Laboratory Medicine Commons^™

Injured Proximal Tubules Stain Positivity For Arginase-1 To Indicate Acute Tubular Injury (Ati), Jessica Anderson, Neal Blatt, Olabisi Afolayan-Oloye, Hassan Kanaan, Wei Li, Larysa Wickman, Ping Zhang

Conference Presentation Abstracts

Background: A recent study indicates that arginase-1 participates in M2 macrophage-mediated renal tubular regeneration in a rodent model (Shin et al. JASN 2022). As injured proximal tubule cells have a phagocytotic capacity (stain positively for CD68 and kidney injury moleucule-1 in previous studies), we hypothesized that the injured proximal tubules may stain positively for arginase1. Design: We analyzed PAS-stained renal biopsy sections for evidence of ATI using a semiquantitative scale: 0 (no injury) to 1-2+ (mild to moderate ATI) to 3+ (severe ATI). First group (N=7) consisted of renal biopsies that had no evidence of ATI or were obtained from …

Lingual Alveolar Soft Part Sarcoma In A 78-Year-Old Woman: A Case Report And Comprehensive Review Of The Literature From 1952 To 2022, Aliaksandr Aksionau, Nestor Enriquez Dela Cruz, Andrew T Meram, Hugo Cuellar-Saenz, Jillian R Aveni, Hidehiro Takei

Faculty, Staff and Student Publications

BACKGROUND: Alveolar soft part sarcoma (ASPS) is a rare translocation-related soft tissue sarcoma, occurring mainly in the limbs and trunk in young adults and adolescents. ASPS is rarely seen in the head and neck and one fourth of those cases described are tongue primary. Given its nonspecific symptoms, clinical findings, and rarity in this location, lingual ASPS (L-ASPS) has been reported to be commonly misdiagnosed as various benign tumors, leading to adverse outcomes.

METHODS: We report a case of L-ASPS occurring in the oldest (78 years) female patient published to date and comprehensively review the literature from 1952 to 2022. …

Epstein-Barr Virus-Associated Lymphoepithelial Carcinoma Arising In The Parotid Gland: A Case Report And Literature Review, Akinobu Kubota, Nobuyuki Bandoh, Takashi Goto, Ken-Ichi Matsumoto, Tomomi Yamaguchi-Ishochi, Yasutaka Kato, Hiroshi Nishihara, Hidehiro Takei

Faculty, Staff and Student Publications

A 60-year-old woman presented with a 3-year history of a slow-growing, painless mass in their left parotid gland. Ultrasonography revealed a well-circumscribed, lobulated, hypoechoic mass measuring 19x12x10 mm in the left parotid gland. Computed tomography revealed a well-circumscribed, solid mass with homogeneous enhancement. Fluorodeoxyglucose-positron emission tomography revealed uptake by the tumor but no uptake in other organs, including the nasopharynx. The patient underwent superficial parotidectomy with adequate safety margins and selective neck dissection followed by radiotherapy. No facial paralysis or recurrence of the tumor had been observed as of 20 months post-operation. Histologically, the tumor was composed of sheets of …

Ultrastructural Findings Of Budding Ballooning Clusters Are Best Correlated With Punctate Autoimmune Antibodies Seen By Immunofluorescence In Minimal Change Disease, Vasudevan Mahalingam, Seyedalireza Fatemi, Wei Li, Hassan Kanaan, Ping Zhang

Conference Presentation Abstracts

Background: The etiology of minimal change disease (MCD) remains a mystery as the only hallmark findings are the diffuse effacement of foot processes by electron microscopy (EM). Punctate IgG staining floating outside of glomerular capillary loops have recently been identified as autoimmune antibodies against nephrin in podocytes from a set of MCD cases (Watts AJB et al., JASN 2022;33:238-252). The corresponding ultrastructural findings by EM, however, of the autoimmune antibodies are not yet described. We hypothesized that budding ballooning clusters (BBC) seen in EM may be correlated with the punctate IgG staining granules. Design: We identified 7 patients with MCD …

