2022
Ethical analysis examining the prioritisation of living donor transplantation in times of healthcare rationing
Kulkarni S, Flescher A, Ahmad M, Bayliss G, Bearl D, Biondi L, Davis E, George R, Gordon E, Lyons T, Wightman A, Ladin K. Ethical analysis examining the prioritisation of living donor transplantation in times of healthcare rationing. Journal Of Medical Ethics 2022, 49: 389-392. PMID: 34983855, PMCID: PMC10314075, DOI: 10.1136/medethics-2021-107574.Peer-Reviewed Original ResearchConceptsTransplant communityDonor transplantsTransplant hospitalsSARS-CoV-2 infectionHealth systemEnd-stage liverSARS-CoV-2Exposure riskDonor transplantationTransplant proceduresUnited NetworkKidney diseaseDialysis centersElective proceduresPatient preparednessTransplantEarly detectionCOVID-19 pandemicRiskHospitalRecipientsTier 3BAcceptable riskCareImportant option
2021
Genetic and Epidemiologic Analyses of an Outbreak of Pneumocystis jirovecii Pneumonia Among Kidney Transplant Recipients in the United States
Azar MM, Cohen E, Ma L, Cissé OH, Gan G, Deng Y, Belfield K, Asch W, Grant M, Gleeson S, Koff A, Gaston DC, Topal J, Curran S, Kulkarni S, Kovacs JA, Malinis M. Genetic and Epidemiologic Analyses of an Outbreak of Pneumocystis jirovecii Pneumonia Among Kidney Transplant Recipients in the United States. Clinical Infectious Diseases 2021, 74: 639-647. PMID: 34017984, PMCID: PMC9012955, DOI: 10.1093/cid/ciab474.Peer-Reviewed Original ResearchConceptsKidney transplant recipientsCases of PCPPneumocystis pneumoniaClinic visitsRisk factorsClinic exposureLow absolute lymphocyte countRisk of PCPAbsolute lymphocyte countFrequent clinic visitsPneumocystis jirovecii pneumoniaStrong risk factorNon-white raceCase-control analysisBelatacept groupMonthly infusionsTransplant recipientsBaseline characteristicsJirovecii pneumoniaLymphocyte countMultilocus sequence typingInterhuman transmissionRespiratory specimensUnivariate analysisEpidemiologic data
2019
Outcomes From Right Versus Left Deceased-Donor Kidney Transplants: A US National Cohort Study
Kulkarni S, Wei G, Jiang W, Lopez LA, Parikh CR, Hall IE. Outcomes From Right Versus Left Deceased-Donor Kidney Transplants: A US National Cohort Study. American Journal Of Kidney Diseases 2019, 75: 725-735. PMID: 31812448, PMCID: PMC7288694, DOI: 10.1053/j.ajkd.2019.08.018.Peer-Reviewed Original ResearchConceptsAdjusted hazard ratioDeath-censored graft failureRight kidneyGraft failureKidney sideLeft kidneyUS national cohort studyDeceased donor kidney transplantCause graft failureCold ischemia timeDeceased donor kidneysNational cohort studyConditional logistic regressionProportional hazards modelGraft functionGraft lossPosttransplantation outcomesTransplant eraCohort studyHazard ratioKidney transplantCardiac deathIschemia timeSurgical considerationsRecipient pairsAssociation of Racial Disparities With Access to Kidney Transplant After the Implementation of the New Kidney Allocation System
Kulkarni S, Ladin K, Haakinson D, Greene E, Li L, Deng Y. Association of Racial Disparities With Access to Kidney Transplant After the Implementation of the New Kidney Allocation System. JAMA Surgery 2019, 154: 618-625. PMID: 30942882, PMCID: PMC6583835, DOI: 10.1001/jamasurg.2019.0512.Peer-Reviewed Original ResearchConceptsDeceased donor transplantsKidney allocation systemDonor transplantsKidney transplantTransplant probabilityDeath/Race/ethnicityHispanic individualsWhite individualsOrgan procurementBlack individualsNew kidney allocation systemRetrospective cohort studyWait-listed patientsKidney transplant databaseStatus changesAntibody categoriesLevel of sensitizationInactive statusInactive patientsTransplant databaseTransplant outcomesCohort studyMedian ageAntibody group
2018
Race, Risk, and Willingness of End-Stage Renal Disease Patients Without Hepatitis C Virus to Accept an HCV-Infected Kidney Transplant
