Public Health Interests
Yale Cancer Center: Liver Cancer Program
My scientific and clinical research covers a broad array from basic science studies of ischemia/reperfusion injury and genomics of chronic allograft nephropathy to clinical modulation of immunosuppression to improve and extend organ function. I have extensive experience in living donation, especially, living donor liver transplantation, and have not only performed more than 200 living donor hepatectomies, but published our experiences and opinions.
Extensive Research Description
Most recently, I have been heavily involved in national liver allocation and distribution. During my career, I have been extensively involved in scientific and clinical research as well as extensive public policy development and consensus generation. My scientific research began with ischemia/reperfusion injury in livers, immunologic modulation to improve and prolong graft function, and currently working on ex-vivo machine perfusion and 3-D bioprinting for transplantation.
St Peter SD, Post DJ, Rodriguez-Davalos MI, Douglas DD, Moss AA, Mulligan DC. Tacrolimus as a liver flush solution to ameliorate the effects of ischemia/reperfusion injury following liver transplantation. Liver Transpl. 2003 Feb; 9(2):144-9. PubMed MID:12548508.
Adding to the scientific research came the opportunity to publish our clinical outcomes, with particular emphasis on Living Donor Liver Transplantation and modulation of immunosuppression.
Hsieh TH, Mekeel KL, Crowell MD, Nguyen CC, Das A, Aqel BA, Carey EJ, Byrne TJ, Vargas HE, Douglas DD, Mulligan DC, Harrison ME. “Endoscopic treatment of anastomotic biliary strictures after living donor liver transplantation: outcomes after maximal stent therapy”. Gastrointest Endosc. 2013 Jan; 77(1):47-54 Epub 2012 Oct 11. PubMed PMID:23062758. DOI:10.1016/j.gie.2012.08.034.
Reddy KS, Devarapalli Y, Mazur M, Hamawi K, Chakkera H, Moss A, Mekeel K, Post D, Heilman R, Mulligan D. Alemtuzumab with rapid steroid taper in simultaneous kidney and pancreas transplantation: comparison to induction with antithymocyte globulin. Transplant Proc. 2010 Jul-Aug; 42(6):2006-8. PubMed PMID:20692393.
Since coming to Yale, I have been working with our team to establish successful ex-vivo machine perfusion for solid organ transplantation and utilization of 3-D bioprinting for transplantation.
- Munoz-Abraham AS, Patron-Lozano R, Narayan RR, Judeeba SS, Alkukhun A, Alfadda TI, Belter JT, Mulligan DC, Morotti R, Zinter JP, Geibel JP, Rodriguez-Davalos MI. Extracorporeal Hypothermic Perfusion Device for Intestinal Graft Preservation to Decrease Ischemic Injury During Transportation. Gastrointest Surg. 2016 Feb;20(2):313-21.
Most recently, I have become heavily involved with national issues regarding liver allocation and distribution. As the past Chair of the UNOS Liver and Intestinal Transplantation Committee, I led two major national forum meetings sponsored by HRSA as well as multiple webinars, conferences and regional meetings to create consensus around what is best for patients to best utilize the scarce national resources.
- Edwards EB, Harper AM, Hirose R, Mulligan DC. The impact of broader regional sharing of livers: 2-year results of “Share 35”. Liver Transpl 2016 Apr;22 PMID: 26890858. (4):399-409. DOI: 10.1002/lt.24418.
- Gentry SE, Hirose R, Mulligan D. Resolving Misconceptions About Liver Allocation and Redistricting Methodology. JAMA Surg. 2016 Oct 1;151(10):991-992. doi: 10.1001/jamasurg.2016.1315. No abstract available. PMID: 27333440.
- Gentry SE, Segev DL, Kaiske BL, Mulligan DC, Hirose R. “Robust Models Support Redistricting Liver Allocation to Reduce Geographic Disparity”. Transplantation. 2015 Sep;99(9):e159-60. DOI: 10.1097/TP.0000000000000834. No abstract available. PMID: 26308421
Complete List of Published Work in MyBibliography:
D. Research Support
U01 AI063594-11 Heeger (PI); Formica (Site PI) 09/01/2015-08/31/2019
Effects of Inhibiting Early Inflammation in Kidney Transplant Patients: Randomized Controlled Trial of Infliximab (Remicade) Induction Therapy for Deceased Donor Kidney Transplant Recipients.
The objective of the study is to determine the efficacy of intravenous infliximab administered at the time of transplantation, prior to reperfusion, on 2-year kidney transplant survival and function.
QRK306 QPI-1002 Kulkarni (PI) 12/2015-12/2019
A Phase 3, Randomized, Double-Blind, Placebo Controlled Study to Evaluate the Efficacy and Safety of QPI-1002 for Prevention of Delayed Graft Function in Recipients of a Donation after Brain Death Older Donor Kidney Transplant (ReGIFT)
The objective is to determine the efficacy of QPI-1002 in reducing the incidence and severity of delayed graft function in comparison to placebo in recipients of a donation after brain death older donor kidney.
IM103-177 Formica (PI) 09/2015-06/2019
Evaluation of Acute Rejection Rates in de novo Renal Transplant Recipients Following Thymoglobulin Induction, CNI-free, NulojixÒ (belatacept) -based Immunosuppression
The primary objective is to assess the incidence of clinically-suspected and biopsy proven acute rejection (CSBPAR) at 6 months post-transplant in de novo renal allograft recipients treated with thymoglobulin induction, rapid corticosteroid withdrawal, and maintenance belatacept in combination with MMF or EVL, or maintenance TAC in combination with MMF.
HIC#1405014029 Heeger (PI); Kulkarni (Site PI) 09/2014-06/2017
Eculizumab for Prevention of Delayed Graft Function in Deceased Donor Kidney Transplantation
This is a pilot prospective, randomized study to test the efficacy of eculizumab (vs. placebo; given once at the time of transplantation and once 24 hours later) in preventing DGF in first adult recipients of deceased donor kidneys.
CTOT U01 RFA-AI-08-015 Friedewald (PI); Heilman (Site PI) 07/01/2009 - 06/30/2014
Proteogenomics for Organ Transplantation: Prediction, Diagnosis, Intervention, Clinical Trials in Organ Transplantation