3q262/Mecom Rearrangements By Pericentric Inv(3): Diagnostic Challenges And Clinicopathologic Features, Zhenya Tang, Wei Wang, Su Yang, Hanadi El Achi, Hong Fang, Karen Amelia Nahmod, Gokce A Toruner, Jie Xu, Beenu Thakral, Edward Ayoub, Ghayas C Issa, C Cameron Yin, M James You, Roberto N Miranda, Joseph D Khoury, L Jeffrey Medeiros, Guilin Tang

Faculty, Staff and Student Publications

MECOM rearrangement (MECOM-R) resulting from 3q26.2 aberrations is often associated with myeloid neoplasms and inferior prognosis in affected patients. Uncommonly, certain 3q26.2/MECOM-R can be subtle/cryptic and consequently overlooked by karyotyping. We identified 17 acute myeloid leukemia (AML) patients (male/female: 13/4 with a median age of 67 years, range 42 to 85 years) with a pericentric inv(3) leading to MECOM-R, with breakpoints at 3p23 (n = 11), 3p25 (n = 3), 3p21 (n = 2) and 3p13 (n = 1) on 3p and 3q26.2 on 3q. These pericentric inv(3)s were overlooked by karyotyping initially in 16 of 17 …

Molecular Detection Of Entamoeba Histolytica In Diarrheic Fecal Samples From Patients Attending National Hepatology And Tropical Medicine Research Institute, Azza Hasan Abbas, El Shahat Ahmed Elshahat, Heba Mohamed Abdelglil

Journal of Medicine in Scientific Research

Background: Amoebiasis is a worldwide disease caused by Entamoeba histolytica infection. The true prevalence is unknown due to the difficulty in distinguishing Entamoeba histolytica from non-pathogenic amoebas especially when microscopic diagnosis is performed, to overcome microscopy misidentification. Polymerase Chain Reaction (PCR) assay is necessary as a highly sensitive and specific technique. Objective: To determine the value of Real-Time PCR (RT.PCR) in the diagnosis of Entamoeba histolytica in the stool samples of diarrheic patients attending NHTMI versus microscopy, copro- antigen, and serum antibodies detection techniques. Subjects and Methods: A cross-sectional study was conducted on 150 diarrheic patients. Their stool samples were …

Angiotensin I-Converting Enzyme Insertion/Deletion Gene Polymorphism And Its Association With Diabetic Nephropathy In Type-2 Diabetes Mellitus Patients: An Egyptian Study, Yasmine M. Amrousy, Tamer M. Soliman, Haythem A. Tolba, Aisha Elshimy

Journal of Medicine in Scientific Research

Background Diabetic nephropathy (DN) is one of the most serious complications associated with type-2 diabetes mellitus (T2DM). With variable allele and genotype frequencies, the angiotensin I-converting enzyme (ACE) insertion–deletion (I/D) gene polymorphism has been suggested as a risk factor for DN. Objective The purpose of the study was to find whether ACE I/D polymorphism is associated with DN in Egyptian T2DM patients and its relation to ACE concentration and C-reactive protein quantitative level. Participants and methods A case–control study of 98 T2DM patients was divided into two groups: group 1, T2DM patients without DN, and group 2, T2DM patients with …

Assessing Serum Ferritin Together With Some Inflammatory Biomarkers In Overweight And Obese Hospital Care Workers At Elgalaa Teaching Hospital And Its Correlation With Metabolic Syndrome, Sahar Mohamed Said Elbayoumi, Hanan Farouk, Heba Abdelaziz

Journal of Medicine in Scientific Research

Obesity is known to be associated with elevated levels of inflammatory markers. One of the major problems associated with morbidity and mortality. The aim of the study was to assess the posing effect of obesity on the levels of serum ferritin, total cholesterol, HDL and LDL, triglycerides, HBA1C, CRP, and Uric acid with CBC, on random well-being colleague females. Patient and methods: 100 adult female health workers were categorized into three entities according to both BMI and waist circumference, as normal, overweight, and obese. Results: increased serum ferritin as an inflammatory marker might correlate to BMI, in juniors; and might …