McCauley M, Mussell A, Goldberg D, Sawinski D, Molina RN, Tomlin R, Doshi SD, Abt P, Bloom R, Blumberg E, Kulkarni S, Esnaola G, Shults J, Thiessen C, Reese PP. Race, Risk, and Willingness of End-Stage Renal Disease Patients Without Hepatitis C Virus to Accept an HCV-Infected Kidney Transplant. Transplantation 2018, 102: e163-e170. PMID: 29346260, DOI: 10.1097/tp.0000000000002099.Peer-Reviewed Original ResearchConceptsHepatitis C virusHCV cure ratesCure rateC virusUninfected kidneyEnd-stage renal disease patientsHCV-negative patientsPrior transplant recipientsRenal disease patientsHigh cure ratesEffective antiviral treatmentKidney recipientsTransplant recipientsKidney transplantMost patientsOlder patientsAntiviral treatmentWhite patientsDeceased donorsAllograft qualityFuture trialsBlack raceDisease patientsPatient acceptanceYoung donors
2017
Opting out: a single-centre pilot study assessing the reasons for and the psychosocial impact of withdrawing from living kidney donor evaluation
Thiessen C, Jaji Z, Joyce M, Zimbrean P, Reese P, Gordon EJ, Kulkarni S. Opting out: a single-centre pilot study assessing the reasons for and the psychosocial impact of withdrawing from living kidney donor evaluation. Journal Of Medical Ethics 2017, 43: 756. PMID: 28258071, DOI: 10.1136/medethics-2016-103512.Peer-Reviewed Original ResearchConceptsSingle-center pilot studyKidney donor evaluationUS transplant centersPotential living donorsPostoperative periodTransplant centersDonor evaluationLiving donorsKidney donationModifiable barriersPsychosocial impactStudy participantsPilot studyDonor advocateFinancial burdenDonor autonomyQualitative studyDonationIndividualsParticipantsVaried reasons
2016
Perioperative outcomes of coronary artery bypass graft in renal transplant recipients in the United States: results from the Nationwide Inpatient Sample
Tooley JE, Bohl DD, Kulkarni S, Rodriguez‐Davalos M, Mangi A, Mulligan DC, Yoo PS. Perioperative outcomes of coronary artery bypass graft in renal transplant recipients in the United States: results from the Nationwide Inpatient Sample. Clinical Transplantation 2016, 30: 1258-1263. PMID: 27440000, DOI: 10.1111/ctr.12816.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCoronary Artery BypassCoronary Artery DiseaseDatabases, FactualFemaleHospital CostsHospital MortalityHumansKidney TransplantationLength of StayLinear ModelsLogistic ModelsMaleMiddle AgedPostoperative ComplicationsRenal DialysisRenal Insufficiency, ChronicRetrospective StudiesTreatment OutcomeUnited StatesYoung AdultConceptsChronic kidney diseaseNationwide Inpatient SampleLength of stayCKD patientsCABG surgeryHospital mortalityPerioperative outcomesInpatient SampleCardiovascular diseaseCoronary artery bypass graftKidney transplant patientsRenal transplant recipientsRetrospective cohort studyArtery bypass graftRate of complicationsTotal hospital chargesBetter perioperative outcomesCause of morbidityCost of hospitalizationNumber one causeGraft lossPerioperative complicationsTransplant patientsTransplant recipientsCohort study
2014
Written informed consent for living liver donor evaluation: Compliance with centers for medicare and medicaid services and organ procurement and transplantation network guidelines and alibi offers
Thiessen C, Kim YA, Yoo PS, Rodriguez‐Davalos M, Mulligan D, Kulkarni S. Written informed consent for living liver donor evaluation: Compliance with centers for medicare and medicaid services and organ procurement and transplantation network guidelines and alibi offers. Liver Transplantation 2014, 20: 416-424. PMID: 24415564, DOI: 10.1002/lt.23822.Peer-Reviewed Original Research
2013
Written Informed Consent for Living Kidney Donors: Practices and Compliance With CMS and OPTN Requirements
Thiessen C, Kim YA, Formica R, Bia M, Kulkarni S. Written Informed Consent for Living Kidney Donors: Practices and Compliance With CMS and OPTN Requirements. American Journal Of Transplantation 2013, 13: 2713-2721. PMID: 24020884, DOI: 10.1111/ajt.12406.Peer-Reviewed Original ResearchConceptsConsent formKidney donorsKidney donor evaluationLiving Kidney DonorsKidney transplantRoutine followTransplant centersDonor evaluationUS CentersOPTN policyOrgan procurementHealth problemsInformed consentInformed consent practicesPrior yearSurgeryDonor consentConsentConsent practicesDonorsComplicationsTransplantComplianceFollowYears
