A5056827315- Organ Transplantation Techniques and Outcomes
- Renal Transplantation Outcomes and Treatments
- Liver Disease and Transplantation
- Hepatocellular Carcinoma Treatment and Prognosis
- Organ Donation and Transplantation
- Liver Disease Diagnosis and Treatment
- Transplantation: Methods and Outcomes
- Clinical Nutrition and Gastroenterology
- Cholangiocarcinoma and Gallbladder Cancer Studies
- COVID-19 Impact on Reproduction
- Organ and Tissue Transplantation Research
- Multiple and Secondary Primary Cancers
- Child Nutrition and Feeding Issues
- Pancreatic function and diabetes
- COVID-19 and healthcare impacts
- Animal Virus Infections Studies
- RNA Research and Splicing
- Religious Education and Schools
- Dysphagia Assessment and Management
- Healthcare Systems and Reforms
- COVID-19 Clinical Research Studies
- Biliary and Gastrointestinal Fistulas
- Intestinal Malrotation and Obstruction Disorders
- Biomedical Ethics and Regulation
- Renal and Vascular Pathologies
Duke University
2018-2023
Duke Medical Center
2018-2021
Duke University Hospital
2020-2021
University of California, San Francisco
2013-2018
Howard Hughes Medical Institute
2013
Massachusetts Institute of Technology
2013
Production of haploid gametes from diploid progenitor cells is mediated by a specialized cell division, meiosis, where two divisions, meiosis I and II, follow single S phase. Errors in progression to II lead aneuploid polyploid gametes, but the regulatory mechanisms controlling this transition are poorly understood. Here, we demonstrate that conserved kinase Ime2 regulates timing order meiotic divisions translation. coordinates translational activation cluster genes at I–meiosis transition,...
In the United States, there are significant geographic disparities in time to transplantation for patients with hepatocellular carcinoma (HCC); it is possible that rapid contributes higher rates of posttransplant HCC recurrence because insufficient tumor biology manifest. this study, we compared transplant and their slower counterparts. We identified adult liver (LT) candidates Organ Procurement Transplantation Network/United Network Sharing (UNOS) data set who were granted an initial...
Current guidelines recommend ultrasound (US) for hepatocellular carcinoma (HCC) surveillance in cirrhosis. We assess predictors of decreased US sensitivity detecting HCC. At a single center the United States, all HCC patients evaluated liver transplantation (LT) received an abdominal US. From 2007-2015, consecutive presenting untreated lesions found on computed tomography (CT) or magnetic resonance imaging (MRI) within 3 months were compared with findings. Multivariate logistic regression...
Cirrhosis leads to sarcopenia and functional decline that can severely impact one's ability function at home in society. Self‐reported disability scales quantify disability—Activities of Daily Living (ADL) Instrumental Activities (IADL)—are validated predict mortality older adults. To evaluate liver transplantation (LT) candidates its on outcomes, consecutive outpatients ≥18 years listed for LT with laboratory Model End‐Stage Liver Disease scores ≥12 a single high‐volume US center were...
Historically in the United States, kidneys for simultaneous liver-kidney transplantation (SLKT) candidates were allocated with livers, prioritizing SLKT recipients over much of kidney waiting list. A 2017 change policy delineated renal function criteria and implemented a safety net kidney-after-liver transplantation. We compared use outcomes transplant policy. Network Organ Sharing Standard Transplant Analysis Research files used to identify adults who received liver transplantations (LT)...
The Organ Procurement and Transplantation Network (OPTN)/United for Sharing (UNOS) database is the most comprehensive collection of liver transplantation data, but quality these data with respect to hepatocellular carcinoma (HCC) recurrence has not been well assessed. In this study, we compared observed HCC rates in UNOS expected calculated a hierarchical model adjusted recipient tumor characteristics. We used Standard Transplant Analysis Research set adult transplant patients an initial...
