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 count
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
Peritransplant 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 transplant
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
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 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 changeDe Novo Belatacept in a Human Immunodeficiency Virus–Positive Kidney Transplant Recipient
Cohen E, Mulligan D, Kulkarni S, Tichy E. De Novo Belatacept in a Human Immunodeficiency Virus–Positive Kidney Transplant Recipient. American Journal Of Transplantation 2016, 16: 2753-2757. PMID: 27137752, DOI: 10.1111/ajt.13852.Peer-Reviewed Original ResearchConceptsRenal transplant recipientsTransplant recipientsHuman immunodeficiency virus–positive kidney transplant recipientHIV-positive renal transplant recipientsPositive renal transplant recipientsHIV-positive Black menActive antiretroviral agentsKidney transplant recipientsNew-onset diabetesHuman immunodeficiency virusImmunosuppressive regimensFirst transplantAntiretroviral agentsCalcineurin inhibitorsImmunodeficiency virusKidney donorsDrug interactionsTransplantRecipientsBlack menSuccessful casesDe novoBelataceptHypertensionHyperlipidemia
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 bioavailabilityDuration of Prophylaxis against Fungal Infection in Kidney Transplant Recipients
Guerra CM, Formica RN, Kulkarni S, Asch WS, Tichy EM. Duration of Prophylaxis against Fungal Infection in Kidney Transplant Recipients. Progress In Transplantation 2015, 25: 311-315. PMID: 26645924, DOI: 10.7182/pit2015929.Peer-Reviewed Original ResearchConceptsKidney transplant recipientsTransplant recipientsDuration of admissionCandida esophagitisFungal infectionsAdult kidney transplant recipientsEpisodes of thrushDuration of prophylaxisRetrospective chart reviewPrimary outcome measureFisher's exact testAdministration of nystatinStudent's t-testChart reviewOutcome measuresExact testEsophagitisProphylaxisRecipientsInfectionProtocol changesT-testAdmissionTransplantP-valuePsychiatric and medical adverse events for kidney transplant recipients with lithium induced kidney disease
Zimbrean P, Formica R, Ash W, Lettieri D, Kulkarni S. Psychiatric and medical adverse events for kidney transplant recipients with lithium induced kidney disease. Journal Of Psychosomatic Research 2015, 78: 634. DOI: 10.1016/j.jpsychores.2015.03.148.Peer-Reviewed Original Research
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
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 mapCareSignificant 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