2021
Quantifying 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 threshold
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
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
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 knowledgeDonationDecisionsAllograft transmission of hepatitis C during the window period: Weighing the new risks and costs in the era of donor shortage
Choe J, Merola J, Kulkarni S, Mulligan DC. Allograft transmission of hepatitis C during the window period: Weighing the new risks and costs in the era of donor shortage. Clinical Transplantation 2017, 31 PMID: 28643333, DOI: 10.1111/ctr.13022.Peer-Reviewed Original Research
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 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-value
2014
Individual exome analysis in diagnosis and management of paediatric liver failure of indeterminate aetiology
Vilarinho S, Choi M, Jain D, Malhotra A, Kulkarni S, Pashankar D, Phatak U, Patel M, Bale A, Mane S, Lifton RP, Mistry PK. Individual exome analysis in diagnosis and management of paediatric liver failure of indeterminate aetiology. Journal Of Hepatology 2014, 61: 1056-1063. PMID: 25016221, PMCID: PMC4203706, DOI: 10.1016/j.jhep.2014.06.038.Peer-Reviewed Original ResearchMeSH KeywordsAmino Acid SequenceBase SequenceCarboxylic Ester HydrolasesChildCholestasisDNA Mutational AnalysisEnd Stage Liver DiseaseExomeFatal OutcomeFemaleGenes, RecessiveHepatolenticular DegenerationHeterozygoteHomozygoteHumansInfant, NewbornLiver FailureLiver Failure, AcuteMaleMembrane ProteinsMitochondrial ProteinsMolecular Sequence DataPedigreeReceptor, Notch2RNA Splice SitesSequence Homology, Amino AcidConceptsFatal acute liver failureWhole-exome sequencingAdvanced liver diseaseAcute liver failureIndeterminate etiologyYear old femaleLiver failureLiver diseaseMetabolic liver diseasePatient 3Treatment optionsPhenotypic spectrumPediatric liver failureDecompensated liver cirrhosisManagement of childrenOptimal treatment optionsAge 3 monthsNovel inborn errorLiver transplantAtypical presentationLiver cirrhosisHepatocerebral mitochondrial DNA depletion syndromePatient 1Patient 2Unknown etiologySegmental 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
CT angiography in potential living kidney donors: 80 kVp versus 120 kVp.
Davarpanah AH, Pahade JK, Cornfeld D, Ghita M, Kulkarni S, Israel GM. CT angiography in potential living kidney donors: 80 kVp versus 120 kVp. American Journal Of Roentgenology 2013, 201: w753-60. PMID: 24147505, DOI: 10.2214/ajr.12.10439.Peer-Reviewed Original ResearchAlloantibody and Complement Promote T Cell–Mediated Cardiac Allograft Vasculopathy Through Noncanonical Nuclear Factor-&kgr;B Signaling in Endothelial Cells
Jane-wit D, Manes TD, Yi T, Qin L, Clark P, Kirkiles-Smith NC, Abrahimi P, Devalliere J, Moeckel G, Kulkarni S, Tellides G, Pober JS. Alloantibody and Complement Promote T Cell–Mediated Cardiac Allograft Vasculopathy Through Noncanonical Nuclear Factor-&kgr;B Signaling in Endothelial Cells. Circulation 2013, 128: 2504-2516. PMID: 24045046, PMCID: PMC3885874, DOI: 10.1161/circulationaha.113.002972.Peer-Reviewed Original ResearchConceptsCardiac allograft vasculopathyPanel reactive antibodyNuclear factor-κB signalingFactor-κB signalingAllograft vasculopathyT cellsEndothelial cellsMembrane attack complexAlloreactive T cell activationChronic antibody-mediated rejectionNoncanonical nuclear factorProinflammatory gene programAntibody-mediated rejectionDonor-specific antibodiesGraft endothelial cellsLate allograft lossAlloreactive T cellsAllogeneic endothelial cellsT cell activationAttack complexHuman T cellsAllograft lossHeart transplantationTransplantation patientsLesion pathogenesisClinical 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 studyRetrocaval Renal Artery Bifurcation Is Not a Contraindication to Laparoscopic Right Donor Nephrectomy
Gandelman JA, Yoo PS, Kulkarni S. Retrocaval Renal Artery Bifurcation Is Not a Contraindication to Laparoscopic Right Donor Nephrectomy. Journal Of The American College Of Surgeons 2013, 217: 406-411. PMID: 23791562, DOI: 10.1016/j.jamcollsurg.2013.03.026.Peer-Reviewed Original ResearchConceptsDelayed graft functionLaparoscopic donor nephrectomyDonor nephrectomyGraft functionRecipient outcomesExact testRight-sided laparoscopic donor nephrectomyLaparoscopic right donor nephrectomyBifurcation groupComplex arterial anatomyLeft-sided kidneyOutcomes 30 daysRenal artery bifurcationRight donor nephrectomyRight-sided kidneyRight renal arteryLeft-sided nephrectomyCommon anatomic variantFisher's exact testMann-Whitney U testNonbifurcation groupTotal nephrectomyUreteral complicationsComplication rateCreatinine clearanceRapamycin-treated human endothelial cells preferentially activate allogeneic regulatory T cells
Wang C, Yi T, Qin L, Maldonado RA, von Andrian UH, Kulkarni S, Tellides G, Pober JS. Rapamycin-treated human endothelial cells preferentially activate allogeneic regulatory T cells. Journal Of Clinical Investigation 2013, 123: 1677-1693. PMID: 23478407, PMCID: PMC3613923, DOI: 10.1172/jci66204.Peer-Reviewed Original ResearchMeSH KeywordsAdaptor Proteins, Signal TransducingAnimalsArteriesB7-H1 AntigenCD4-Positive T-LymphocytesCell ProliferationCells, CulturedCoculture TechniquesFemaleGene ExpressionGene Knockdown TechniquesHuman Umbilical Vein Endothelial CellsHumansImmunosuppression TherapyInterleukin-6Lymphocyte ActivationMiceMice, SCIDProgrammed Cell Death 1 Ligand 2 ProteinRegulatory-Associated Protein of mTORRNA, Small InterferingSirolimusT-Lymphocytes, RegulatoryTOR Serine-Threonine KinasesTranscriptional ActivationTransplantation, HomologousConceptsEffect of rapamycinT cellsEndothelial cellsAllograft rejectionHuman endothelial cellsPD-L1PD-L2Allogeneic regulatory T cellsHuman-mouse chimeric modelInhibitory molecule PD-L1Inflammatory cytokines IL-6Alloantigen-specific mannerAllograft endothelial cellsHuman arterial allograftsImmune-mediated rejectionGraft endothelial cellsEffector T cellsRegulatory T cellsMemory T cellsT cell responsesAntigen-presenting cellsCytokines IL-6Mock-treated cellsAllogeneic CD4Effector cytokines
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 kinase