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4. The Impact of Kidney/Pancreas Transplantation on Peripheral Arterial Disease.

Author

Knight, Richard J., Ye, Yan, Graviss, Edward A., Nguyen, Duc T., Garami, Zsolt, Yi, Stephanie G., Hobeika, Mark, Bavare, Charudatta S., Sadhu, Archana R., and Gaber, A. Osama

Subjects
PERIPHERAL vascular diseases, PANCREAS transplantation, CAROTID intima-media thickness, CHRONIC kidney failure, CORONARY artery disease, TYPE 2 diabetes, KIDNEY diseases
Abstract

Introduction: It is unclear whether kidney/pancreas (KP) transplantation will prevent the progression of peripheral arterial disease (PAD) in patients with insulin dependent diabetes (IDDM) and end‐stage renal disease. We sought to determine the pre‐ and posttransplant prevalence of symptomatic PAD and changes in carotid artery intima‐media thickness (IMT) in KP recipients. Methods: In this single center study, outcomes were compared between KP recipients with and without a history of PAD. A subset of recipients underwent pre‐ and posttransplant IMT measurements. Results: Among the study group (N = 107), 18 (17%) recipients admitted to a pretransplant history of symptomatic PAD, comprised 11 foot infections and 7 amputations (5 minor and 2 major). Baseline characteristics of age, gender, race, years of diabetes, dialysis history, smoking history, years of hypertension, and history of coronary artery disease (CAD) were equivalent between PAD and non‐PAD cohorts. At a median follow‐up of 60 months (IQR: 28, 110), 16 (15%) KP recipients had suffered a PAD event. In multivariate analysis, a pretransplant history of PAD (hazard ratio [HR] 9.66, p < 0.001) and CAD (HR 3.33, p = 0.04) were independent predictors of posttransplant PAD events. Among a subset of 20 recipients (3 with PAD), mean IMT measurements pretransplant and at a median of 24 (range 18–24) months posttransplant, showed no evidence of disease progression. Conclusion: Based on IMT measurements and clinical results, KP transplantation stabilized PAD in most patients, but did not alter outcomes of symptomatic PAD recipients. A pretransplant history of PAD and CAD was an independent predictor of posttransplant PAD events. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Delayed Implantation of Pumped Kidneys Decreases Renal Allograft Futility in Combined Liver–Kidney Transplantation

Author

Lunsford, Keri E., Agopian, Vatche G., Yi, Stephanie G., Nguyen, Duc T.M., Graviss, Edward A., Harlander-Locke, Michael P., Saharia, Ashish, Kaldas, Fady M., Mobley, Constance M., Zarrinpar, Ali, Hobeika, Mark J., Veale, Jeffrey L., Podder, Hemangshu, Farmer, Douglas G., Knight, Richard J., Danovitch, Gabriel M., Gritsch, H. Albin, Li, Xian C., Ghobrial, R. Mark, Busuttil, Ronald W., and Gaber, A. Osama

Published
2020
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10. CD4+T cell immunity is dependent on an intrinsic stem-like program

Author

Zou, Dawei, Yin, Zheng, Yi, Stephanie G., Wang, Guohua, Guo, Yang, Xiao, Xiang, Li, Shuang, Zhang, Xiaolong, Gonzalez, Nancy M., Minze, Laurie J., Wang, Lin, Wong, Stephen T. C., Osama Gaber, A., Ghobrial, Rafik M., Li, Xian C., and Chen, Wenhao

Abstract

CD4+T cells are central to various immune responses, but the molecular programs that drive and maintain CD4+T cell immunity are not entirely clear. Here we identify a stem-like program that governs the CD4+T cell response in transplantation models. Single-cell-transcriptomic analysis revealed that naive alloantigen-specific CD4+T cells develop into TCF1hieffector precursor (TEP) cells and TCF1−CXCR6+effectors in transplant recipients. The TCF1−CXCR6+CD4+effectors lose proliferation capacity and do not reject allografts upon adoptive transfer into secondary hosts. By contrast, the TCF1hiCD4+TEPcells have dual features of self-renewal and effector differentiation potential, and allograft rejection depends on continuous replenishment of TCF1−CXCR6+effectors from TCF1hiCD4+TEPcells. Mechanistically, TCF1 sustains the CD4+TEPcell population, whereas the transcription factor IRF4 and the glycolytic enzyme LDHA govern the effector differentiation potential of CD4+TEPcells. Deletion of IRF4 or LDHA in T cells induces transplant acceptance. These findings unravel a stem-like program that controls the self-renewal capacity and effector differentiation potential of CD4+TEPcells and have implications for T cell-related immunotherapies.

