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
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
2017
Assessing Living Donor Priorities Through Nominal Group Technique
Dorflinger LM, Kulkarni S, Thiessen C, Klarman S, Fraenkel L. Assessing Living Donor Priorities Through Nominal Group Technique. Progress In Transplantation 2017, 28: 29-35. PMID: 29243533, PMCID: PMC5735019, DOI: 10.1177/1526924817746682.Peer-Reviewed Original ResearchConceptsImpact of donationMost salientDonation decisionsNominal group techniquePersonal benefitsFuture researchAddress factorsMost peopleParticipantsAltruismLifestyle factorsTransplant programsNumber of donorsFuture healthCampaign effortsIndividualsPotential donorsKidneyPublic campaignsSupportGroup techniqueSalientLack of knowledgeDonationDecisions
2016
Parathyroidectomy prior to kidney transplant decreases graft failure
Callender GG, Malinowski J, Javid M, Zhang Y, Huang H, Quinn CE, Carling T, Tomlin R, Smith JD, Kulkarni S. Parathyroidectomy prior to kidney transplant decreases graft failure. Surgery 2016, 161: 44-50. PMID: 27863776, DOI: 10.1016/j.surg.2016.10.003.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overCohort StudiesConfidence IntervalsDatabases, FactualFemaleGraft RejectionGraft SurvivalHumansHyperparathyroidismKidney Failure, ChronicKidney TransplantationMaleMiddle AgedOdds RatioParathyroid HormoneParathyroidectomyPreoperative CareRetrospective StudiesRisk AssessmentTreatment OutcomeConceptsYear post-kidney transplantationPost-kidney transplantationDelayed graft functionGraft failureKidney transplantationGraft functionParathyroid hormoneUremic hyperparathyroidismKidney diseaseFirst year post-kidney transplantationSerum parathyroid hormone levelsCurrent Kidney DiseaseGlobal Outcomes (KDIGO) guidelinesParathyroid hormone levelsSerum parathyroid hormoneAdult patientsKidney transplantOutcomes guidelinesRetrospective reviewSingle institutionCurrent guidelinesHormone levelsSurvival 1ParathyroidectomyTransplantationPerioperative 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 studyEculizumab Therapy for Chronic Antibody‐Mediated Injury in Kidney Transplant Recipients: A Pilot Randomized Controlled Trial
Kulkarni S, Kirkiles‐Smith N, Deng YH, Formica RN, Moeckel G, Broecker V, Bow L, Tomlin R, Pober JS. Eculizumab Therapy for Chronic Antibody‐Mediated Injury in Kidney Transplant Recipients: A Pilot Randomized Controlled Trial. American Journal Of Transplantation 2016, 17: 682-691. PMID: 27501352, DOI: 10.1111/ajt.14001.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAntibodies, Monoclonal, HumanizedChronic DiseaseComplement C5Complement Inactivating AgentsEarly Intervention, EducationalFemaleFollow-Up StudiesGlomerular Filtration RateGraft RejectionGraft SurvivalHumansIsoantibodiesKidney Failure, ChronicKidney Function TestsKidney TransplantationLiving DonorsMaleMiddle AgedPilot ProjectsPrognosisRisk FactorsTissue DonorsTransplant RecipientsYoung AdultConceptsDe novo donor-specific antibodiesComplement inhibitionTreatment groupsNovo donor-specific antibodiesAntibody-Mediated InjuryC1q-positive patientsDonor-specific antibodiesKidney transplant recipientsPrimary end pointEndothelial cell injuryMo of observationEculizumab therapyEculizumab treatmentHumoral injuryTransplant recipientsKidney transplantRenal functionKidney functionChronic settingEGFR trajectoriesTreatment periodCell injuryPatientsEnd pointPercentage change
2015
Novel Once-Daily Extended-Release Tacrolimus Versus Twice-Daily Tacrolimus in De Novo Kidney Transplant Recipients: Two-Year Results of Phase 3, Double-Blind, Randomized Trial
