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Full-Text Articles in Nephrology

Horseshoe Kidneys In Transplantation: Underutilization Despite Comparable Quality And Favorable Outcomes: Unos Registry Analysis (2007-2023), Abigail W. Cheng, Samrawi Misiker, Roberto Sagaribay, Kavita Batra Apr 2026

Horseshoe Kidneys In Transplantation: Underutilization Despite Comparable Quality And Favorable Outcomes: Unos Registry Analysis (2007-2023), Abigail W. Cheng, Samrawi Misiker, Roberto Sagaribay, Kavita Batra

School of Medicine Research Poster Showcase

Introduction: Horseshoe kidneys (HSKs) are the most common renal fusion anomaly, occurring in approximately 1 in 500 individuals and often discovered incidentally. Historically excluded from transplantation due to complex anatomy, advances in surgical techniques have made HSK transplantation increasingly feasible. Although successful procurement and transplantation have been described in case reports, national-level data comparing donor characteristics and organ utilization between HSK and non-HSK donors remain limited. This study characterizes donor demographics, clinical profiles, and organ utilization of HSK donors using the United Network for Organ Sharing (UNOS) database.

Methods: A retrospective analysis of the UNOS kidney transplant registry was performed, …


Improving Vaccination In People With Ckd: Report From A National Kidney Foundation Working Group, Susan F. Massengill, Kenneth A. Andreoni, Keith A. Bellovich, Cheryl Courtlandt, Vimal K. Derebail, David L. Feldman, Gia J. Oh, John W. Sleasman, Kristina A. Bryant, Improving Vaccination In Ckd Working Group Mar 2026

Improving Vaccination In People With Ckd: Report From A National Kidney Foundation Working Group, Susan F. Massengill, Kenneth A. Andreoni, Keith A. Bellovich, Cheryl Courtlandt, Vimal K. Derebail, David L. Feldman, Gia J. Oh, John W. Sleasman, Kristina A. Bryant, Improving Vaccination In Ckd Working Group

Department of Surgery Faculty Papers

People with chronic kidney disease (CKD) are particularly vulnerable to vaccine-preventable infections. Therefore, the National Kidney Foundation organized a multidisciplinary working group, including people with CKD and family care partners, to develop recommendations to improve vaccination rates, vaccination effectiveness, and health care for the CKD population. A modified Delphi process was used to achieve consensus on the recommendations. Recommendations on vaccination in CKD patients were organized into these categories: (1) patient preferences; (2) assessing the vaccination status of patients with CKD; (3) assessing vaccine response in patients with CKD; (4) vaccination of immunocompromised patients; (5) vaccination in posttransplant patients; (6) …


From Waitlist To Activation: Exploring Patient Barriers And Team Interactions In Kidney Transplant Readiness, Judith I. Eguzoikpe Feb 2026

From Waitlist To Activation: Exploring Patient Barriers And Team Interactions In Kidney Transplant Readiness, Judith I. Eguzoikpe

Harrisburg University Dissertations and Theses

Kidney transplant candidates frequently experience prolonged inactive waitlist status due to incomplete readiness requirements, yet limited understanding exists regarding how patient barriers and team interactions intersect to influence activation timelines. This transcendental-phenomenological study explored how patient barriers and team dynamics contribute to delays in kidney transplant readiness, guided by Team Theory. Semi-structured interviews were conducted with 16 participants (8 patients, 8 healthcare professionals) between December 2025 and February 2026. Data were analyzed using systematic phenomenological methods to identify patterns that address patient barriers, team interaction effects, and the teamwork improvements needed for earlier activation. Five interconnected themes emerged: Navigating a …


Association Of Perioperative Factors With Lymph Node Positivity In Bladder Cancer Following Radical Cystectomy, Alyssa Laguerta, Kimberly Toumazos, Virgil Kevin Demario, Vaishnavi Patel, Balaji Reddy, Mark Quiring, Evan Jones, Young Son, Ronald Clearie, Thomas Mueller May 2025

Association Of Perioperative Factors With Lymph Node Positivity In Bladder Cancer Following Radical Cystectomy, Alyssa Laguerta, Kimberly Toumazos, Virgil Kevin Demario, Vaishnavi Patel, Balaji Reddy, Mark Quiring, Evan Jones, Young Son, Ronald Clearie, Thomas Mueller

Rowan-Virtua Research Day

Introduction and objectives: The treatment of bladder carcinoma relies on a multimodal approach, including chemotherapy, radical cystectomy, and lymph node dissection, but clear guidelines for the optimal strategy remain ambiguous. Radical cystectomy is complex, with high morbidity and mortality, yet limited research has focused on its short-term implications for lymph node-positive bladder cancer. This study aims to address these gaps by identifying perioperative factors linked to lymph node positivity and comparing outcomes between lymph node-positive and negative patients.

