2024
Approach to sexual dysfunction in patients with chronic liver disease
Maxwell M, Alvarado M, Khungar V. Approach to sexual dysfunction in patients with chronic liver disease. Clinical Liver Disease 2024, 23: e0190. PMID: 38872775, PMCID: PMC11168852, DOI: 10.1097/cld.0000000000000190.Peer-Reviewed Original ResearchAbnormal Liver Tests in Pregnancy
Khungar V, Tran T. Abnormal Liver Tests in Pregnancy. 2024, 289-296. DOI: 10.1201/9781003524489-44.Peer-Reviewed Original ResearchHepatitis B
Khungar V, Han T. Hepatitis B. 2024, 227-235. DOI: 10.1201/9781003524489-36.Peer-Reviewed Original ResearchAcute fatty liver disease of pregnancy
White M, Han H, Khungar V. Acute fatty liver disease of pregnancy. Clinical Liver Disease 2024, 23: e0145. PMID: 38487350, PMCID: PMC10939648, DOI: 10.1097/cld.0000000000000145.Peer-Reviewed Original Research
2023
Cardiac evaluation of the liver transplant candidate
Possick S, Khungar V, Deshpande R. Cardiac evaluation of the liver transplant candidate. Current Opinion In Organ Transplantation 2023, 29: 299-304. PMID: 37995156, DOI: 10.1097/mot.0000000000001122.Peer-Reviewed Original ResearchObstructive coronary artery diseaseLiver transplant candidatesRight heart catheterizationCoronary artery diseaseRisk stratificationCirrhotic cardiomyopathyFractional flow reserveTransplant candidatesNegative predictive valueCirrhotic patientsCardiac evaluationArtery diseaseDiagnostic criteriaPredictive valueAdult liver transplant candidatesInferior vena cava sizeEvaluation of liverSpecific echocardiographic parametersKidney transplant candidatesSevere aortic stenosisProhibitive surgical riskDiastolic function assessmentPerioperative risk stratificationCoronary calcium scoringNew diagnostic criteriaNurturing a Culture of Diversity and Inclusion in Resident Clinic
Khungar V, Whitman L, Genao I. Nurturing a Culture of Diversity and Inclusion in Resident Clinic. 2023, 377-385. DOI: 10.1007/978-3-031-40273-9_23.Peer-Reviewed Original Research
2021
Prevalence and Factors Associated With Statin Use Among Patients With Nonalcoholic Fatty Liver Disease in the TARGET-NASH Study
Thomson MJ, Serper M, Khungar V, Weiss LM, Trinh H, Firpi-Morell R, Roden M, Loomba R, Barritt AS, Gazis D, Mospan AR, Fried MW, Reddy KR, Lok AS. Prevalence and Factors Associated With Statin Use Among Patients With Nonalcoholic Fatty Liver Disease in the TARGET-NASH Study. Clinical Gastroenterology And Hepatology 2021, 20: 458-460.e4. PMID: 33775894, PMCID: PMC8464616, DOI: 10.1016/j.cgh.2021.03.031.Peer-Reviewed Original ResearchConceptsNonalcoholic fatty liver diseaseFatty liver diseaseLiver diseaseStatin useReal-world cohortCoenzyme reductase inhibitorsHepatic decompensationCardiovascular eventsPatient factorsCardiovascular diseasePatientsLower mortalityReductase inhibitorsStatinsDiseasePrevalenceRiskDecompensationCarcinomaHepatotoxicityCohortMortalityReproductive Health and Liver Disease: Practice Guidance by the American Association for the Study of Liver Diseases
Sarkar M, Brady CW, Fleckenstein J, Forde KA, Khungar V, Molleston JP, Afshar Y, Terrault NA. Reproductive Health and Liver Disease: Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology 2021, 73: 318-365. PMID: 32946672, DOI: 10.1002/hep.31559.Peer-Reviewed Original ResearchThe Mucosally-Adherent Rectal Microbiota Contains Features Unique to Alcohol-Related Cirrhosis