Incidental Vascular Lesion In Explanted Liver: A Rare Case Report And Review Of The Literature, Rossana Kazemimood, Shohreh Eliaszadeh, Kenneth Wind

Faculty, Staff and Student Publications

Hepatic small vessel neoplasm (HSVN) is a rare vascular hepatic lesion that is usually an asymptomatic incidental finding. Here we present a case of a 66-year-old male with HSVN who was discovered to have a lesion presenting as a small nodule in an explanted liver. HSVN is a recently described hepatic vascular lesion that has been previously underdiagnosed. It has an uncertain long-term malignant potential, so close follow-up is recommended.

Clonal Isolates Of Treponema Pallidum Subsp Pallidum Nichols Provide Evidence For The Occurrence Of Microevolution During Experimental Rabbit Infection And In Vitro Culture, Diane G Edmondson, Bridget D De Lay, Blake M Hanson, Lindsay E Kowis, Steven J Norris

Faculty, Staff and Student Publications

The recent development of a system for long-term in vitro culture of the syphilis spirochete, Treponema pallidum subsp. pallidum, has introduced the possibility of detailed genetic analysis of this bacterium. In this study, the in vitro culture system was used to isolate and characterize clonal populations of T. pallidum subsp. pallidum Nichols, the most widely studied strain. In limiting dilutions experiments, it was possible to establish cultures with inocula as low as 0.5 T. pallidum per well despite the long generation time (~35 to 40 hours) of this organism. Six Nichols strain clones isolated by limiting dilution were characterized in …

A Large Screen Identifies Beta-Lactam Antibiotics Which Can Be Repurposed To Target The Syphilis Agent, Kathryn A Hayes, Jules M Dressler, Steven J Norris, Diane G Edmondson, Brandon L Jutras

Faculty, Staff and Student Publications

Syphilis, caused by the spirochete Treponema pallidum subsp. pallidum (hereafter called T. pallidum), is re-emerging as a worldwide sexually transmitted infection. A single intramuscular dose of benzathine penicillin G is the preferred syphilis treatment option. Both supply shortage concerns and the potential for acquired antibiotic resistance further the need to broaden the repertoire of syphilis therapeutics. We reasoned that other β-lactams may be equally or more effective at targeting the disease-causing agent, Treponema pallidum, but have yet to be discovered due to a previous lack of a continuous in vitro culture system. Recent technical advances with respect to …

Extensive Fibrosis In Mediastinal Seminoma Is A Diagnostic Pitfall In Small Biopsies: Two Case Reports, Anthony R Liccardi, Kristen Thomas, Navneet Narula, Lea Azour, Andre L Moreira, Fang Zhou

Faculty, Staff and Student Publications

Background

In mediastinal biopsies that show fibrosis, the differential diagnosis includes fibrosing mediastinitis, immunoglobulin G subclass 4-related disease, Hodgkin lymphoma, as well as reactive fibrotic and inflammatory changes adjacent to other processes including neoplasms.

Cases Description

We report two cases of incidentally detected mediastinal seminoma that contained extensive areas of paucicellular fibrosis, which precluded accurate preoperative biopsy diagnosis. The fibrosis consisted of mildly inflamed, densely scarred tissue with thin dilated vessels, and was present to a significant extent that is suggestive of spontaneous regression. These features are not currently described in the World Health Organization Classification of Thoracic Tumors. In …

Exceptional Response To Pembrolizumab For Treatment Of Metastatic Chemorefractory Endometrial Carcinoma In A Patient With Lynch Syndrome: A Case Report, Samantha Batman, J Alejandro Rauh-Hain, Michaela Onstad Grinsfelder, Ross Harrison, Monica Avila, Han Cun, Jeffrey Andrew How, Nidhi Tandon, Xiaohong Wang, Emily Hinchcliff, Amir Anthony Jazaeri, Kathleen M Schmeler