Methods: We conducted a retrospective analysis of 4382 bladder cancer patients who underwent radical cystectomy, collecting comprehensive clinical and surgical data. Clinical …


Impact The Utilization Of Evidenced Based Practices Has On Post Kidney Transplant Patient Outcomes, Judith Bautista, Vicky Loren Dela Cruz, Ervieneth Martin, Jennifer Mauricio, Alf Bernardino May 2025

Impact The Utilization Of Evidenced Based Practices Has On Post Kidney Transplant Patient Outcomes, Judith Bautista, Vicky Loren Dela Cruz, Ervieneth Martin, Jennifer Mauricio, Alf Bernardino

Covenant Nurses Week 2025

No abstract provided.


Evaluation Of Short-Term Complications In Laparoscopic Peritoneal Dialysis Catheter Placement - A Single Tertiary Center Experience, Cristina Raluca Iorga, Iuliana Andreiana, Simona Hildegrad Stancu, Traian Constantin, Victor Strambu, Cristian Iorga Oct 2024

Evaluation Of Short-Term Complications In Laparoscopic Peritoneal Dialysis Catheter Placement - A Single Tertiary Center Experience, Cristina Raluca Iorga, Iuliana Andreiana, Simona Hildegrad Stancu, Traian Constantin, Victor Strambu, Cristian Iorga

Journal of Mind and Medical Sciences

Background. Peritoneal dialysis is a form of kidney function replacement that is not as widespread as hemodialysis. However, it has recognized advantages, such as preservation of residual renal function, lack of vascular access, and the ability to be performed at home. On the other hand, it requires the correct insertion of a peritoneal dialysis (PD) catheter and maintaining its patency. Methods. We conducted a retrospective study of 126 patients with end-stage renal disease who underwent laparoscopic Tenckhoff catheter placement for peritoneal dialysis between January 2016 and December 2022. The study analyzed the frequency and type of complications registered within three …


Salvage Of A Kidney Transplant With A Mycotic Extrarenal Pseudoaneursym Using Donor Vessels, Audrey Horn, Kelli L. Summers, William Fuell, Adarsh Vijay, Hoonbae Jeon, Melissa Donovan, Kiara Tulla, Anil Paramesh Jul 2024

Salvage Of A Kidney Transplant With A Mycotic Extrarenal Pseudoaneursym Using Donor Vessels, Audrey Horn, Kelli L. Summers, William Fuell, Adarsh Vijay, Hoonbae Jeon, Melissa Donovan, Kiara Tulla, Anil Paramesh

School of Medicine Faculty Publications

A 63-year-old male developed a mycotic pseudoaneurysm (MPA) two months after a renal transplant at the anastomotic site. He presented with uncontrolled hypertension and elevated creatinine. The pseudoaneurysm occurred at the anastomosis between the two donor renal arteries and the left external iliac artery. We describe a unique surgical reconstruction where the MPA was resected and the vasculature was reconstructed using deceased donor vessels. A deceased donor common iliac artery including superior gluteal and inferior gluteal branches were used as a jump graft from the contralateral common iliac artery to the two transplanted renal arteries. The external iliac artery was …


A Modified Switching Procedure From Temporary To Tunneled Central Venous Dialysis Catheters, Johannes Eberhard, Constantin Bedau, Andrew Genius Chapple, Julia Klein, Christoph Reissfelder, Anna Isabelle Kaelsch, Andreas Lutz Heinrich Gerken, Sebastian Zach, Kay Schwenke Jun 2024

A Modified Switching Procedure From Temporary To Tunneled Central Venous Dialysis Catheters, Johannes Eberhard, Constantin Bedau, Andrew Genius Chapple, Julia Klein, Christoph Reissfelder, Anna Isabelle Kaelsch, Andreas Lutz Heinrich Gerken, Sebastian Zach, Kay Schwenke

