A5013219628- Renal Transplantation Outcomes and Treatments
- Transplantation: Methods and Outcomes
- Organ Transplantation Techniques and Outcomes
- T-cell and B-cell Immunology
- Renal Diseases and Glomerulopathies
- Organ Donation and Transplantation
- Renal and Vascular Pathologies
- Cytomegalovirus and herpesvirus research
- Complement system in diseases
- Hematopoietic Stem Cell Transplantation
- Monoclonal and Polyclonal Antibodies Research
- Immune Cell Function and Interaction
- Pregnancy and Medication Impact
- Blood groups and transfusion
- Xenotransplantation and immune response
- Immunotherapy and Immune Responses
- Organ and Tissue Transplantation Research
- Polyomavirus and related diseases
- Liver Disease and Transplantation
- Advanced Biosensing Techniques and Applications
- Prenatal Screening and Diagnostics
- Cancer Genomics and Diagnostics
- Reproductive System and Pregnancy
- Hepatitis Viruses Studies and Epidemiology
- Advanced biosensing and bioanalysis techniques
Duke University
2004-2025
Duke Medical Center
2000-2025
Johns Hopkins University
2012-2023
Johns Hopkins Medicine
2012-2023
Jackson Memorial Hospital
2022
Hsin Sheng College of Medical Care and Management
2021
National Institutes of Health
2018
Sidney Kimmel Comprehensive Cancer Center
2018
Johns Hopkins Hospital
2016-2018
National Heart Lung and Blood Institute
2017
Abstract Objective To develop and validate an integrative system to predict long term kidney allograft failure. Design International cohort study. Setting Three cohorts including transplant recipients from 10 academic medical centres Europe the United States. Participants Derivation cohort: 4000 consecutive prospectively recruited in four French between 2005 2014. Validation cohorts: 2129 three 1428 North America, 2002 Additional validation randomised controlled trials ( NCT01079143 ,...
The presence of preexisting (memory) or de novo donor-specific HLA antibodies (DSAs) is a known barrier to successful long-term organ transplantation. Yet, despite the fact that laboratory tools and our understanding histocompatibility have advanced significantly in recent years, criteria define DSA assign level risk for given vary markedly between centers. A collaborative effort American Society Histocompatibility Immunogenetics Transplantation provided logistical support generating...
Pretransplant antibodies, particularly anti-CD40, correlate with risk of recurrent focal segmental glomerulosclerosis after kidney transplant.
Antibody-mediated rejection (AMR) is typically treated with plasmapheresis (PP) and intravenous immunoglobulin (standard of care; SOC); however, there an unmet need for more effective therapy. We report a phase 2b, multicenter double-blind randomized placebo-controlled pilot study to evaluate the use human plasma-derived C1 esterase inhibitor (C1 INH) as add-on therapy SOC AMR. Eighteen patients received 20 000 units INH or placebo n = 9, 9) in divided doses every other day 2 weeks. No...
The initial contact point between a recipient's immune system and transplanted graft is the vascular endothelium. Clinical studies suggest pathogenic role for non-HLA antiendothelial cell antibodies (AECAs) in allograft rejection; however, evidence linking AECAs of known specificity to vivo injury lacking. Here, we used high-density protein arrays identify target antigens isolated from sera recipients kidney transplants experiencing antibody-mediated rejection absence donor-specific HLA...
Human bone marrow (BM) plasma cells are heterogeneous, ranging from newly arrived antibody-secreting (ASCs) to long-lived (LLPCs). We provide single-cell transcriptional resolution of 17,347 BM ASCs five healthy adults. Fifteen clusters identified minted (cluster 1) expressing MKI67 and high major histocompatibility complex (MHC) class II that progress late 5–8 through intermediate 2–4. Additional ASC include the following: immunoglobulin (Ig) M predominant (likely extra-follicular origin),...
The XVI-th Banff Meeting for Allograft Pathology was held in Banff, Alberta, Canada, from 19th-23rd September 2022, as a joint meeting with the Canadian Society of Transplantation. In addition to key focus on impact microvascular inflammation and biopsy-based transcript analysis Classification, further sessions were devoted other aspects kidney transplant pathology, particular T cell-mediated rejection, activity chronicity indices, digital xenotransplantation, clinical trials, surrogate...