Published
2024
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13. Hospitalization and survival of solid organ transplant recipients with coronavirus disease 2019: A propensity matched cohort study

Author

Swan, Joshua T., primary, Rizk, Elsie, additional, Jones, Stephen L., additional, Nwana, Nwabunie, additional, Nicolas, Juan C., additional, Tran, Anh Thu, additional, Xu, Jiaqiong, additional, Nisar, Tariq, additional, Menser, Terri, additional, Yi, Stephanie G., additional, Moore, Linda W., additional, Huang, Howard J., additional, Ghobrial, R. Mark, additional, Gaber, A. Osama, additional, and Knight, Richard J., additional

Published
2022
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16. Early humoral immune response to two doses of severe acute respiratory syndrome coronavirus 2 vaccine in a diverse group of solid organ transplant candidates and recipients

Author

Huang, Howard J., primary, Yi, Stephanie G., additional, Mobley, Constance M., additional, Saharia, Ashish, additional, Bhimaraj, Arvind, additional, Moore, Linda W., additional, Kloc, Malgorzata, additional, Adrogue, Horacio E., additional, Graviss, Edward A., additional, Nguyen, Duc T., additional, Eagar, Todd N., additional, Jones, Stephen L., additional, Ankoma‐Sey, Victor, additional, MacGillivray, Thomas E., additional, Knight, Richard J., additional, Gaber, A. Osama, additional, and Ghobrial, R. Mark, additional

Published
2022
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17. Risk Factors Associated With an Impaired Antibody Response in Kidney Transplant Recipients Following 2 Doses of the SARS-CoV-2 mRNA Vaccine

Author

Yi, Stephanie G., primary, Moore, Linda W., additional, Eagar, Todd, additional, Graviss, Edward A., additional, Nguyen, Duc T., additional, Ibrahim, Hassan, additional, Huang, Howard J., additional, Hobeika, Mark, additional, McMillan, Robert, additional, Saharia, Ashish, additional, Mobley, Constance, additional, Podder, Hemangshu, additional, Drews, Ashley, additional, Ghobrial, R. Mark, additional, Gaber, A. Osama, additional, and Knight, Richard J., additional

Published
2021
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19. Contributors to Volume 1

Author

Advani, Shailesh, Akdur, Aydincan, Arriola, Kimberly Jacob, Arunachalam, Priya, Axelrod, David, Balamurugan, Appakalai N., Batra, Ramesh, Beebe, David S., Bellin, Melena D., Benedetti, Enrico, Bhardi, Elissa, Birjiniuk, Joav, Boletis, Ioannis N., Brayman, Kenneth L., Bregman, Adam, Burton, Victoria, Caicedo, Juan Carlos, Callender, Clive O., Carpenter, Jennifer, Carpenter, Dustin J., Cherry, Mark J., Cooper, Matthew, Cronin, David C., II, Davis, LaShara, Davis, Earnest J., Delmonico, Francis L., Di Cocco, Pierpaolo, Dor, Frank J.M.F., Downs, Elissa M., Einecke, Gunilla, Emamaullee, Juliet, Erhardt, A.J., Fan, Pang Yen, Farney, Alan, Fratti, Alberto, Freedman, Barry I., Gaber, A.O., Gaines, Malendie T., Gallon, Lorenzo, Ghahramani, Nasrollah, Gill, John S., Gill, Justin, Glannon, Walter, Gruessner, Rainer W.G., Gruessner, Angelika C., Gürlüler, Ercüment, Gutmann, Thomas, Haase-Kromwijk, Bernadette J.J.M., Haberal, Mehmet, Hajjiri, Zahraa Fayez, Halloran, Philip F., Han, Duck J., Hebert, Sean A., Hemke, Aline C., Ho, Erica, Hoitsma, Andries J., Hughes, Nancy Scheper, Ibrahim, Hassan N., Jay, Colleen, Kahn, Jeffrey, Kaisar, Maria, Kamei, Hideya, Kandaswamy, Raja, Kaufman, Dixon B., Kenmochi, Takashi, Kittle, Haley, Kiuchi, Tetsuya, Klitenic, Samantha B., Knight, Richard J., Kocak, Burak, Kodipad, Ahad Ahmed, Kumar, Suresh, Laftavi, Mark R., Land, Walter G., Langer, Robert, Lebovitz, Evan E., Lee-Riddle, Grace S., Levan, Macey L., Leventhal, Joseph R., Liou, H. Peter, Lonze, Bonnie E., Madill-Thomsen, Katelynn S., Maluf, Daniel G., Maple, Hannah, Marinaki, Smaragdi, Mas, Valeria R., Matas, Arthur J., Mathew, James M., Matossian, Debora, Mena-Gutierrez, Alejandra M., Menser, Terri, Modi, Pranjal, Mokshagundam, Sri Prakash L., Montgomery, Robert A., Muench, Dorothy, Mulligan, David, Murad, Dina N., Murillo, Ariana, Nahi, Skylar L., Najarian (deceased), John S., Narayanan, Siddharth, Nathan, Jaimie D., Nguyen, Hana, Nguyen, Anh Vinh T., Nishio-Lucar, Angie, Norin, Allen J., Olausson, Michael, Onishi, Yasuharu, Pankewycz, Oleh G., Papalois, Vassilios, Pengel, Liset, Petrochenkov, Egor, Pirenne, Jacques, Ploeg, Rutger, Radcliffe-Richards, Janet, Ramanathan, Karthik, Ratner, Lloyd E., Reeves-Daniel, Amber M., Ross, Lainie Friedman, Rule, Andrew D., Sakai, Tetsuro, Sakuma, Yasunaru, Samaga, Krishna Kumar, Schold, Jesse D., Schroeter, Andreas, Seth, Abhinav, Shapiro, A. M. James, Shenoy, Surendra, Siegler, Mark, Spaggiari, Mario, Spak, Cedric W., Steiner, Robert, Stern, Jeffrey M., Subba Rao, Budithi, Tanabe, Kazunari, Tantisattamo, Ekamol, Thistlethwaite, J. Richard, Toledo, Alexander H., Troppmann, Christoph, Tullius, Stefan G., Tzvetanov, Ivo, Verghese, Priya S., Wadström, Jonas, Warburton, Karen, Waterman, Amy D., West-Thielke, Patricia, Wood, Emily H., Yi, Stephanie G., and Yu, Jennifer