School of Medicine Faculty Publications

Background: Tunneled central venous catheters are commonly used for dialysis in patients without a functional permanent vascular access. In an emergent setting, a non-tunneled, temporary central venous catheter is often placed for immediate dialysis. The most critical step in the catheter insertion is venipuncture, which is often a major cause for longer intervention times and procedure-related adverse events. To avoid this critical step when placing a more permanent tunneled catheter, an exchange over a previously placed temporary one can be considered. In this paper, we present a modified switching approach with a separate access site. Methods: In this retrospective analysis …


Evaluating Serum Copper And Kidney Function In A Cohort Of Bariatric Surgery Patients, Katherine Mckeon, Mchael Cook, John Baker, Kyle Lapenna, Hua He, Amanda Anderson, Felicia Rabito Apr 2024

Evaluating Serum Copper And Kidney Function In A Cohort Of Bariatric Surgery Patients, Katherine Mckeon, Mchael Cook, John Baker, Kyle Lapenna, Hua He, Amanda Anderson, Felicia Rabito

School of Medicine Faculty Publications

Association for Clinical and Translational Science 2024; April 3 - April 5, 2024; Las Vegas, NV


The Utility Of Interventional Anesthesia, Kylie Daguio, Kiley Jackson, Samantha Boever, Andrew Chang, James Keane, Leonard B. Goldstein Mar 2024

The Utility Of Interventional Anesthesia, Kylie Daguio, Kiley Jackson, Samantha Boever, Andrew Chang, James Keane, Leonard B. Goldstein

SOMA Faculty Publications

no abstract


Advancing Virtual At-Home Care For Community Health Center Patients Using Patient Self-Care Tools, Technology, And Education [Letter], Cheryl Modica, Joy H. Lewis, Curtis Bay Feb 2024

Advancing Virtual At-Home Care For Community Health Center Patients Using Patient Self-Care Tools, Technology, And Education [Letter], Cheryl Modica, Joy H. Lewis, Curtis Bay

SOMA Faculty Publications

Abstract

Introduction

Health centers are community-based, patient directed primary care providers that offer accessible, high-quality primary care within medically underserved communities. Screening for cancer and managing complex chronic conditions such as diabetes, hypertension, obesity, and depression are vital services for the vulnerable populations seen by community health centers. Delivering care for complex chronic conditions and preventive services using virtual models that integrate self-care tools and technology is an important approach to increasing access for hard-to-reach patients served by health centers.

Objective

This study aimed to explore the use of a virtual care model, applied using a systems approach and patient-driven …


Impact Of Tiered Implementation Of Clinical Decision Support System For Acute Kidney Injury And Nephrotoxin Exposure In Cardiac Surgery Patients, Christopher M. Justice Ii Jan 2024

Impact Of Tiered Implementation Of Clinical Decision Support System For Acute Kidney Injury And Nephrotoxin Exposure In Cardiac Surgery Patients, Christopher M. Justice Ii

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Nephrotoxin exposure may worsen kidney injury and impair kidney recovery if continued in patients with acute kidney injury (AKI).

Objective: To determine if tiered implementation of a clinical decision support system (CDSS) would reduce nephrotoxin use in cardiac surgery patients with AKI.

Methods: We assessed patients admitted to the cardiac surgery intensive care unit at a tertiary care center from January 2020 to December 2021, and August 2022 to September 2023. A passive electronic AKI alert was activated in Jul 2020, followed by an electronic nephrotoxin alert in March 2023. In this alert, active nephrotoxic medication orders resulted in …


Bridging The Gap: Assessing Cmv Dnaemia In Kidney Transplant Recipients With Previous Solid Organ Transplants, Goni Katz-Greenberg, Julie M Steinbrink, Krishna Shah, Jennifer S Byrns Jan 2024

Bridging The Gap: Assessing Cmv Dnaemia In Kidney Transplant Recipients With Previous Solid Organ Transplants, Goni Katz-Greenberg, Julie M Steinbrink, Krishna Shah, Jennifer S Byrns

Faculty, Staff and Students Publications

Cytomegalovirus (CMV) infection poses a significant threat to solid organ transplant (SOT) recipients and can lead to various complications and adverse outcomes. In an effort to prevent CMV infection, it is common to utilize prophylactic strategies, including antiviral medications such as valganciclovir, especially for high-risk patients. Risk factors for CMV infection in kidney transplant recipients (KTRs) include CMV mismatch between donor and recipient (i.e., donor positive, recipient negative), and intensity of immunosuppression, such as the use of T-cell depleting agents. However, little attention has been given to KTRs with a history of prior SOTs, despite their prolonged exposure to immunosuppressive …


