A5078585185- Transplantation: Methods and Outcomes
- Renal Transplantation Outcomes and Treatments
- Organ Transplantation Techniques and Outcomes
- Mechanical Circulatory Support Devices
- Polyomavirus and related diseases
- SARS-CoV-2 and COVID-19 Research
- Cytomegalovirus and herpesvirus research
- Tuberous Sclerosis Complex Research
- Respiratory viral infections research
- Hepatitis C virus research
- Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Trauma Management and Diagnosis
- COVID-19 Clinical Research Studies
- Telomeres, Telomerase, and Senescence
- Organ Donation and Transplantation
- Cardiac Arrest and Resuscitation
- Organ and Tissue Transplantation Research
- Pleural and Pulmonary Diseases
- Cardiac Structural Anomalies and Repair
- Tracheal and airway disorders
- Circular RNAs in diseases
- Resilience and Mental Health
- Myeloproliferative Neoplasms: Diagnosis and Treatment
- Infectious Encephalopathies and Encephalitis
- Blood transfusion and management
Vanderbilt University Medical Center
2020-2025
Pulmonary and Allergy Associates
2020-2023
Brigham and Women's Hospital
2013-2021
Harvard University
2013-2021
Society of Thoracic Surgeons
2018
Hospital of the University of Pennsylvania
2017
Johns Hopkins University
2008
Duke Medical Center
2005
Decisions to transplant organs from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid test-positive (NAT+) donors must balance risk of donor-derived transmission events (DDTE) with the scarcity available organs.Organ Procurement and Transplantation Network (OPTN) data were used compare organ utilization recipient outcomes between SARS-CoV-2 NAT+ NAT- donors. was defined by either a positive upper or lower tract (LRT) sample within 21 days procurement. Potential DDTE...
Lung transplantation is characterized by very high rates of acute and chronic allograft rejection. We hypothesize that activation innate immunity augments adaptive immunity, leading to rejection after lung transplantation. In support this idea, we have recently demonstrated recipients heterozygous for either two functional polymorphisms (Asp299Gly or Thr399Ile) in Toll-like receptor 4 (TLR4) associated with endotoxin hyporesponsiveness decreased over the first 6 months transplant.In current...
Abstract Solid organ transplant (SOT) recipients are at high risk for severe coronavirus disease 2019 (COVID‐19). Studies suggest that early intervention with monoclonal antibody (MAB) treatment directed against the SARS‐CoV‐2 spike protein may reduce of emergency department visits or hospitalization COVID‐19, especially in high‐risk patients. Herein, we describe our single‐center experience 93 SOT (50 kidney, 17 liver, 11 lung, nine heart, and six dual‐organ) mild to moderate COVID‐19 who...
Patients with obesity are at increased risk for developing acute respiratory distress syndrome (ARDS). Some centers consider a relative contraindication to receiving extracorporeal membrane oxygenation (ECMO) support, despite growing implementation of ECMO ARDS in the general population.
Patients with short telomeres and interstitial lung disease may have decreased chronic allograft dysfunction (CLAD)-free survival following transplantation. The relationship between post-transplant telomere length outcomes transplantation has not been characterised among all recipients, regardless of native disease. This was a single-centre prospective cohort study. Consenting transplant recipients had their measured using quantitative real-time PCR assays on peripheral blood collected at...
The importance of mental toughness on lung transplant outcomes is unknown. We performed a pilot study to assess whether pretransplant grit and resilience are associated with short-term posttransplant outcomes. enrolled 31 candidates, whom 7 (26%) had greater toughness, defined as the upper tertile for both within our cohort. There were no differences in baseline characteristics between patients higher lower toughness. Greater was shorter hospital length stay (LOS) [12 days (interquartile...
Abstract Background Characterization of transplant transmitted infections associated with drowned organ donors and the recipients is not well delineated, posing challenges for optimal management prophylaxis strategies. Broader sharing may pose additional considerations due to pathogen variation. Methods We reviewed 22 potential donor disease transmission events (PDDTEs) from reported Organ Procurement Transplantation Network (OPTN) ad hoc Disease Transmission Advisory Committee (DTAC)...
