2023
Honoring the gift: The transformative potential of transplant-declined human organs
Albert C, Harris M, DiRito J, Shi A, Edwards C, Harkins L, Lysyy T, Kulkarni S, Mulligan D, Hosgood S, Watson C, Friend P, Nicholson M, Haakinson D, Saeb-Parsy K, Tietjen G. Honoring the gift: The transformative potential of transplant-declined human organs. American Journal Of Transplantation 2023, 23: 165-170. PMID: 36695696, DOI: 10.1016/j.ajt.2022.11.015.Peer-Reviewed Original Research
2022
Blood Transcriptomes of SARS-CoV-2–Infected Kidney Transplant Recipients Associated with Immune Insufficiency Proportionate to Severity
Sun Z, Zhang Z, Banu K, Al Azzi Y, Reghuvaran A, Fredericks S, Planoutene M, Hartzell S, Kim Y, Pell J, Tietjen G, Asch W, Kulkarni S, Formica R, Rana M, Maltzman JS, Zhang W, Akalin E, Heeger PS, Cravedi P, Menon MC. Blood Transcriptomes of SARS-CoV-2–Infected Kidney Transplant Recipients Associated with Immune Insufficiency Proportionate to Severity. Journal Of The American Society Of Nephrology 2022, 33: 2108-2122. PMID: 36041788, PMCID: PMC9678030, DOI: 10.1681/asn.2022010125.Peer-Reviewed Original ResearchConceptsKidney transplant recipientsImmune activation pathwaysImmunosuppressant useKTR cohortAcute illnessBlood transcriptomeAcute casesT cellsCOVID-19Most kidney transplant recipientsPost-acute COVID-19Adaptive immune system activationManagement of immunosuppressionReinstitution of immunosuppressionAcute COVID-19Serum inflammatory cytokinesCOVID-19 severity scoreCOVID-19 infectionImmune system activationUpregulation of neutrophilActivation pathwayTransplant recipientsChart reviewImmune signaturesLymphocyte countEthical 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
Inactive status is an independent predictor of liver transplant waitlist mortality and is associated with a transplant centers median meld at transplant
Merola J, Gan G, Stewart D, Noreen S, Mulligan D, Batra R, Haakinson D, Deng Y, Kulkarni S. Inactive status is an independent predictor of liver transplant waitlist mortality and is associated with a transplant centers median meld at transplant. PLOS ONE 2021, 16: e0260000. PMID: 34793524, PMCID: PMC8601542, DOI: 10.1371/journal.pone.0260000.Peer-Reviewed Original ResearchConceptsDonor service areasWaitlist mortalityTransplant centersMedian MELDHigh mortalityStatus changesLiver transplant waitlist mortalityDeceased donor transplantsInactive statusTransplant probabilityInactive patientsMELD scoreDonor transplantsHazard ratioIndependent predictorsTransplant ratesCare coordinationMortalityPatientsTransplantLevel cohortsTertileSignificant differencesCohortMELDEverything has a value, except human life
Orandi BJ, Kulkarni S. Everything has a value, except human life. Transplant International 2021, 34: 1571-1572. PMID: 34192376, PMCID: PMC8363555, DOI: 10.1111/tri.13966.Peer-Reviewed Original ResearchGenetic 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 dataLiving Donor Nephrectomy: Approaches, Innovations, and Outcomes
Merola J, Cooper M, Kulkarni S. Living Donor Nephrectomy: Approaches, Innovations, and Outcomes. 2021, 291-302. DOI: 10.1007/978-3-030-53618-3_13.Peer-Reviewed Original ResearchDonor nephrectomySuperior long-term outcomesLong-term outcomesCareful preoperative planningSingle-port surgeryKidney transplantationSurgical riskDeceased donorsOrgan recipientsSurgical approachSurgical considerationsSurgical techniqueKidney donationNephrectomyPreoperative planningInformed consentOutcomesAdequate trainingRiskDonorsAllograftsDonationSurgeryTransplantationSurgeonsQuantifying Risk Tolerance Among Potential Living Kidney Donors With the Donor-Specific Risk Questionnaire
Thiessen C, Gannon J, Li S, Skrip L, Dobosz D, Gan G, Deng Y, Kennedy K, Gray D, Mussell A, Reese PP, Gordon EJ, Kulkarni S. Quantifying Risk Tolerance Among Potential Living Kidney Donors With the Donor-Specific Risk Questionnaire. American Journal Of Kidney Diseases 2021, 78: 246-258. PMID: 33508397, DOI: 10.1053/j.ajkd.2020.11.028.Peer-Reviewed Original ResearchConceptsKidney failure riskKidney failureDonor evaluationRisk QuestionnaireGreater patient-centered carePotential Living Kidney DonorsRisk estimatesKidney transplant centersKidney donor evaluationMultivariable logistic regressionLiving Kidney DonorsTime of enrollmentPatient-centered careTransplant centersTransplant teamKidney donorsRisk groupsPatient engagementAbstractTextLogistic regressionStudy designLongitudinal mixed-methods studyRecipientsMixed-methods studyRisk thresholdLeveling-up versus leveling-down to address health disparities in transplantation
Kulkarni S, Ladin K. Leveling-up versus leveling-down to address health disparities in transplantation. American Journal Of Transplantation 2021, 21: 917-918. PMID: 33326686, PMCID: PMC7986107, DOI: 10.1111/ajt.16458.Peer-Reviewed Original Research