Revolutionizing Psoriasis Topical Treatment: Enhanced Efficacy Through Ceramide/Phospholipid Composite Cerosomes Co-Delivery Of Cyclosporine And Dithranol: In-Vitro, Ex-Vivo, And In-Vivo Studies, Sammar Fathy Elhabal, Nashwa Abdelaal, Saeed A S Al-Zuhairy, Mohamed Fathi Mohamed Elrefai, Mohamed Mansour Khalifa, Mohammad Ahmad Khasawneh, Ahmed Mohsen Elsaid Hamdan, Passant M Mohie, Rania A Gad, Soad L Kabil, Mohamed Kandeel El-Ashery, Bhaskara R Jasti, Nahla A Elzohairy, Nehal Elfar, Tayseer Elnawawy, Fatma E Hassan, Mohamed Ahmed El-Nabarawi Jan 2024

Revolutionizing Psoriasis Topical Treatment: Enhanced Efficacy Through Ceramide/Phospholipid Composite Cerosomes Co-Delivery Of Cyclosporine And Dithranol: In-Vitro, Ex-Vivo, And In-Vivo Studies, Sammar Fathy Elhabal, Nashwa Abdelaal, Saeed A S Al-Zuhairy, Mohamed Fathi Mohamed Elrefai, Mohamed Mansour Khalifa, Mohammad Ahmad Khasawneh, Ahmed Mohsen Elsaid Hamdan, Passant M Mohie, Rania A Gad, Soad L Kabil, Mohamed Kandeel El-Ashery, Bhaskara R Jasti, Nahla A Elzohairy, Nehal Elfar, Tayseer Elnawawy, Fatma E Hassan, Mohamed Ahmed El-Nabarawi

Faculty, Staff and Students Publications

PURPOSE: Improving the treatment of psoriasis is a serious challenge today. Psoriasis is an immune-mediated skin condition affecting 125 million people worldwide. It is commonly treated with cyclosporine-A (CsA) and dithranol (DTH). CsA suppresses the activation of T-cells, immune cells involved in forming psoriatic lesions. Meanwhile, DTH is a potent anti-inflammatory and anti-proliferative drug that effectively reduces the severity of psoriasis symptoms such as redness, scaling, and skin thickness. CsA and DTH belong to BCS class II with limited oral bioavailability. We aim to develop a drug delivery system for topical co-delivery of CsA and DTH, exploring its therapeutic potential. …


Pre-Clinical Protective Potentials Of Carica Papaya Constituents In Experimentally Induced Anemia, Hassan Abdulsalam Adewuyi, Adamu Yusuf Kabiru, Hadiza Lami Muhammad, Halimat Yusuf Lukman, Mayowa Solomon Owolabi, Ibrahim Jonathan, Ahmed M El-Gazzar, Mohamed H Mahmoud, Gaber El-Saber Batiha, Bashir Lawal Jan 2024

Pre-Clinical Protective Potentials Of Carica Papaya Constituents In Experimentally Induced Anemia, Hassan Abdulsalam Adewuyi, Adamu Yusuf Kabiru, Hadiza Lami Muhammad, Halimat Yusuf Lukman, Mayowa Solomon Owolabi, Ibrahim Jonathan, Ahmed M El-Gazzar, Mohamed H Mahmoud, Gaber El-Saber Batiha, Bashir Lawal

Faculty, Staff and Students Publications

OBJECTIVE: Anemia is a pathological condition characterized by reduced oxygen bioavailability and/or changes in hematological parameters. This study investigated the anti-anemic activities of

METHOD: Twenty-seven rats were randomized into nine groups of three rats as follows; group 1 was the normal (non-induced) group, 2-9 were anemic rats administered 1 mL distilled water, standard drug (3 mg/kg body weight (bw) ferrous sulphate), 100, 300 and 500 mg/kg bw of crude methanolic extract of CP (CMECP) of the leaf and 100, 300 and 500 mg/kg bw of CMECP of the seed respectively in the first stage of the study. In the second …


Machine Learning For Dynamic And Early Prediction Of Acute Kidney Injury After Cardiac Surgery, Christopher T Ryan, Zijian Zeng, Subhasis Chatterjee, Matthew J Wall, Marc R Moon, Joseph S Coselli, Todd K Rosengart, Meng Li, Ravi K Ghanta Dec 2023

