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 dataImpact of Low-Dose Fluconazole on Tacrolimus Dosing in Renal Transplant
Johnston JP, Cohen EA, Casal GH, Asch WS, Reardon DP. Impact of Low-Dose Fluconazole on Tacrolimus Dosing in Renal Transplant. Journal Of Pharmacy Practice 2021, 35: 701-706. PMID: 33759619, DOI: 10.1177/08971900211000702.Peer-Reviewed Original ResearchConceptsLow-dose fluconazoleRenal transplant patientsAdverse drug reactionsTAC levelsTransplant patientsGraft rejectionDrug reactionsTherapeutic levelsSingle-center retrospective chart reviewPost-operative day 10Azole antifungal therapySubtherapeutic tacrolimus levelsTAC dose adjustmentRenal transplant recipientsTotal daily doseRetrospective chart reviewTacrolimus dosingTacrolimus levelsRenal transplantTransplant recipientsChart reviewSecondary outcomesDaily doseDose adjustmentPrimary outcome
2020
Identifying a Kidney Transplant Recipient COVID Phenotype to Aid Test Utilization in the Setting of Limited Testing Availability—Does One Exist?
Virmani S, Gleeson SE, Girone GF, Malhotra D, Cohen EA, Klarman SE, Asch WS. Identifying a Kidney Transplant Recipient COVID Phenotype to Aid Test Utilization in the Setting of Limited Testing Availability—Does One Exist? Transplantation Proceedings 2020, 52: 2584-2591. PMID: 32711848, PMCID: PMC7305913, DOI: 10.1016/j.transproceed.2020.05.033.Peer-Reviewed Original ResearchConceptsKidney transplant recipientsSARS-CoV-2BK viremiaLimited testing availabilityTesting availabilitySevere acute respiratory syndrome 2 virusImmunosuppressed kidney transplant recipientsOutpatient testing centerPolyoma BK viremiaCOVID-19 infectionPositive predictive valueTransplant recipientsImmunocompetent patientsSymptomatic patientsImmunosuppressed patientsTransplant centersHigh morbidityEmergency departmentInpatient treatmentGeneral populationHigh incidencePatientsCenter deliveriesPredictive valueTest utilization
2018
New England BK consortium: Regional survey of BK screening and management protocols in comparison to published consensus guidelines
Gabardi S, Pavlakis M, Tan C, Francis J, Cardarelli F, Asch W, Bodziak K, Chobanian M, Gilligan H, Gohh R, Kung S, Inker L, Martin S, Rodig N, Rossi A, Chandraker A. New England BK consortium: Regional survey of BK screening and management protocols in comparison to published consensus guidelines. Transplant Infectious Disease 2018, 20: e12985. PMID: 30175491, DOI: 10.1111/tid.12985.Peer-Reviewed Original ResearchConceptsRenal transplant recipientsConsensus guidelinesBKPyV-associated nephropathyCNI dose reductionPlasma viral loadUse of leflunomideCopies/mLHalf of centersMajority of centersManagement protocolCause biopsiesImmunosuppression reductionIntravenous immunoglobulinTransplant recipientsRenal biopsyViral loadBK polyomavirusPrimary treatmentDose reductionBiopsyUniform screeningNephropathyBKPyVShort durationScreening
2016
New Organ Allocation System for Combined Liver-Kidney Transplants and the Availability of Kidneys for Transplant to Patients with Stage 4–5 CKD
Asch WS, Bia MJ. New Organ Allocation System for Combined Liver-Kidney Transplants and the Availability of Kidneys for Transplant to Patients with Stage 4–5 CKD. Clinical Journal Of The American Society Of Nephrology 2016, 12: 848-852. PMID: 28028050, PMCID: PMC5477211, DOI: 10.2215/cjn.08480816.Commentaries, Editorials and LettersConceptsLiver-kidney transplantSimultaneous liver-kidney transplantOrgan allocationCombined liver-kidney transplantAvailability of kidneysMultiorgan transplant recipientsEquitable organ allocationMedical criteriaOrgan allocation systemLiver recipientsTransplant recipientsTransplant activityNephrology communityTransplantKidneyRecipientsStage 4Great controversyCKDPatientsAKICriteria
2015
Duration 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-value
2014
Oncologic Issues and Kidney Transplantation: A Review of Frequency, Mortality, and Screening
Asch WS, Bia MJ. Oncologic Issues and Kidney Transplantation: A Review of Frequency, Mortality, and Screening. Advances In Kidney Disease And Health 2014, 21: 106-113. PMID: 24359993, DOI: 10.1053/j.ackd.2013.07.003.BooksMeSH KeywordsAnus NeoplasmsBreast NeoplasmsCarcinoma, Renal CellColorectal NeoplasmsEarly Detection of CancerFemaleHumansImmunocompromised HostImmunosuppressive AgentsKidney Failure, ChronicKidney NeoplasmsKidney TransplantationLymphoproliferative DisordersNeoplasmsSkin NeoplasmsUterine Cervical NeoplasmsConceptsStandard incidence ratioKidney transplantationKidney transplant recipientsDevelopment of malignancyReview of frequencyTransplant recipientsIncidence ratiosCommon malignancyTreatment recommendationsTumor surveillanceOncologic issuesGeneral populationTumor growthMalignancyOncogenic virusesCurrent preventionTransplantationRiskEarly ageImmunosuppressantsReviewCancerMortalityRecipientsPrevention