2024
Ethical implications of prioritizing utility at all costs: The rise of out-of-sequence transplants
Kulkarni S, Ladin K. Ethical implications of prioritizing utility at all costs: The rise of out-of-sequence transplants. American Journal Of Transplantation 2024, 25: 232-233. PMID: 39299671, DOI: 10.1016/j.ajt.2024.09.014.Peer-Reviewed Original ResearchNRP Possibly Violates “Do No Harm” and Is Not Worth Risking the Perception That It Does
Flescher A, Kulkarni S, Ladin K. NRP Possibly Violates “Do No Harm” and Is Not Worth Risking the Perception That It Does. The American Journal Of Bioethics 2024, 24: 54-56. PMID: 38829598, DOI: 10.1080/15265161.2024.2336803.Peer-Reviewed Original ResearchComplications in kidney transplantation: A case-based guide to management, edited by Fahad Aziz and Sandesh Parajuli 2022 Springer Nature
Kim M, Kulkarni S. Complications in kidney transplantation: A case-based guide to management, edited by Fahad Aziz and Sandesh Parajuli 2022 Springer Nature. American Journal Of Transplantation 2024, 24: 872-873. DOI: 10.1016/j.ajt.2024.01.009.Peer-Reviewed Original Research
2023
Time to reconsider the role of donor hepatitis C status in the Kidney Donor Risk Index
Potluri V, Kulkarni S. Time to reconsider the role of donor hepatitis C status in the Kidney Donor Risk Index. American Journal Of Transplantation 2023, 23: 595-596. PMID: 36775203, PMCID: PMC11181137, DOI: 10.1016/j.ajt.2023.02.013.Peer-Reviewed Original ResearchHonoring 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
A Pharmacist-Driven Intervention Designed to Improve Medication Accuracy in the Outpatient Kidney Transplant Setting
Cohen E, 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 ResearchPharmacist-driven interventionsHigh-risk medicationsMedication reconciliationMedication errorsElectronic medical recordsMedication discrepanciesMedication listIntervention groupHigh-risk medication discrepanciesInadequate medication reconciliationMedication list accuracyMedication list discrepanciesMedication error ratesPatient's medication listPost-interventionTransplant nursesControl groupMedical accuracyPharmacist-drivenSecondary outcomesPrimary outcomeMedical recordsInterventionMedicationPharmacistsThe 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 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 pairs
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