Machine Learning For Dynamic And Early Prediction Of Acute Kidney Injury After Cardiac Surgery, Christopher T Ryan, Zijian Zeng, Subhasis Chatterjee, Matthew J Wall, Marc R Moon, Joseph S Coselli, Todd K Rosengart, Meng Li, Ravi K Ghanta

Faculty, Staff and Students Publications

OBJECTIVE: Acute kidney injury after cardiac surgery increases morbidity and mortality. Diagnosis relies on oliguria or increased serum creatinine, which develop 48 to 72 hours after injury. We hypothesized machine learning incorporating preoperative, operative, and intensive care unit data could dynamically predict acute kidney injury before conventional identification.

METHODS: Cardiac surgery patients at a tertiary hospital (2008-2019) were identified using electronic medical records in the Medical Information Mart for Intensive Care IV database. Preoperative and intraoperative parameters included demographics, Charlson Comorbidity subcategories, and operative details. Intensive care unit data included hemodynamics, medications, fluid intake/output, and laboratory results. Kidney Disease: Improving …


Prevalence Of Central Venous Stenosis Among Black And White Eskd Patients With Dysfunctional Dialysis Access, Vipul Chitalia Md, Jonathan Ravid, Arinze Nkiruka, Kristina Yamkovoy, Matthew Diamond, Rohit Pillai, Tyler J. Ryan, Saran Lotfollahzadeh, Janice Weinberg, Alik Farber, Rajendran Vivendhan, Jean Francis, Nathanael Fillmore, Najia Idrees Nov 2023

Prevalence Of Central Venous Stenosis Among Black And White Eskd Patients With Dysfunctional Dialysis Access, Vipul Chitalia Md, Jonathan Ravid, Arinze Nkiruka, Kristina Yamkovoy, Matthew Diamond, Rohit Pillai, Tyler J. Ryan, Saran Lotfollahzadeh, Janice Weinberg, Alik Farber, Rajendran Vivendhan, Jean Francis, Nathanael Fillmore, Najia Idrees

Journal of Health Disparities Research and Practice

In the United States, significant racial and ethnic disparities exist in chronic kidney disease (CKD) and its management. Hemodialysis constitutes the main stay of renal replacement therapy for end-stage kidney disease (ESKD), which is initiated using central venous catheters (CVC) in most CKD patients in the United States. Black ESKD patients have higher usage and greater time on CVC for hemodialysis compared to White patients. This trend places Black patients at a potentially higher risk for CVC-related complications such as central venous stenosis (CVS). We posited that Black patients would have a higher prevalence and a greater risk of CVS. …


Assessing Kidney Transplantation Using Ecmo-Supported Donors Within A Kdpi-Based Allocation System, Peter J. Altshuler, Devon J. Pace, William A. Preston, Sage Vincent, Ashesh P. Shah, Jaime M. Glorioso, Warren R. Maley, Adam M. Frank, Carlo B. Ramirez, Sharon West, Richard Hasz Jr., Adam S. Bodzin Oct 2023

Assessing Kidney Transplantation Using Ecmo-Supported Donors Within A Kdpi-Based Allocation System, Peter J. Altshuler, Devon J. Pace, William A. Preston, Sage Vincent, Ashesh P. Shah, Jaime M. Glorioso, Warren R. Maley, Adam M. Frank, Carlo B. Ramirez, Sharon West, Richard Hasz Jr., Adam S. Bodzin

Department of Surgery Faculty Papers

Background.

Organ donors supported by extracorporeal membrane oxygenation (ECMO) have historically been considered high-risk and are judiciously utilized. This study examines transplant outcomes using renal allografts from donors supported on ECMO for nondonation purposes.

Methods.

Retrospective review of the Gift of Life (Pennsylvania, New Jersey, Delaware) organ procurement organization database, cross-referenced to the Organ Procurement and Transplantation Network database, assessed kidney transplants using donors supported on venoarterial (VA) and venovenous (VV) ECMO for nondonation purposes. Transplants using VA- and VV-ECMO donors were compared with Kidney Donor Profile Index (KDPI)-stratified non-ECMO donors. Regression modeling of the entire ECMO and non-ECMO populations …


Use Of Point Of Care Ultrasound In The Pre-Op Evaluation Of Dialysis Patients Needing Creation Of Permanent Arteriovenous Access – Preliminary Study, Urvashi Mathur, Sotero Peralta Oct 2023

Use Of Point Of Care Ultrasound In The Pre-Op Evaluation Of Dialysis Patients Needing Creation Of Permanent Arteriovenous Access – Preliminary Study, Urvashi Mathur, Sotero Peralta

Research Colloquium

Background: Non-invasive ultrasound evaluation is part of the preoperative evaluation of patients needing creation of arteriovenous access. This study requires patients to return for an additional visit for imaging or visit an outpatient imaging facility. These visits produce delays in surgery and increase costs in healthcare. Point of care ultrasound examination at the same time of initial physician visit, allows to decrease cost, improvement of anatomical planning, and decrease timing of surgery.

