at risk for AKI. The authors created noninvasive urinary oximeter that provides continuous measurements oxygen partial pressure and instantaneous urine flow. They hypothesized are feasible with this prototype device low during surgery associated the subsequent development Methods This was prospective observational pilot study. Continuous flow were...
Recipient outcomes after kidney transplant from deceased donors who received dialysis prior to donation are not well described.
Deceased donor kidneys with AKI are often discarded for fear of poor transplant outcomes. Donor biomarkers that predict post-transplant renal recovery could improve organ selection and reduce discard. We tested whether higher levels urinary YKL-40, a repair phase protein, associate improved recipient outcomes in prospective cohort study involving deceased kidney donors from five procurement organizations. measured YKL-40 concentration 1301 (111 had AKI, defined as doubling serum creatinine)...
Background and objectives The influence of deceased-donor AKI on post-transplant outcomes is poorly understood. few published studies about preimplant biopsy have reported conflicting results regarding associations between recipient outcomes. Design, setting, participants, & measurements This multicenter study aimed to evaluate reports acute tubular necrosis (ATN) delayed graft function (DGF), secondarily for death-censored failure, first adjusting the kidney donor risk index then...
Ischemia-reperfusion injury (IRI) leading to delayed graft function (DGF), defined by the United Network for Organ Sharing as dialysis in first week (UNOS-DGF), associates with poor kidney transplant outcomes. Controversies remain, however, about initiation thresholds and utility other criteria denote less severe IRI, or slow (SGF).Multicenter, prospective study of deceased-donor recipients compare UNOS-DGF a definition that combines impaired creatinine reduction 48 hours greater than 1...
The role of serum cystatin C (Scyc), neutrophil gelatinase-associated lipocalin, and interleukin-18 in predicting early graft function after kidney transplant is poorly defined.We conducted a multicenter prospective cohort study deceased-donor transplants. We collected serial blood samples for the first 3 days monitored need dialysis within 1 week at months transplant.Among 78 recipients with biomarker measurements, 26 had delayed (DGF; hemodialysis transplant). Of those not dialyzed, 29...
Background and objectives Unfavorable histology on procurement biopsies is the most common reason for deceased donor kidney discard. We sought to assess reproducibility of biopsy findings. Design, setting, participants, & measurements compiled a continuous cohort kidneys transplanted at our institution from 1/1/2006 12/31/2016 that had least one performed, excluded cases with missing reports those used in multiorgan transplants. Suboptimal was defined as presence advanced sclerosis...
Summary Background and objectives Current tools to predict outcomes after kidney transplantation are inadequate. The objective of this study was determine the association perioperative urine neutrophil gelatinase-associated lipocalin IL-18 with poor 1-year allograft function (return dialysis or estimated GFR<30 ml/min per 1.73 m 2 ). Design, setting, participants, & measurements Neutrophil from early post-transplant measured in prospective, multicenter deceased-donor transplant...
A translational study in renal transplantation suggested YKL-40, a chitinase 3-like-1 gene product, plays an important role acute kidney injury (AKI) and repair, but data are lacking about this protein urine from native human kidneys. This is ancillary to single-center, prospective observational cohort of patients with clinically-defined AKI according Network serum creatinine criteria. We determined the association YKL -40 ≥ 5 ng/ml, alone or combined neutrophil gelatinase-associated...
<i>Background/Aims:</i> Clinical methods to predict allograft function soon after kidney transplantation are ineffective. <i>Methods:</i> We analyzed urine cystatin C (CyC) in a prospective multicenter observational cohort study of deceased-donor transplants determine its peritransplant excretion pattern, utility for predicting delayed graft (DGF) and association with 3-month function. Serial samples were collected 2 days following transplant blindly CyC. defined DGF...
Accurate and reliable assessment tools are needed in transplantation. The objective of this prospective, multi-center study was to determine the associations alpha pi iso-enzymes glutathione S-transferase (GST), measured from perfusate solution at start end (base post) kidney allograft machine perfusion, with subsequent delayed graft function (DGF). We also compared GST iso-enzyme levels discarded versus transplanted kidneys. A total 428 kidneys were linked outcomes as recorded by United...
The factors that influence deceased donor kidney procurement biopsy reliability are not well established. We examined the impact of technique and pathologist training on accuracy.We retrospectively identified all kidney-only transplants at our center from 2006 to 2016 with both reperfusion biopsies performed information available (n = 392). Biopsies were scored using a previously validated system, classifying "suboptimal" histology as presence least 1 following: glomerulosclerosis ≥11%,...