Lymphangioleiomyomatosis (LAM), a multisystem disease of women, is manifest by the proliferation smooth muscle-like cells in lung resulting cystic destruction. Women with LAM can also develop renal angiomyolipomas. caused mutations tuberous sclerosis complex genes (TSC1 or TSC2), hyperactive mammalian Target Rapamycin (mTOR) signaling. The mTOR inhibitor, Rapamycin, stabilizes function and decreases volume angiomyolipomas, but declines angiomyolipomas regrow when treatment discontinued,...
Rationale: Early mobilization of extracorporeal membrane oxygenation (ECMO)-supported patients is increasingly common, but it remains unknown whether there are factors predictive achieving higher intensity among those able to participate in physical therapy. Additionally, data regarding the safety and feasibility early with femoral cannulation, particularly ambulation, sparse. Objectives: To determine associated out-of-bed versus in-bed therapy ECMO-supported participating therapy,...
Donor-derived cell-free DNA (dd-cfDNA%) is a biomarker of early acute lung allograft dysfunction (ALAD), with value ≥1.0% indicating injury. Whether dd-cfDNA% useful in patients >2 y posttransplant unknown. Our group previously demonstrated that median recipients ≥2 without ALAD was 0.45%. In cohort, biologic variability estimated by reference change (RCV) 73%, suggesting exceeding 73% may be pathologic. this study, we aimed to determine whether or absolute thresholds are optimal for detecting ALAD.
Reports on outcomes following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in lung transplant recipients remain limited.We performed a single-center, observational study of diagnosed with SARS-CoV-2 between 5/1/2020 and 3/15/2022 that were followed for median 123 days. We analyzed changes spirometry, allograft dysfunction (ALAD) incidence, hospitalization, mechanical ventilation needs, secondary infection, survival.In our cohort 336 patients, 103 developed disease...
Background. Donor-derived cell-free DNA (dd-cfDNA) is a useful biomarker for the diagnosis of acute allograft injury within first 1 to 2 y after lung transplant, but its utility diagnosing chronic dysfunction (CLAD) has not yet been studied. Understanding baseline dd-cfDNA kinetics beyond initial posttransplant necessary step in determining as CLAD biomarker. We seek establish dd-cfDNA% levels clinically stable recipients who are >2 posttransplant. Methods. performed prospective,...
ABSTRACT Background Coccidioidomycosis is a fungal infection that poses serious risk when transmitted through organ transplantation. We analyzed cases reported to the Organ Procurement and Transplantation Network ad hoc Disease Transmission Advisory Committee from 2013 2022. Methods Donors and/or recipients who had positive Coccidioides immitis/posadasii serology, pathology, culture were included in this study. Cases adjudicated as ‘proven’ or ‘probable’ for donor factors, timing of...
Despite an increasing emphasis on patient-centered outcomes in medicine, transplant centers do not systematically report information health-related quality of life, nor are such measures incorporated into algorithms for organ allocation or program assessment.
Coronavirus disease 2019 (COVID-19) has increased the demand for extracorporeal membrane oxygenation (ECMO) and introduced distinct challenges to patient selection ECMO. Standardized processes amidst resource limitations are lacking, data on ECMO consults underreported. We retrospectively reviewed consecutive adult acute respiratory failure received at a single academic medical center from April 1, 2020, February 28, 2021, evaluated implementation of multidisciplinary committee (ECMO...
Alemtuzumab, a monoclonal antibody targeting CD52 that causes lymphocyte apoptosis, is form of advanced immunosuppression currently used as therapy for refractory acute cellular rejection and chronic lung allograft dysfunction in transplant recipients.Side effects alemtuzumab include bone marrow suppression, infection malignancy. Whether can be safely recipients have an increased propensity suppression due to telomeropathies unknown.In retrospective case series, we report outcomes associated...
Abstract Hyaluronan (HA) is associated with innate immune response activation and may be a marker of allograft dysfunction in lung transplant recipients. This was prospective, single center study comparing levels bronchioalveolar lavage (BAL) serum HA the immobilizer LYVE-1 recipients without acute cellular rejection (ACR). Chronic (CLAD)-free survival also evaluated based on levels. 78 were enrolled total 115 diagnostic biopsies 1.5 years median follow-up. Serum correlated BAL (r = 0.25, p...