Methods: We reviewed the UTRGV Vascular Surgery Database from January to December 2020, for patients who has elective outpatient arteriovenous access creation, in which has pre-operative evaluation with …


Penile Calciphylaxis In An End Stage Renal Disease Patient., Juan Enrique Garcia Lopez, Alain Velazquez Blanco, Aileen Aguilar, Sareena Siyas, Daniel Ibarias Paz, Mays Abdulazeez, Jesus Garza-Tamez, Desmond Adamu Oct 2023

Penile Calciphylaxis In An End Stage Renal Disease Patient., Juan Enrique Garcia Lopez, Alain Velazquez Blanco, Aileen Aguilar, Sareena Siyas, Daniel Ibarias Paz, Mays Abdulazeez, Jesus Garza-Tamez, Desmond Adamu

Research Colloquium

Background: Penile Calciphylaxis occurs in about 1–4% of hemodialysis patients worldwide. Associated mortality rates are very high, and hyperparathyroidism is the second most frequently associated disorder. Addressing the resulting metabolic imbalance, and surgical intervention guided by findings of radiological studies may improve quality of life. The pathogenesis is thought to be mediated by vascular smooth muscle cells which differentiate into osteoblast-like cells. Decrease in vascular calcification inhibitory proteins fetuin-A and matrix Gla is found in patients on dialysis causing systemic medial calcification of arterioles, leading to epidermal ischemia, tissue infarction, and ulceration.

Case presentation: 47-year-old male with history of coronary …


Distinguishing Renal Cell Carcinoma From Normal Kidney Tissue Using Mass Spectrometry Imaging Combined With Machine Learning, Vishnu Shankar, Kanchustambham Vijayalakshmi, Rosalie Nolley, Geoffrey A Sonn, Chia-Sui Kao, Hongjuan Zhao, Ru Wen, Livia S Eberlin, Robert Tibshirani, Richard N Zare, James D Brooks Jun 2023

Distinguishing Renal Cell Carcinoma From Normal Kidney Tissue Using Mass Spectrometry Imaging Combined With Machine Learning, Vishnu Shankar, Kanchustambham Vijayalakshmi, Rosalie Nolley, Geoffrey A Sonn, Chia-Sui Kao, Hongjuan Zhao, Ru Wen, Livia S Eberlin, Robert Tibshirani, Richard N Zare, James D Brooks

Faculty, Staff and Students Publications

PURPOSE: Accurately distinguishing renal cell carcinoma (RCC) from normal kidney tissue is critical for identifying positive surgical margins (PSMs) during partial and radical nephrectomy, which remains the primary intervention for localized RCC. Techniques that detect PSM with higher accuracy and faster turnaround time than intraoperative frozen section (IFS) analysis can help decrease reoperation rates, relieve patient anxiety and costs, and potentially improve patient outcomes.

MATERIALS AND METHODS: Here, we extended our combined desorption electrospray ionization mass spectrometry imaging (DESI-MSI) and machine learning methodology to identify metabolite and lipid species from tissue surfaces that can distinguish normal tissues from clear cell …


Refractory Thrombocytopenia During Liver Transplantation Requiring Splenectomy, Ivana Wrobleski Wilder, Alexander Reskallah, Catherine M Pivalizza, John S Bynon, Evan G Pivalizza Jan 2023

Refractory Thrombocytopenia During Liver Transplantation Requiring Splenectomy, Ivana Wrobleski Wilder, Alexander Reskallah, Catherine M Pivalizza, John S Bynon, Evan G Pivalizza