Published
2024
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22. Donation after circulatory death liver transplantation: An in‐depth analysis and propensity score–matched comparison

Author

Hobeika, Mark J., primary, Saharia, Ashish, additional, Mobley, Constance M., additional, Menser, Terri, additional, Nguyen, Duc T., additional, Graviss, Edward A., additional, McMillan, Robert R., additional, Podder, Hemangshu, additional, Nolte Fong, Joy V., additional, Jones, Stephen L., additional, Yi, Stephanie G., additional, Elshawwaf, Mahmoud, additional, Gaber, Ahmed O., additional, and Ghobrial, Rafik M., additional

Published
2021
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24. Early Experience With COVID-19 and Solid Organ Transplantation at a US High-volume Transplant Center

Author

Yi, Stephanie G., primary, Rogers, Alex W., additional, Saharia, Ashish, additional, Aoun, Maria, additional, Faour, Romy, additional, Abdelrahim, Maen, additional, Knight, Richard J., additional, Grimes, Kevin, additional, Bullock, Samantha, additional, Hobeika, Mark, additional, McMillan, Robert, additional, Mobley, Constance, additional, Moaddab, Mozhgon, additional, Huang, Howard J., additional, Bhimaraj, Arvind, additional, Ghobrial, R. Mark, additional, and Gaber, A. Osama, additional

Published
2020
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28. Combined lung and liver transplantation: Analysis of a single‐center experience

Author

Yi, Stephanie G., primary, Burroughs, Sherilyn Gordon, additional, Loebe, Matthias, additional, Scheinin, Scott, additional, Seethamraju, Harish, additional, Jyothula, Soma, additional, Monsour, Howard, additional, McFadden, Robert, additional, Podder, Hemangshu, additional, Saharia, Ashish, additional, Asham, Emad H., additional, Boktour, Maha, additional, Gaber, A. Osama, additional, and Ghobrial, R. Mark, additional

Published
2013
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30. The Effect of Adrenal Replacement Therapy on Rates of Fungal Colonization and Mortality in Critically Ill Patients Awaiting Liver Transplantation.

Author

Yi SG, Sadhu AR, Jones SL, Turner K, Monsour H, Donahue K, Xia X, Gaber AO, Ghobrial RM, and Burroughs SG

Abstract

Background: The effect of adrenal replacement therapy (ART) with hydrocortisone on critical endpoints such as infection and mortality in critically ill patients with cirrhosis remains unclear. We evaluated our indications for ART in patients with cirrhosis with clinical symptoms of adrenal insufficiency (AI), and examined the rate of peri-transplant fungal colonization and mortality associated with ART., Methods: Seventy-eight patients with cirrhosis admitted to our institution's surgical intensive care unit (ICU) over a 4-year period met criteria for AI by vasopressor requirement and baseline cortisol levels. Outcomes included disposition at 90-days, fungal colonization, and fungal infection in the presence or absence of ART., Results: In total, 56 patients received hydrocortisone (HC+) while 22 did not (HC-). The HC+ and HC- groups had comparable median Model for End-stage Liver Disease (MELD) scores (26.5 vs. 25, respectively; p=0.93), median ICU lengths of stay (23 vs. 20 days, respectively; p=0.54) and median cortisol levels (18 μg/dL for both, p=0.87). Fungal cultures (FC) from blood, urine or bronchoalveolar lavage/sputum were positive for 44% of HC+, and 40.9% of HC- (p=0.77) had mortality rates between HC+ and HC- groups that were not significantly different (60.7% vs. 50%, respectively; p=0.39; α=0.05). The 90-day outcomes for HC+ vs. HC- (39.3% vs. 50% discharged, respectively; p=0.39; α=0.05) and those surviving to transplant (17.9% vs. 36.4%, respectively; p=0.08; α=0.05) were not significantly different between the two groups., Conclusion: In this small single-center series, we found that steroid administration for AI does not affect the rate of fungal colonization/infection or mortality. Further prospective studies are required to determine the utility of ART and factors affecting the rate of FC and mortality in these patients.

Published
2013
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