Faculty, Staff and Student Publications

Advanced endometrial cancer is associated with poor outcomes and few treatment options exist. Recently, the US Federal Drug Administration approved pembrolizumab for the treatment of endometrial cancers that are deficient in mismatch repair and have high microsatellite instability (MSI). Lynch syndrome is an autosomal dominant disease that causes MSI-high endometrial cancer. We report a case of a 46-year-old woman with Lynch syndrome and advanced endometrial cancer who experienced progressive disease after treatment with chemotherapy with carboplatin and paclitaxel. She was then treated with single-agent pembrolizumab and had an exceptional response. She was noted to have a significant decrease in the …

Case Report: Immune Checkpoint Inhibitor-Induced Multiorgan Vasculitis Successfully Treated With Rituximab, Sehrish Qureshi, Naszrin Arani, Vishnu Parvathareddy, Amanda Tchakarov, Maen Abdelrahim, Maria Suarez-Almazor, Jianjun Zhang, Don Lynn Gibbons, John Heymach, Mehmet Altan, Ala Abudayyeh

Faculty, Staff and Student Publications

Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of cancer. ICIs have a unique side effect profile, generally caused by inflammatory tissue damage, with clinical features similar to autoimmune conditions. Acute kidney injury from ICIs has been well studied; incidence ranges from 1% to 5%, with higher incidence when combination ICI therapies are used. Although the overall reported incidence of ICI-associated glomerulonephritis is less than 1%, vasculitis is the most commonly reported ICI-related glomerulonephritis. Other biopsy findings include thrombotic microangiopathy, focal segmental glomerulosclerosis, minimal change disease, and IgA nephropathy with secondary amyloidosis. We report a case in which a woman …

Futility In Acute Care Surgery: First Do No Harm, Melissa Hornor, Uzer Khan, Michael W Cripps, Allyson Cook Chapman, Jennifer Knight-Davis, Thaddeus J Puzio, Bellal Joseph

Faculty, Staff and Student Publications

The consequences of the delivery of futile or potentially ineffective medical care and interventions are devastating on the healthcare system, our patients and their families, and healthcare providers. In emergency situations in particular, determining if escalating invasive interventions will benefit a frail and/or severely critically ill patient can be exceedingly difficult. In this review, our objective is to define the problem of potentially ineffective care within the specialty of acute care surgery and describe strategies for improving the care of our patients in these difficult situations.

Comprehensive Identification And Expression Analyses Of The Snrk Gene Family In Casuarina Equisetifolia In Response To Salt Stress, Di Ai, Yujiao Wang, Yongcheng Wei, Jie Zhang, Jingxiang Meng, Yong Zhang

Faculty, Staff and Student Publications

Background

Sucrose nonfermenting-1 (SNF1)-related protein kinases (SnRKs) play crucial roles in plant signaling pathways and stress adaptive responses by activating protein phosphorylation pathways. However, there have been no comprehensive studies of the SnRK gene family in the widely planted salt-tolerant tree species Casuarina equisetifolia. Here, we comprehensively analyze this gene family in C. equisetifolia using genome-wide identification, characterization, and profiling of expression changes in response to salt stress.

Results

A total of 26 CeqSnRK genes were identified, which were divided into three subfamilies (SnRK1, SnRK2, and SnRK3). The intron–exon structures and protein‑motif compositions were similar within each subgroup but …

A High-Resolution 3d Atlas Of The Spectrum Of Tuberculous Andcovid-19 Lung Lesions, Gordon Wells, Joel N Glasgow, Kievershen Nargan, Kapongo Lumamba, Rajhmun Madansein, Kameel Maharaj, Leon Y Perumal, Malcolm Matthew, Robert L Hunter, Hayden Pacl, Jacelyn E Peabody Lever, Denise D Stanford, Satinder P Singh, Prachi Bajpai, Upender Manne, Paul V Benson, Steven M Rowe, Stephan Le Roux, Alex Sigal, Muofhe Tshibalanganda, Carlyn Wells, Anton Du Plessis, Mpumelelo Msimang, Threnesan Naidoo, Adrie J C Steyn