Faculty, Staff and Student Publications

Although thrombocytopenia is common in end-stage liver disease, severe, refractory thrombocytopenia during liver transplantation is rare, and if immune based, usually presents months or years later. This case describes an adult woman in whom preoperative evaluation had not determined an immune-related cause of thrombocytopenia. Clot strength was dramatically impaired as measured by thrombelastography during the transplant. Following a lack of response to repeat platelet transfusions, splenectomy was performed after graft reperfusion with rapid temporal restoration of clot strength. This case shows a severe manifestation of perioperative thrombocytopenia during liver transplantation and clinically guided management when measured clot strength is too …


Epigenetic Basis Of Diabetic Vasculopathy, Theja Bhamidipati, Manishekhar Kumar, Sumit S. Verma, Sedat Kacar, Diamond Reese, Michelle M. Martinez, Malgorzata M. Kamocka, Kenneth W. Dunn, Chandan K. Sen, Kanhaiya Singh Dec 2022

Epigenetic Basis Of Diabetic Vasculopathy, Theja Bhamidipati, Manishekhar Kumar, Sumit S. Verma, Sedat Kacar, Diamond Reese, Michelle M. Martinez, Malgorzata M. Kamocka, Kenneth W. Dunn, Chandan K. Sen, Kanhaiya Singh

Einstein Health Papers

Type 2 diabetes mellitus (T2DM) causes peripheral vascular disease because of which several blood-borne factors, including vital nutrients fail to reach the affected tissue. Tissue epigenome is sensitive to chronic hyperglycemia and is known to cause pathogenesis of micro- and macrovascular complications. These vascular complications of T2DM may perpetuate the onset of organ dysfunction. The burden of diabetes is primarily because of a wide range of complications of which nonhealing diabetic ulcers represent a major component. Thus, it is imperative that current research help recognize more effective methods for the diagnosis and management of early vascular injuries. This review addresses …


The Lawnmower And The Pediatric Lower Extremity: A Catastrophic Combination, Alvaro Tamayo-Gutierrez, Hassan N Ibrahim Sep 2022

The Lawnmower And The Pediatric Lower Extremity: A Catastrophic Combination, Alvaro Tamayo-Gutierrez, Hassan N Ibrahim

Faculty, Staff and Student Publications

Heart failure can lead to renal impairment, an interaction now termed "cardiorenal syndrome." The prevalent physiological explanation for the renal impairment that accompanies heart failure centers around the forward failure hypothesis, which emphasizes the role of left ventricular dysfunction in causing edema, and the backward failure hypothesis, which singles out venous congestion as the dominant mechanism of edema and reduced glomerular filtration rate. In this review, we provide an appraisal on venous congestion, an extremely important contributor that has received little attention. We also summarize the pharmacology of loop diuretics, explain current understanding of diuretic resistance, and address controversies regarding …


Hypertension Management In Patients With Chronic Kidney Disease, Sean A Hebert, Hassan N Ibrahim Sep 2022

Hypertension Management In Patients With Chronic Kidney Disease, Sean A Hebert, Hassan N Ibrahim

Faculty, Staff and Student Publications

Hypertension and chronic kidney disease are closely linked. Patients with chronic kidney disease have hypertension almost universally and uncontrolled hypertension accelerates the decline in kidney function. The pathophysiology of hypertension in chronic kidney disease is complex, but is largely related to reduced nephron mass, sympathetic nervous system overactivation, involvement of the renin-angiotensin-aldosterone system, and generalized endothelial dysfunction. Consensus guidelines for blood pressure targets have adopted a blood pressure <120/80 mm Hg in native chronic kidney disease and <130/80 mm Hg in kidney transplant recipients. Guidelines also strongly advocate for renin-angiotensin-aldosterone system blockade as the first-line therapy.


Fatal Case Of Ebv-Negative Posttransplant Lymphoproliferative Disorder With Hemophagocytic Lymphohistiocytosis In An Adult Kidney Transplant Recipient, Sergio Mazzola Poli De Figueiredo, John C Johnson, Kirill A Lyapichev, Heather L Stevenson, Alfred Lea, Syed Hussain, Rupak D Kulkarni, Jeffrey H Fair, Muhammad Mujtaba, Mike L Kueht Sep 2022

Fatal Case Of Ebv-Negative Posttransplant Lymphoproliferative Disorder With Hemophagocytic Lymphohistiocytosis In An Adult Kidney Transplant Recipient, Sergio Mazzola Poli De Figueiredo, John C Johnson, Kirill A Lyapichev, Heather L Stevenson, Alfred Lea, Syed Hussain, Rupak D Kulkarni, Jeffrey H Fair, Muhammad Mujtaba, Mike L Kueht