2010
KDOQI US Commentary on the 2009 KDIGO Clinical Practice Guideline for the Care of Kidney Transplant Recipients
Bia M, Adey DB, Bloom RD, Chan L, Kulkarni S, Tomlanovich S. KDOQI US Commentary on the 2009 KDIGO Clinical Practice Guideline for the Care of Kidney Transplant Recipients. American Journal Of Kidney Diseases 2010, 56: 189-218. PMID: 20598411, DOI: 10.1053/j.ajkd.2010.04.010.Peer-Reviewed Original ResearchMeSH KeywordsClinical ProtocolsCreatinineGlomerular Filtration RateGlucocorticoidsHumansImmunocompromised HostImmunosuppression TherapyKidney DiseasesKidney TransplantationLife StyleLip NeoplasmsMonitoring, PhysiologicNeoplasmsPostoperative CarePractice Guidelines as TopicSkin NeoplasmsTransplantation, HomologousUnited StatesConceptsKidney transplant recipientsKidney Foundation Kidney Disease Outcomes Quality InitiativeKidney Disease Outcomes Quality InitiativeKDIGO guidelinesTransplant recipientsNational Kidney Foundation Kidney Disease Outcomes Quality InitiativeUS kidney transplant recipientsKDIGO Clinical Practice GuidelineKDOQI US CommentaryClinical practice guidelinesSpecific patient populationsKDIGO recommendationsPosttransplant periodTransplant careTransplant centersUS patientsPatient populationTransplant nephrologistsPractice guidelinesCardiovascular careTransplant guidelinesLifestyle changesComplex careExcellent road mapCareKidney Transplantation and HIV: Does Recipient Privacy Outweigh the Donor's Right to Information?
Formica RN, Asch WS, Wagner KR, Kulkarni S. Kidney Transplantation and HIV: Does Recipient Privacy Outweigh the Donor's Right to Information? Clinical Journal Of The American Society Of Nephrology 2010, 5: 924-928. PMID: 20203162, PMCID: PMC2863980, DOI: 10.2215/cjn.06820909.Peer-Reviewed Original ResearchConceptsHIV-positive individualsKidney transplantationMedical historyRecipient's medical historyAlternative treatment optionHIV statusKidney donorsTreatment optionsKidney donationConsensus groupTransplantationDonation procedureAbstractTextRecipient's rightRecipientsPotential donorsHealth informationPotential recipientsSpecific diseasesPanel reviewHIVDonors' rightsRiskDonorsState statues
2008
Living kidney donor informed consent practices vary between US and non-US centers
Parekh AM, Gordon EJ, Garg AX, Waterman AD, Kulkarni S, Parikh CR. Living kidney donor informed consent practices vary between US and non-US centers. Nephrology Dialysis Transplantation 2008, 23: 3316-3324. PMID: 18599559, PMCID: PMC2720811, DOI: 10.1093/ndt/gfn295.Peer-Reviewed Original ResearchConceptsTransplant centersDonor riskInformed consentKidney donorsPsychosocial evaluationNon-US respondentsWorld Transplant CongressChronic kidney diseaseUS transplant centersPotential donorsKidney donation ratesMedical complicationsDonor evaluationInformed consent processKidney diseaseConsensus statementUS CentersMedical riskTransplant professionalsDonation ratesOrgan donationConsent formPsychosocial risksSupport groupsConsent process
2003
The sickest first? Disparities with model for end‐stage liver disease‐based organ allocation: One region's experience
Schaffer RL, Kulkarni S, Harper A, Millis JM, Cronin DC. The sickest first? Disparities with model for end‐stage liver disease‐based organ allocation: One region's experience. Liver Transplantation 2003, 9: 1211-1215. PMID: 14586883, DOI: 10.1053/jlts.2003.50192.Peer-Reviewed Original ResearchConceptsCadaver liversMELD scoreHepatocellular carcinomaOrgan allocationRegion patientsEnd-stage liver diseaseEquitable organ distributionMean MELD scoreMedian MELD scoreHigh MELD scoreLiver transplant programNumber of transplantationsOrgan Sharing regionsLiver recipientsPretransplantation mortalityMELD exceptionsLiver diseaseSingle centerUnited NetworkTransplant programsWaiting listTransplantationEvidence-based systemOrgan procurementTransplantation Network