Rostaing L, Bunnapradist S, Grinyó J, Ciechanowski K, Denny J, Silva H, Budde K, Group E, Denny J, Kulkarni S, Hricik D, Bresnahan B, Bunnapradist S, El-Sabrout R, Chan L, Ciancio G, El-Ghoroury M, Goldstein M, Gaston R, Gohh R, Killackey M, King A, Knight R, Kore A, Sudan D, Friedmann J, Mulgaonkar S, Nolan C, Pankewycz O, Pirsch J, Schaefer H, Steinberg S, Gelb B, True K, West-Thielke P, Waybill M, Wolf J, Ketel B, Harland R, Shihab F, Cassuto E, Le Meur Y, Rostaing L, Mariat C, Grinyó J, Puig J, Seron D, Tisone G, Ciechanowski K, Foroncewicz B, Wlodarczyk Z, Budde K, Witzke O, Mondragon G, Urrea E, Gomez J, Acevedo R, del Carmen Rial M, Novoa P, Silva H, Garcia V, Carvalho D, Saber L, Contieri F, Bastos M, Manfro R, Kanellis J, Eris J, O’Connell P, Hughes P, Russ G, Pidgeon G, Dittmer I, Kee T, Vathsala A, Naumovic R, Mitic I, Parmjeet R. Novel Once-Daily Extended-Release Tacrolimus Versus Twice-Daily Tacrolimus in De Novo Kidney Transplant Recipients: Two-Year Results of Phase 3, Double-Blind, Randomized Trial. American Journal Of Kidney Diseases 2015, 67: 648-659. PMID: 26717860, DOI: 10.1053/j.ajkd.2015.10.024.Peer-Reviewed Original ResearchConceptsTotal daily doseDe novo kidney transplant recipientsNovo kidney transplant recipientsKidney transplant recipientsIR-TacKidney transplantationTransplant recipientsAdverse eventsTreatment failureDaily extended-release tacrolimusDe novo kidney transplantationMean total daily doseLower total daily doseExtended-release tacrolimusOnce-Daily ExtendedTarget trough rangesTwice-Daily TacrolimusNew-onset diabetesSafety end pointSerious adverse eventsPhase 3 trialImmediate-release tacrolimusParticipant eligibility criteriaTwo-year resultsImproved bioavailability
2014
Segmental Grafts in Adult and Pediatric Liver Transplantation: Improving Outcomes by Minimizing Vascular Complications
Rodriguez-Davalos MI, Arvelakis A, Umman V, Tanjavur V, Yoo PS, Kulkarni S, Luczycki SM, Schilsky M, Emre S. Segmental Grafts in Adult and Pediatric Liver Transplantation: Improving Outcomes by Minimizing Vascular Complications. JAMA Surgery 2014, 149: 63-70. PMID: 24284803, DOI: 10.1001/jamasurg.2013.3384.Peer-Reviewed Original ResearchConceptsDonor liver transplantSegmental graftsRight lobeLiver transplantVascular complicationsSegmental allograftsDeceased donorsLateral segmentConsecutive liver transplant patientsDonor graft recipientsHepatic artery stenosisReduced-size graftsWaiting list mortalityLiver transplant patientsPortal vein thrombosisPediatric liver transplantationMultidisciplinary team approachInnovative surgical techniquesBiliary complicationsSegmental transplantsStrict patientGraft survivalList mortalityLiver transplantationTransplant patients
2013
Clinical outcomes associated with conversion from brand-name to generic tacrolimus in hospitalized kidney transplant recipients
Heavner MS, Tichy EM, Yazdi M, Formica RN, Kulkarni S, Emre S. Clinical outcomes associated with conversion from brand-name to generic tacrolimus in hospitalized kidney transplant recipients. American Journal Of Health-System Pharmacy 2013, 70: 1507-1512. PMID: 23943182, DOI: 10.2146/ajhp120783.Peer-Reviewed Original ResearchConceptsKidney transplant recipientsBrand-name tacrolimusTrough tacrolimus levelsTransitions of careTransplant recipientsAcute rejectionTacrolimus levelsTacrolimus dosageHospital admissionBiopsy-proven acute rejectionSingle-center observational studyTacrolimus trough levelsMonths of dischargePercentage of patientsMeeting study criteriaPeriod of careGeneric tacrolimusKidney transplantTrough concentrationsTrough levelsClinical outcomesDosage adjustmentGeneric formulationStudy criteriaObservational study
2012
Intermedin is overexpressed in hepatocellular carcinoma and regulates cell proliferation and survival
Guo X, Schmitz JC, Kenney BC, Uchio EM, Kulkarni S, H. CH. Intermedin is overexpressed in hepatocellular carcinoma and regulates cell proliferation and survival. Cancer Science 2012, 103: 1474-1480. PMID: 22625651, PMCID: PMC7659195, DOI: 10.1111/j.1349-7006.2012.02341.x.Peer-Reviewed Original ResearchConceptsHepatocellular carcinomaCell proliferationHepatocellular carcinoma (HCC) clinical samplesRat ischemic modelEarly-stage diseaseHuman hepatocellular carcinoma tumorsSNU-398 cellsHuman umbilical vascular endothelial cellsRole of intermedinDownregulation of Gli1Real-time RT-PCRDose-dependent mannerHepatocellular carcinoma tumorsVascular endothelial cellsMRNA expression levelsStage diseaseExtracellular signal-regulated kinaseSK-Hep-1Ischemic modelIMD expressionBenign liverCarcinoma tumorsImmunohistochemical analysisTherapeutic targetSignal-regulated kinaseA One-Day Centralized Work-up for Kidney Transplant Recipient Candidates: A Quality Improvement Report