2020
The Development of a Comprehensive Multi-Institutional, Multi-Disciplinary Infrastructure for the Successful Implementation of a Robotic-Assisted Kidney Transplant (RAKT) Program
Haakinson D, Tzvetanov I, Turner A, Deshpande R, Formica R, Kulkarni S, Benedetti E, Mulligan D. The Development of a Comprehensive Multi-Institutional, Multi-Disciplinary Infrastructure for the Successful Implementation of a Robotic-Assisted Kidney Transplant (RAKT) Program. Journal Of The American College Of Surgeons 2020, 231: e224. DOI: 10.1016/j.jamcollsurg.2020.08.597.Peer-Reviewed Original ResearchINACTIVE STATUS CHANGE IS AN INDEPENDENT PREDICTOR OF WAITLIST MORTALITY AND DISPROPORTIONATELY IMPACTS PATIENTS IN DONOR SERVICE AREAS WITH A HIGHER MEDIAN MELD AT TRANSPLANT
Batra R, Noreen S, Stewart D, Haakinson D, Gan G, Deng Y, Mulligan D, Kulkarni S. INACTIVE STATUS CHANGE IS AN INDEPENDENT PREDICTOR OF WAITLIST MORTALITY AND DISPROPORTIONATELY IMPACTS PATIENTS IN DONOR SERVICE AREAS WITH A HIGHER MEDIAN MELD AT TRANSPLANT. Transplantation 2020, 104: s213-s213. DOI: 10.1097/01.tp.0000699484.39814.91.Peer-Reviewed Original ResearchReply to “Ethical principles governing organ transplantation apply to paired exchange programs”
Ladin K, Kulkarni S. Reply to “Ethical principles governing organ transplantation apply to paired exchange programs”. American Journal Of Transplantation 2020, 20: 1758-1759. PMID: 32337792, DOI: 10.1111/ajt.15945.Peer-Reviewed Original ResearchEthical principles governing organ transplantation apply to paired exchange programs
Kulkarni S, Ladin K. Ethical principles governing organ transplantation apply to paired exchange programs. American Journal Of Transplantation 2020, 20: 1223-1224. PMID: 32022980, PMCID: PMC7217160, DOI: 10.1111/ajt.15807.Peer-Reviewed Original ResearchDeceased donors: Defining drug‐related deaths
Cmunt K, Danovitch G, Delmonico F, Fynn‐Thompson F, Glazier A, Grandas J, Gunderson S, Jendrisak M, Johnson HK, Kulkarni S, Lipkowitz G, Meyer K, Mulligan D, Nathan H, Mone T, Moritz M, O'Connor K, Payne W, Souter M, Wood RP. Deceased donors: Defining drug‐related deaths. Clinical Transplantation 2020, 34: e13800. PMID: 32077534, DOI: 10.1111/ctr.13800.Peer-Reviewed Original ResearchA Pharmacist-Driven Intervention Designed to Improve Medication Accuracy in the Outpatient Kidney Transplant Setting.
Cohen EA, McKimmy D, Cerilli A, Kulkarni S. A Pharmacist-Driven Intervention Designed to Improve Medication Accuracy in the Outpatient Kidney Transplant Setting. Drug, Healthcare And Patient Safety 2020, 12: 229-235. PMID: 33269008, PMCID: PMC7701366, DOI: 10.2147/DHPS.S264022.Peer-Reviewed Original Research
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 pairsPeritransplant eculizumab does not prevent delayed graft function in deceased donor kidney transplant recipients: Results of two randomized controlled pilot trials
Schröppel B, Akalin E, Baweja M, Bloom RD, Florman S, Goldstein M, Haydel B, Hricik DE, Kulkarni S, Levine M, Mehrotra A, Patel A, Poggio ED, Ratner L, Shapiro R, Heeger PS. Peritransplant eculizumab does not prevent delayed graft function in deceased donor kidney transplant recipients: Results of two randomized controlled pilot trials. American Journal Of Transplantation 2019, 20: 564-572. PMID: 31452319, DOI: 10.1111/ajt.15580.Peer-Reviewed Original ResearchConceptsDeceased donor kidney transplant recipientsDonor kidney transplant recipientsKidney transplant recipientsGraft functionTransplant recipientsDeceased donor kidney transplantationDeceased donor kidney transplantAnti-C5 monoclonal antibodyDeceased donor recipientsRabbit antithymocyte globulinRate of DGFSerum creatinine reductionAdverse event incidenceDelayed graft functionDonor kidney transplantationDonor kidney transplantsIschemia-reperfusion injuryHigh-risk populationSafety/efficacyObservational human dataAntithymocyte globulinDGF rateKidney transplantationDonor recipientsKidney transplantAssociation 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
Ongoing Disparities in Access to Kidney Transplantation in the Post-Kidney Allocation System Era
Kulkarni S, Ladin K, Greene E, Li L, Deng Y. Ongoing Disparities in Access to Kidney Transplantation in the Post-Kidney Allocation System Era. Journal Of The American College Of Surgeons 2018, 227: e60. DOI: 10.1016/j.jamcollsurg.2018.08.155.Peer-Reviewed Original ResearchBuilding Local Communities of Prior Living Donors and Creating a Social Architecture to Improve Rates of Living Kidney Donation
Kulkarni S, Yoo P, Batra R, Haakinson D, Schulam P, Mulligan D. Building Local Communities of Prior Living Donors and Creating a Social Architecture to Improve Rates of Living Kidney Donation. Journal Of The American College Of Surgeons 2018, 227: e29. DOI: 10.1016/j.jamcollsurg.2018.08.074.Peer-Reviewed Original Research