Shen TD, Daniel SG, Patel S, Kaplan E, Phung L, Lemelle-Thomas K, Chau L, Herman L, Trisolini C, Stonelake A, Toal E, Khungar V, Bittinger K, Reddy KR, Wu GD. The Mucosally-Adherent Rectal Microbiota Contains Features Unique to Alcohol-Related Cirrhosis. Gut Microbes 2021, 13: 1987781. PMID: 34747331, PMCID: PMC8583005, DOI: 10.1080/19490976.2021.1987781.Peer-Reviewed Original ResearchConceptsAlcohol-related cirrhosisRectal swabsBacterial culture studiesAssociated gut microbiomeCross-sectional analysisHost-derived metabolitesConcentration-dependent mannerAdult patientsMucosal microenvironmentCirrhosis etiologyPatient populationDifferent etiologiesColonic mucosaCirrhosisMucosal microbiotaGut microbiotaGut microbiomeAdherent microbiotaFecal microbiotaOxidative metabolitesSwabsStoolDisease statesEase of collectionCellular proliferation
2019
Predictors, Presentation, and Treatment Outcomes of Recurrent Hepatocellular Carcinoma After Liver Transplantation: A Large Single Center Experience
Ekpanyapong S, Philips N, Loza BL, Abt P, Furth EE, Tondon R, Khungar V, Olthoff K, Shaked A, Hoteit MA, Reddy KR. Predictors, Presentation, and Treatment Outcomes of Recurrent Hepatocellular Carcinoma After Liver Transplantation: A Large Single Center Experience. Journal Of Clinical And Experimental Hepatology 2019, 10: 304-315. PMID: 32655233, PMCID: PMC7335705, DOI: 10.1016/j.jceh.2019.11.003.Peer-Reviewed Original ResearchRecurrent hepatocellular carcinomaLiver transplantationHepatocellular carcinomaHCC recurrenceHCC recurrence post-LTPost-LT HCC recurrenceLarge single-center experienceAccepted therapeutic optionRecurrence post-LTSirolimus-based immunosuppressionSingle-center experiencePredictors of recurrencePredictors of survivalMultiple recurrent lesionsExplant pathologyPost-LTPeritoneal diseasePeritoneal recurrenceInitial recurrenceMedian survivalCenter experienceLow albuminCareful candidate selectionClinical presentationMedian timeTacrolimus and Indomethacin Are Safe and Effective at Reducing Pancreatitis After Endoscopic Retrograde Cholangiopancreatography in Patients Who Have Undergone Liver Transplantation
Thiruvengadam NR, Forde KA, Chandrasekhara V, Ahmad NA, Ginsberg GG, Khungar V, Kochman ML. Tacrolimus and Indomethacin Are Safe and Effective at Reducing Pancreatitis After Endoscopic Retrograde Cholangiopancreatography in Patients Who Have Undergone Liver Transplantation. Clinical Gastroenterology And Hepatology 2019, 18: 1224-1232.e1. PMID: 31622734, DOI: 10.1016/j.cgh.2019.10.014.Peer-Reviewed Original ResearchConceptsEndoscopic retrograde cholangiopancreatographyRisk of PEPDevelopment of PEPLiver transplantationTrough levelsBiliary complicationsIndomethacin useRectal indomethacinRetrospective studyRetrograde cholangiopancreatographyERCP proceduresOdds ratioMixed-effects multivariable logistic regressionEffectiveness of tacrolimusIncidence of PEPTacrolimus trough levelsCommon adverse eventsChronic kidney diseaseGlomerular filtration rateMultivariable logistic regressionRate of pancreatitisAddition of indomethacinChronic rejectionSevere PEPStable doseReducing Hospital Admissions for Paracentesis: A Quality Improvement Intervention