Formica RN, Barrantes F, Asch WS, Bia MJ, Coca S, Kalyesubula R, McCloskey B, Leary T, Arvelakis A, Kulkarni S. A One-Day Centralized Work-up for Kidney Transplant Recipient Candidates: A Quality Improvement Report. American Journal Of Kidney Diseases 2012, 60: 288-294. PMID: 22571868, DOI: 10.1053/j.ajkd.2012.04.008.Peer-Reviewed Original ResearchConceptsKidney transplantImprovement reportMultivariable Cox proportional hazards modelsCox proportional hazards modelKidney transplant candidacyMinimal listing criteriaGroup of patientsUniversity-based hospitalQuality improvement reportProportional hazards modelTransplant candidacyTransplant evaluationUNOS waitlistWaitlist placementTransplant centersComorbid conditionsMedian timeMultivariable analysisTransplant practitionersDialysis exposureFunctional statusWait listHazards modelPatientsRecipient candidates
2011
Combined Liver Kidney Transplantation: Critical Analysis of a Single-Center Experience
Cimsit B, Schilsky M, Moini M, Cartiera K, Arvelakis A, Kulkarni S, Formica R, Caldwell C, Taddei T, Asch W, Emre S. Combined Liver Kidney Transplantation: Critical Analysis of a Single-Center Experience. Transplantation Proceedings 2011, 43: 901-904. PMID: 21486624, DOI: 10.1016/j.transproceed.2011.02.033.Peer-Reviewed Original ResearchConceptsLiver-kidney transplantationHigh MELD scoreKidney transplantationMELD scoreKidney diseaseEnd-stage liver disease (MELD) scoreCombined liver-kidney transplantationGraft/patient survivalLow glomerular filtration rateOrgan allocation algorithmsPrimary biliary sclerosisRecurrence of HCVSevere HCV recurrenceTransplantation of patientsLiver Disease scoreSerum creatinine levelsRenal allograft rejectionSingle-center experienceGlomerular filtration rateHepatitis C virusPolycystic kidney diseaseBiliary sclerosisHCV recurrenceIschemic hepatitisOLT patients
2010
Accepting a donor kidney: an evaluation of patients’ and transplant surgeons’ priorities
Solomon DA, Rabidou N, Kulkarni S, Formica R, Fraenkel L. Accepting a donor kidney: an evaluation of patients’ and transplant surgeons’ priorities. Clinical Transplantation 2010, 25: 786-793. PMID: 20964716, PMCID: PMC4846340, DOI: 10.1111/j.1399-0012.2010.01342.x.Peer-Reviewed Original ResearchConceptsKidney qualityDonor kidneysTransplant surgeonsEvaluation of patientsMann-Whitney U testTransplant outcomesPatient characteristicsSpearman correlation coefficientPatient prioritiesWaiting listPatientsAvailable kidneysClinical practiceSurgeon rankingsKidneyU testSurgeonsCategorical variablesPatient autonomyComputer surveyCorrelation coefficientTransplantationFactorsGreat valueSignificant Sirolimus and Dronedarone Interaction in a Kidney Transplant Recipient
Tichy EM, Medwid AJ, Mills EA, Formica RN, Kulkarni S. Significant Sirolimus and Dronedarone Interaction in a Kidney Transplant Recipient. Annals Of Pharmacotherapy 2010, 44: 1338-1341. PMID: 20484171, DOI: 10.1345/aph.1p114.Peer-Reviewed Original ResearchConceptsSignificant pharmacokinetic interactionsTrough concentrationsPharmacokinetic interactionsHorn Drug Interaction Probability ScaleNarrow therapeutic index medicationsDrug Interaction Probability ScaleKidney transplant recipientsPost-kidney transplantDronedarone initiationExcessive immunosuppressionImmunosuppressive regimenIndex medicationSirolimus toxicityTransplant recipientsMycophenolate mofetilStable doseConcurrent administrationAtrial fibrillationSirolimus concentrationsBloody diarrheaTherapeutic misadventureDose reductionClose monitoringDronedaroneSirolimus
2003
Solid-organ transplant recipients treated with drotrecogin alfa (activated) for severe sepsis
Kulkarni S, Naureckas E, Cronin DC. Solid-organ transplant recipients treated with drotrecogin alfa (activated) for severe sepsis. Transplantation 2003, 75: 899-901. PMID: 12660522, DOI: 10.1097/01.tp.0000054842.34916.e8.Peer-Reviewed Original ResearchConceptsSolid organ transplant recipientsSolid organ transplantsSevere sepsisDrotrecogin alfaTransplant recipientsMultisystem organ failureImmunosuppressed recipientsOrgan failurePatient populationEffective adjuvantProcoagulant responseSepsisHigh mortalityAlfaRecipientsTransplantConventional managementTreatmentInitial successAdjuvantMortality