Faculty, Staff and Student Publications

Our current understanding of the spectrum of TB and COVID-19 lesions in the human lung is limited by a reliance on low-resolution imaging platforms that cannot provide accurate 3D representations of lesion types within the context of the whole lung. To characterize TB and COVID-19 lesions in 3D, we applied micro/nanocomputed tomography to surgically resected, postmortem, and paraffin-embedded human lung tissue. We define a spectrum of TB pathologies, including cavitary lesions, calcium deposits outside and inside necrotic granulomas and mycetomas, and vascular rearrangement. We identified an unusual spatial arrangement of vasculature within an entire COVID-19 lobe, and 3D segmentation of …

Exploration Of The Minimum Necessary Fviii Level At Different Physical Activity Levels In Pediatric Patients With Hemophilia A, Di Ai, Kun Huang, Gang Li, Yingzi Zhen, Xinyi Wu, Ningning Zhang, Aihua Huo, Zhenping Chen, Runhui Wu

Faculty, Staff and Student Publications

BACKGROUND: Physical activity can increase joint stability and reduce the risk of injury in hemophilia patients. There is limited clinical data on target trough FVIII levels during physical activity in hemophilia A patients. Hence, this study aimed to explore the target trough FVIII level required to avoid bleeding during different physical activities in hemophilia A patients.

METHODS: Patients with severe or moderate hemophilia A, who underwent pharmacokinetics (PK) tests at our center were enrolled in this study. Physical activities and clinical information such as bleeding were recorded. The FVIII level during physical activity was calculated by the WAPPS-Hemo.

RESULTS: A …

Aortic Root Dissection Due To An Automated Fastener Device, Ismael A Salas De Armas, L Maximilian Buja, Manish K Patel, Jayeshkumar Patel, Mehmet H Akay, Emre Gok, Igor D Gregoric

Faculty, Staff and Student Publications

Minimally invasive aortic valve replacement through a right thoracotomy is frequently performed in patients with aortic valve disease. The Cor-Knot Device (LSI Solutions) is an automated fastener that secures valve sutures. This case report is for a patient who developed postcardiotomy shock during a minimally invasive aortic valve surgery. The patient was found to have an aortic root dissection involving 90% of the aortic root circumference, including bilateral coronary ostia. The autopsy revealed that the aortic damage could be explained by a direct aortic intimal tear from the distal tip of the device shaft. The device was most likely not …

B-Lymphoblastic Leukemia With Burkitt-Like Morphology And Aberrant Myeloperoxidase Expression: A Diagnostic Conundrum, Karen A Nahmod, Wei Wang, Karan Saluja, Zhenya Tang, L Jeffrey Medeiros, Beenu Thakral

Faculty, Staff and Student Publications

No abstract provided.

Pathologic Predictors Of Response To Treatment Of Immune Checkpoint Inhibitor-Induced Kidney Injury, Ala Abudayyeh, Liye Suo, Heather Lin, Omar Mamlouk, Noha Abdel-Wahab, Amanda Tchakarov

Faculty, Staff and Student Publications

Background: Immune-related adverse events are a management challenge in patients receiving immune checkpoint inhibitors (ICIs). The most common renal immune-related adverse event, acute interstitial nephritis (AIN), is associated with patient morbidity and mortality. AIN, characterized by infiltration of renal tissue with immune cells, may be analogous to kidney transplant rejection. We evaluated clinical variables and pathologic findings to identify predictors of renal response and overall survival (OS) in patients with ICI-induced AIN. Design, setting, participants, and measurements: We reviewed the records and biopsy specimens of all 35 patients treated for ICI-induced AIN at our institution, between August 2007 and August …

Inequity In National Institutes Of Health Predoctoral Fellowships, 2001-2020, Mytien Nguyen, Nghia D Nguyen, Sarwat I Chaudhry, Mayur M Desai, Jose E Cavazos, Dowin Boatright

Faculty, Staff and Student Publications

This cross-sectional study examines trends in number of awards and funding of general and diversity F31 predoctoral fellowships from 2001 to 2020.