With recent changes in United Network for Organ Sharing policy, patients the States with hepatocellular carcinoma (HCC) are likely to spend more time on liver transplantation (LT) waiting list. The increasing wait will allow an opportunity assess tumor biology prior LT. Modified Response Evaluation Criteria Solid Tumors (mRECIST) paradigm provides such a framework this assessment, and yet little is understood of its utility as it would apply listed LT States. Through collaboration between...
The incidence of simultaneous heart-kidney transplant (SHK) has increased markedly in the last 15 years. There are no universally agreed upon indications for SHK vs. heart alone (HA) transplant, and center evaluation processes vary widely. We utilized Scientific Registry Transplant Recipients data from 2003 to 2017 quantify changes practice SHK, examine survival HA, identify patients with marginal benefit SHK. used Kaplan-Meier curves Cox proportional hazards assess differences survival....
The International Intestinal Failure Registry (IIFR) is an international consortium to study intestinal failure (IF) outcomes in a large contemporary pediatric cohort. We aimed identify predictors of early (1-year) enteral autonomy.
To evaluate the effect of Affordable Care Act (ACA) Medicaid expansion on payor mix among patients kidney and liver transplant waiting list as well post-transplant outcomes. Using Scientific Registry Transplant Recipients, we performed a secondary data analysis all from 2007 to 2018. We described changes in by timing state expansion. used competing risks models estimate cause-specific hazard ratios for effects insurance era death/delisting transplant. Poisson regression model incidence rate...
Recent evidence suggests that hypothermic machine perfusion of donor kidneys reduces delayed graft function (DGF). This study addresses the effect (MP) on allograft rejection in United States. We assembled a retrospective cohort patients undergoing kidney-alone transplants UNOS database from June 30, 2004 to May 31, 2017. DGF was defined as dialysis requirement first week post-transplant; at 6 months and 1 year. Multivariable logistic regression adjusted for recipient factors evaluated MP...
We investigated the possibility that patients with hepatocellular carcinoma (HCC) listed for liver transplant tumors just outside stage T2 size criteria may be inaccurately reported as meeting tumor transplant. The United Network Organ Sharing/Standard Transplant Analysis and Research database identified 12,958 transplants HCC exception points from 2006 to 2013, 9,168 of whom were one tumor. A logistic power peak function was fitted single‐tumor histogram, values representing unbiased...
Selection of the optimal treatment modality for primary liver cancers remains complex, balancing patient condition, function, and extent disease. In individuals with preserved resection approach curative intent but may be associated significant mortality. The purpose this study was to establish a simple scoring system based on Model End-stage Liver Disease (MELD) guide risk assessment resections.The 2005-2015 NSQIP database queried patients undergoing malignancy. We first developed model...
Objective: We sought to compare kidney transplantation outcomes between Veterans Affairs (VA) and non-VA transplant centers. Summary Background Data: Transplant care at the VA has previously been scrutinized due geographic systematic barriers. The recently instituted MISSION Act entered effect June 6 th , 2019, which enables veteran access surgical civilian hospitals if certain eligibility criteria are met. Methods: evaluated observed-to-expected outcome ratios (O:E) for graft loss mortality...
Liver transplant allocation policy does not give model for end-stage liver disease (MELD) exception points patients with a single hepatocellular carcinoma (HCC) <2 cm in size, but to multiple small nodules. Because standard-of-care imaging HCC struggles differentiate from other nodules, it is possible that subset of receiving nodules size have HCC. We evaluate risk post-transplant recurrence and wait-list dropout using competing risks regression based on the Fine Gray model. identified 5002...
Key Points Incidence of ESKD in the first year after primary organ transplant ranges from 2.4% to 3.6% and 1.4% 1.8% second post-transplant. National data sources do not currently collect sufficiently reliable follow-up identify pretransplant predictors ESKD. Background Careful selection multiorgan candidates is required avoid unintended consequences patients waiting for kidney alone. The need a safety net among heart lung recipients unknown. objective this study was quantify incidence...