Siddique SM, Porges S, Lane-Fall M, Mehta SJ, Schweickert W, Kinniry J, Taylor A, Lewis JD, Iqbal S, Goldberg D, Shea JA, Stetson R, Coniglio M, Hoteit M, Fishman N, Khungar V. Reducing Hospital Admissions for Paracentesis: A Quality Improvement Intervention. Clinical Gastroenterology And Hepatology 2019, 17: 2630-2633.e2. PMID: 31518719, PMCID: PMC6874893, DOI: 10.1016/j.cgh.2019.09.001.Peer-Reviewed Original ResearchTransient elastography reliably estimates liver fibrosis in autoimmune hepatitis
Mahmud N, Doshi SD, Forde KA, Khungar V. Transient elastography reliably estimates liver fibrosis in autoimmune hepatitis. Clinical And Experimental Hepatology 2019, 5: 244-249. PMID: 31598562, PMCID: PMC6781822, DOI: 10.5114/ceh.2019.87639.Peer-Reviewed Original ResearchAn Automated Text Message Navigation Program Improves the Show Rate for Outpatient Colonoscopy
Mahmud N, Doshi SD, Coniglio MS, Clermont M, Bernard D, Reitz C, Khungar V, Asch DA, Mehta SJ. An Automated Text Message Navigation Program Improves the Show Rate for Outpatient Colonoscopy. Health Education & Behavior 2019, 46: 942-946. PMID: 31431077, PMCID: PMC6889043, DOI: 10.1177/1090198119869964.Peer-Reviewed Original ResearchConceptsIntervention patientsNavigation programAppointment adherenceColonoscopy completionOutpatient colonoscopyPreparation qualityUsual care armPoor bowel preparationBowel preparation qualityHigh patient satisfactionCare armUsual careIntervention armBowel preparationProspective studyAdherence ratesColonoscopy adherencePatient satisfactionEndoscopy centerSimilar demographicsProcedure cancellationsShow ratesPatientsPoststudy surveyAdherenceImproving cirrhosis care: The potential for telemedicine and mobile health technologies
Stotts MJ, Grischkan JA, Khungar V. Improving cirrhosis care: The potential for telemedicine and mobile health technologies. World Journal Of Gastroenterology 2019, 25: 3849-3856. PMID: 31413523, PMCID: PMC6689809, DOI: 10.3748/wjg.v25.i29.3849.Peer-Reviewed Original ResearchConceptsCare of patientsHeart failureHigh-value carePatient-reported outcome measuresLiver disease managementCare of veteransDownstream cost savingsMobile health technologyCirrhosis careHospital readmissionClinical outcomesLiver diseaseSignificant morbidityCancer screeningOutcome measuresCirrhosisPreventative careMortality rateClinical practicePatientsCareDisease managementQuality gapMobile healthHealth technologiesAn Advanced Practice Practitioner–Based Program to Reduce 30‐ and 90‐Day Readmissions After Liver Transplantation
Mahmud N, Halpern S, Farrell R, Ventura K, Thomasson A, Lewis H, Olthoff KM, Levine MH, Nazarian S, Khungar V. An Advanced Practice Practitioner–Based Program to Reduce 30‐ and 90‐Day Readmissions After Liver Transplantation. Liver Transplantation 2019, 25: 901-910. PMID: 30947393, PMCID: PMC6548546, DOI: 10.1002/lt.25466.Peer-Reviewed Original ResearchMeSH KeywordsAgedEnd Stage Liver DiseaseFemaleHumansLiver TransplantationMaleMiddle AgedNurse PractitionersPatient ReadmissionPilot ProjectsPostoperative CarePostoperative ComplicationsProfessional RoleProgram EvaluationRetrospective StudiesRisk FactorsSex FactorsTime FactorsTreatment OutcomeUnited StatesConceptsLiver transplantationReadmission ratesRisk factorsPostexposure groupCare programIndex hospitalization characteristicsRetrospective cohort studyRisk of readmissionHigher readmission ratesAssociated risk factorsAdvanced practice practitionersIndex hospitalizationAnalytic cohortCohort studyHospitalization characteristicsReferral centerHospital readmissionLT centersAdjusted analysisMale sexNurse practitionersReadmissionClinic availabilitySignificant differencesPatients