Faculty, Staff and Student Publications

Renal transplantation usually requires the administration of lifelong immunosuppressive therapy to minimize rejection.1 However, while these immunosuppressants are vital to graft protection, they increase the risk of infection and malignancy. Posttransplant lymphoproliferative disorder (PTLD), a troublesome combination of both, covers a wide range of lymphomas, most commonly B-cell type and has been described in pediatric and adult patients.2 Risk factors for PTLD include Epstein-Barr virus (EBV) infection and immunosuppression and the prevalence of adult kidney transplant PTLD is estimated to be 0.5% to 4%, with the highest incidences occurring within the first year of transplant.2-5 …


Factors Associated With Unplanned Conversion To Open In Nephrectomy For Kidney Cancer, Young Son, Benjamin A. Fink, Justine Garfinkel, Lance Earnshaw, Brian Thomas, Thomas Mueller, David Sussman May 2022

Factors Associated With Unplanned Conversion To Open In Nephrectomy For Kidney Cancer, Young Son, Benjamin A. Fink, Justine Garfinkel, Lance Earnshaw, Brian Thomas, Thomas Mueller, David Sussman

Rowan-Virtua Research Day

Minimally invasive surgery (MIS) has been adopted as an approach in kidney surgery. Laparoscopic kidney surgery has been introduced in the 1990s with robotics emerging a decade after. The minimally invasive approach has been technically feasible and has been shown to be noninferior with preserved oncology standards to open surgery. The ubiquitous use of MIS for kidney cancer has been standard of practice; however, unplanned conversion to open kidney surgery has been characterized at 4.9% for laparoscopic radical nephrectomy compared to 6.0% in robotic radical nephrectomy. Another analysis of 54,246 patients undergoing partial nephrectomy for kidney cancer observed an unplanned …


Transplantability In Burdened Populations: A Regional Analysis Of The Robotic-Assisted Kidney Transplant Impact On Access Given Socioeconomic And Demographic Factors, Earnest James Davis Jr. May 2022

Transplantability In Burdened Populations: A Regional Analysis Of The Robotic-Assisted Kidney Transplant Impact On Access Given Socioeconomic And Demographic Factors, Earnest James Davis Jr.

Dissertations

Introduction/Background

The social contract of health (SCOH) in America that governs healthcare interactions has listed toward provider organizations and away from the patient. End stage renal disease treatment provides an explicatory case to examine an unbalanced SCOH. The study evaluates whether the robot-assisted kidney transplantation (RAKT) technique allows for patients with higher body mass indices and of burdened socioeconomic and sociodemographic status improved access to transplant compared to traditional open kidney transplant (OKT).

Methods

The study set combined extant data for patients transplanted at Chicago from two data sets. Investigators used independent t-tests, chi-squared tests, survival analysis, analysis of frequencies, …


Kidney Disease After Heart And Lung Transplantation, Carlos M Zapata, Hassan N Ibrahim Jan 2022

Kidney Disease After Heart And Lung Transplantation, Carlos M Zapata, Hassan N Ibrahim

Faculty, Staff and Student Publications

Chronic kidney disease (CKD) is not only common after lung and heart transplantation but also is associated with increased morbidity and mortality due to multiple pre-, peri- and post-transplant factors. While the exact incidence of CKD in this population is not well-defined, it seems to have gradually increased over the years as older recipients are more frequently considered. The increasing success of the procedure and expanding transplant candidate pool has allowed many with comorbid conditions to receive a transplant, which was considered prohibitive in the past. This review presents risk factors that have been linked to CKD as well as …


Nonrecurrent Early Post-Transplantation Focal Segmental Glomerulosclerosis., Momina M Ahmed, Massini A Merzkani, Matthew R D'Costa, Muhannad A Leghrouz, Mary E Fidler, Haraldur Bjarnason, Patrick G Dean, Fernando C Fervenza, Sanjit Reddy, Hatem Amer Sep 2020

Nonrecurrent Early Post-Transplantation Focal Segmental Glomerulosclerosis., Momina M Ahmed, Massini A Merzkani, Matthew R D'Costa, Muhannad A Leghrouz, Mary E Fidler, Haraldur Bjarnason, Patrick G Dean, Fernando C Fervenza, Sanjit Reddy, Hatem Amer

Articles, Abstracts, and Reports

No abstract provided.