ABSTRACT Background The removal of preformed antibodies with cleaving enzymes like IdeS (imlifidase) has demonstrated therapeutic potential in organ transplantation for sensitized recipients. However, xenoreactive (XAbs) against porcine glycans are predominantly IgM and considered detrimental pig‐to‐human xenotransplantation. Methods Recombinant IceM, an endopeptidase IgM, was generated Escherichia coli ( E. ). Four maximally MHC‐mismatched rhesus macaques underwent two serial skin...
Background. Despite their clinical importance, routine tests to detect anti-endothelial cell antibodies (AECA) in organ transplantation have not been readily available. This multicenter prospective kidney trial evaluates the efficacy of a novel endothelial crossmatch (ECXM) test donor-reactive AECA associated with allograft rejection. Methods. Pretransplant serum samples from 147 patients were tested for by flow cytometric technique (XM-ONE) using peripheral blood progenitor cells as...
Background and Aims Tolerance is transplantation’s holy grail, as it denotes allograft health without immunosuppression its toxicities. Our aim was to determine, among stable long‐term pediatric liver transplant recipients, the efficacy safety of withdrawal identify operational tolerance. Approach Results We conducted a multicenter, single‐arm trial over 36‐48 weeks. Liver tests were monitored biweekly (year 1), monthly 2), bimonthly (years 3‐4). For‐cause biopsies done at investigators’...
Background This is a cross-sectional study designed to evaluate the histologic characteristics of graft injury in presence anti-angiotensin II type 1 receptor antibody (AT1R-Ab) and anti-endothelial cell (AECA). Methods Non-HLA testing was included posttransplant evaluation for 70 kidney recipients. Biopsies were performed cause 47 patients as protocol remaining 23 patients. Biopsy-proven rejection defined according Banff 2009-2013 criteria. AT1R-Ab measured on an ELISA platform. Patients...
Solid organ transplantation provides the best treatment for end-stage failure, but significant sex-based disparities in transplant access exist. On June 25, 2021, a virtual multidisciplinary conference was convened to address transplantation. Common themes contributing were noted across kidney, liver, heart, and lung transplantation, specifically existence of barriers referral wait listing women, pitfalls using serum creatinine, issue donor/recipient size mismatch, approaches frailty higher...
Focal segmental glomerulosclerosis (FSGS) recurs after kidney transplantation in more than 30% of cases and can lead to allograft loss. Serum soluble urokinase-type plasminogen activator receptor (suPAR) is implicated the pathogenesis native recurrent FSGS.We conducted a retrospective study 25 adults with posttransplantation FSGS. We investigated relationship between suPAR levels podocyte changes impact therapy on structure. assessed response by improvement proteinuria, function, resolution...
ABO and human leukocyte antigen (HLA) alloantibodies provide major immunologic barriers to successful transplantation; however, there is increasing recognition for the role of anti-endothelial cell antibodies (AECAs) in allograft rejection. We investigated relationship between AECAs identified using donor-derived endothelial precursors (ECPs) kidney rejection function.Sixty live donor recipients were tested pretransplant HLA-antibodies flow cytometric crossmatch tests solid-phase bead...
This case involves a 54-year-old patient with polycystic kidney disease and history of hyperacute allograft rejections. Two previous compatible live donor transplants functioned immediately but failed within the first 12 h due to antibody-injury. was referred for third transplant decreased vascular access progressive hypotension from uremic autonomic dysfunction. He broadly sensitized HLA; however, identified through paired donation whom he had no donor-specific HLA antibody (HLA-DSA)....
Abstract To investigate chromatin control of TCR β rearrangement and allelic exclusion, we analyzed structure in double negative (DN) thymocytes, which are permissive for recombination, positive (DP) postallelic exclusion nonpermissive Vβ to DβJβ recombination. Histone acetylation mapping DNase I sensitivity studies indicate segments be hyperacetylated accessible DN thymocytes. However, they separated from each other by hypoacetylated inaccessible trypsinogen chromatin. The transition DP is...