2018
Exploring opportunities to prevent cirrhosis admissions in the emergency department: A multicenter multidisciplinary survey
Siddique SM, Lane‐Fall M, McConnell MJ, Jakhete N, Crismale J, Porges S, Khungar V, Mehta SJ, Goldberg D, Li Z, Schiano T, Regan L, Orloski C, Shea JA. Exploring opportunities to prevent cirrhosis admissions in the emergency department: A multicenter multidisciplinary survey. Hepatology Communications 2018, 2: 237-244. PMID: 29507899, PMCID: PMC5831018, DOI: 10.1002/hep4.1141.Peer-Reviewed Original ResearchEmergency departmentNonmedical factorsHepatic encephalopathyInpatient admissionsEmergency department observation unit protocolTriage decisionsLow-acuity casesLarge-volume paracentesisLiver transplant centersMild hepatic encephalopathyOutpatient specialty careEmergency medicine providersQuality improvement initiativesPatient-based scenariosCirrhosis admissionsReadmission ratesUnit protocolTransplant centersClinical presentationOutpatient settingPatient populationSpecialty careUnit visitsHepatology providersHigher admission
2017
Safety and efficacy of current direct‐acting antiviral regimens in kidney and liver transplant recipients with hepatitis C: Results from the HCV‐TARGET study
Saxena V, Khungar V, Verna EC, Levitsky J, Brown RS, Hassan MA, Sulkowski MS, O'Leary JG, Koraishy F, Galati JS, Kuo AA, Vainorius M, Akushevich L, Nelson DR, Fried MW, Terrault N, Reddy KR. Safety and efficacy of current direct‐acting antiviral regimens in kidney and liver transplant recipients with hepatitis C: Results from the HCV‐TARGET study. Hepatology 2017, 66: 1090-1101. PMID: 28504842, PMCID: PMC5756478, DOI: 10.1002/hep.29258.Peer-Reviewed Original ResearchConceptsSustained virologic responseOmbitasvir/paritaprevir/ritonavirParitaprevir/ritonavirTransplant recipientsLiver transplantKidney transplantAntiviral therapyLarge prospective observational cohort studyChronic hepatitis C virusLiver-kidney transplant recipientsProspective observational cohort studySolid organ transplant recipientsHepatitis C virus (HCV) treatmentBaseline total bilirubinHCV-TARGET studyPrior antiviral therapyAbsence of cirrhosisKidney transplant recipientsLiver transplant recipientsObservational cohort studyOrgan transplant recipientsC virus treatmentGlomerular filtration rateCessation of treatmentSOF/ledipasvir
2010
Racial and insurance disparities in the receipt of transplant among patients with hepatocellular carcinoma
Yu JC, Neugut AI, Wang S, Jacobson JS, Ferrante L, Khungar V, Lim E, Hershman DL, Brown RS, Siegel AB. Racial and insurance disparities in the receipt of transplant among patients with hepatocellular carcinoma. Cancer 2010, 116: 1801-1809. PMID: 20143441, PMCID: PMC3664455, DOI: 10.1002/cncr.24936.Peer-Reviewed Original ResearchConceptsHepatocellular carcinomaAdvanced diseaseCox modelMultivariable logistic regression modelColumbia University Medical CenterReceipt of transplantationPredictors of mortalityAmerican Cancer SocietyUniversity Medical CenterReceipt of transplantLogistic regression modelsLiver transplantTransplant recipientsConsecutive patientsMore patientsBlack patientsHispanic patientsPoor prognosisHCC patientsInsurance statusPoor survivalMedicaid patientsCancer SocietyMedical CenterMedicaid recipients