Low-Dose Immune Tolerance Induction In Children With Severe Hemophilia A With High-Titer Inhibitors: Type Of Factor 8 Mutation And Outcomes, Jie Sun, Zekun Li, Gang Li, Kun Huang, Di Ai, Guoqing Liu, Wanru Yao, Xingjuan Xie, Hao Gu, Yingzi Zhen, Zhenping Chen, Runhui Wu

Faculty, Staff and Student Publications

BACKGROUND: No studies evaluated the role of

OBJECTIVES: To explore the association between

METHODS: Children SHA with high-titer inhibitors who received low-dose ITI therapy at least for 1 year were included in this study. Based on the risk of inhibitor development,

RESULTS: Of 104 children included, 101 had

CONCLUSIONS: Types of

User Satisfaction With Epic/Sunquest Laboratory Information System In A Hospital Laboratory: A Guide For Optimizing Lis User Experience, Aihuan Li

MSMLS Capstone Projects

Abstract

With the development and the increase of using digital information in healthcare system, laboratory information system (LIS) has become a significant part in medical professionals’ job. The topic of assessing users’ satisfaction of using LIS on their job base, is important for the software development and laboratory management to improve the system’s performance.

The aim of this project is twofold. First, it will develop a survey that includes the Questionnaire for User Interaction Satisfaction (QUIS) and case-specific practical questions to evaluate the overall performance of Sunquest/Epic on the base of a clinical laboratory technologist’s job routine. Second, the project …

The Impact Of Age And Sex On Aortic Dissection Outcomes: A True Controversy Or Lack Of Standardization?, Erin F Mccaffrey, Michele Donato, Leeat Keren, Zhenghao Chen, Alea Delmastro, Megan B Fitzpatrick, Sanjana Gupta, Noah F Greenwald, Alex Baranski, William Graf, Rashmi Kumar, Marc Bosse, Christine Camacho Fullaway, Pratista K Ramdial, Erna Forgó, Vladimir Jojic, David Van Valen, Smriti Mehra, Shabaana A Khader, Sean C Bendall, Matt Van De Rijn, Daniel Kalman, Deepak Kaushal, Robert L Hunter, Niaz Banaei, Adrie J C Steyn, Purvesh Khatri, Michael Angelo

Faculty, Staff and Student Publications

Tuberculosis (TB) in humans is characterized by formation of immune-rich granulomas in infected tissues, the architecture and composition of which are thought to affect disease outcome. However, our understanding of the spatial relationships that control human granulomas is limited. Here, we used multiplexed ion beam imaging by time of flight (MIBI-TOF) to image 37 proteins in tissues from patients with active TB. We constructed a comprehensive atlas that maps 19 cell subsets across 8 spatial microenvironments. This atlas shows an IFN-γ-depleted microenvironment enriched for TGF-β, regulatory T cells and IDO1

Ahcc® Supplementation To Support Immune Function To Clear Persistent Human Papillomavirus Infections, Judith A Smith, Anjali A Gaikwad, Lata Mathew, Barbara Rech, Jonathan P Faro, Joseph A Lucci, Yu Bai, Randall J Olsen, Teresa T Byrd

Faculty, Staff and Student Publications

OBJECTIVE: To determine the efficacy, safety, and durability of the use of AHCC supplementation for 6 months to support the host immune system to clear high-risk human papillomavirus (HPV) infections. The AHCC supplement is a proprietary, standardized extract of cultured lentinula edodes mycelia (AHCC

STUDY DESIGN: This was a randomized, double-blind, placebo-controlled study (CTN: NCT02405533) in 50 women over 30 years of age with confirmed persistent high-risk HPV infections for greater than 2 years. Patients were randomized to placebo once daily for 12 months (N = 25) or AHCC 3-g supplementation by mouth once daily on empty stomach for 6 …

Massive Blood Transfusion Practises: A Survey Of Level 1 Trauma Centers, Rebecca C. Parker

DNP Research Projects

Abstract

Background: Traumatic injury is the leading cause of death for individuals under the age of 45 years old, regardless of race, origin, or sex (CDC, 2019). Among patients who sustain traumatic injury, hemorrhage remains the leading cause of death (American College of Surgeons [ACS], 2014). Hemodynamic stability may be achieved through administration of blood products such as packed red blood cells (PRBC), plasma, and platelets (PTL). Patients with severe exsanguination may require administration of blood products in large quantities, also known as a massive blood transfusion (MBT).

Local Problem: Nationally, traumatic injury accounts for over 150,000 deaths annually (American …

Career Transitions: Reflections Of Former Chairs And Academic Health Center Leaders, David N Bailey, L Maximilian Buja, Avrum I Gotlieb, Deborah E Powell, Fred Sanfilippo

Faculty, Staff and Student Publications

The 2022 Association of Pathology Chairs Annual Meeting included a live discussion session and a pre-meeting recorded panel webinar sponsored by the Senior Fellows Group (former chairs of academic departments of pathology who have remained active in the Association of Pathology Chairs). The presentation was focused on transition planning for academic health center leaders. Each of the discussion group panelists had served as a pathology department chair as well as in more senior leadership positions, and they provided perspectives based upon their personal experiences. It was noted that such positions are often "at will" appointments of indeterminate length and that …

Clinicopathological Correlations In Heart Transplantation Recipients Complicated By Death Or Re-Transplantation, Michelle M Mcdonald, Maks Mihalj, Bihong Zhao, Sriram Nathan, Stanislava Matejin, Giulia Ottaviani, Mateja K Jezovnik, Rajko Radovancevic, Biswajit Kar, Igor D Gregoric, L Maximilian Buja

Faculty, Staff and Student Publications

PURPOSE: This study aimed to identify and correlate pathological findings with clinical outcomes in patients after orthotopic heart transplantation (OHT) who either died or underwent a re-transplantation.

METHODOLOGY AND STUDY DESIGN: Single-center retrospective analysis of primary OHT patients who died or were re-transplanted between October 2012 and July 2021. Clinical data were matched with corresponding pathological findings from endomyocardial biopsies on antibody-mediated rejection, cellular rejection, and cardiac allograft vasculopathy. Re-assessment of available tissue samples was performed to investigate acute myocardial injury (AMI) as a distinct phenomenon. These were correlated with clinical outcomes, which included severe primary graft dysfunction. Patients were …

Urinary T Cells Are Detected In Patients With Immune Checkpoint Inhibitor-Associated Immune Nephritis That Are Clonotypically Identical To Kidney T Cell Infiltrates, Shailbala Singh, Leticia C Clemente, Edwin R Parra, Amanda Tchakarov, Chao Yang, Yisheng Li, James P Long, Cassian Yee, Jamie S Lin

Faculty, Staff and Student Publications

Acute kidney injury (AKI) occurs in ~20% of patients receiving immune checkpoint inhibitor (ICI) therapy; however, only 2-5% will develop ICI-mediated immune nephritis. Conventional tests are nonspecific in diagnosing disease pathology and invasive procedures (i.e. kidney biopsy) may not be feasible. In other autoimmune renal diseases, urinary immune cells correlated with the pathology or were predictive of disease activity. Corresponding evidence and analysis are absent for ICI-mediated immune nephritis. We report the first investigation analyzing immune cell profiles of matched kidney biopsies and urine of patients with ICI-AKI. We demonstrated the presence of urinary T cells in patients with immune …