Research Topics
Genomes and GenesSpecies | Rakesh SindhiSummaryAffiliation: Children's Hospital of Pittsburgh Country: USA Publications
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Publications
Allospecific CD154 + T-cytotoxic memory cells as potential surrogate for rejection risk in pediatric intestine transplantationRakesh Sindhi
Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, PA 15224, USA
Pediatr Transplant 16:83-91. 2012..rATG. Rejection-risk assessment with CD154 + TcM may enable informed immunosuppression minimization, and preliminary efficacy comparisons in pediatric ITx...
Reduced immunosuppression in pediatric liver-intestine transplant recipients with CD8+CD28- T-suppressor cellsRakesh Sindhi
Division of Transplantation, University of Pittsburgh, Pittsburgh, PA 15213, USA
Hum Immunol 66:252-7. 2005..Such assays may also permit safe evaluation of prospective immunosuppression withdrawal strategies...
Replacing calcineurin inhibitors with mTOR inhibitors in childrenRakesh Sindhi
Children s Hospital of Pittsburgh and the University of Pittsburgh, Pittsburgh, PA 15217, USA
Pediatr Transplant 9:391-7. 2005..Improvement in renal function and hypertension management, and absence of sirolimus-related adverse events argue for prospective evaluation of regimens in which mTOR inhibitors are used without calcineurin inhibitors in children...
Immune monitoring in small bowel transplantationRakesh Sindhi
Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
Curr Opin Organ Transplant 15:349-56. 2010..Immune monitoring is needed in small bowel transplantation (SBTx) because of a high incidence of rejection and graft loss, and life-threatening complications of high-dose prophylactic immunosuppression...
Enhanced donor-specific alloreactivity occurs independently of immunosuppression in children with early liver rejectionRakesh Sindhi
Thomas E Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA
Am J Transplant 5:96-102. 2005..This is accompanied by a cytotoxic T-cell sub-population with increased requirement for TAC...
Multiparametric effect: concentration analysesRakesh Sindhi
Department of Pediatric Transplantation, Children s Hospital of Pittsburgh, and the University of Pittsburgh, Pittsburgh, PA 15213, USA
Front Biosci 9:1218-21. 2004..The potential implications of these models crystallize the clinical challenges confronting practitioners of clinical, post-transplant immunosuppression...
Cellular alloresponses for rejection-risk assessment after pediatric transplantationRakesh Sindhi
Children s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA, USA
Curr Opin Organ Transplant 16:515-21. 2011..We review the use of mixed lymphocyte coculture-based assays that measure cellular alloresponses, for measurement of the risk of ACR after liver, intestine, and kidney transplantation...
Genetic variants in major histocompatibility complex-linked genes associate with pediatric liver transplant rejectionRakesh Sindhi
Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
Gastroenterology 135:830-9, 839.e1-10. 2008....
Lymphocyte subset reconstitution patterns in children with small bowel transplantation induced with steroid-free rabbit anti-human thymocyte globulinAnjan J Talukdar
Pediatric Transplantation Laboratory, Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh, PA, USA
Pediatr Transplant 13:353-9. 2009..Rejection-prone children also demonstrate significantly higher counts of total lymphocytes, Tc and NK cells prior to SBTx, and may illustrate one basis for enhanced baseline immunocompetence...
Lymphoproliferative disorders and de novo malignancies in intestinal and multivisceral recipients: improved outcomes with new outlooksKareem M Abu-Elmagd
Department of Surgery, Thomas E Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, PA 15213, USA
Transplantation 88:926-34. 2009..To improve outcome, innovative management and immunosuppressant strategies were sequentially evolved...
Evolution of the immunosuppressive strategies for the intestinal and multivisceral recipients with special reference to allograft immunity and achievement of partial toleranceKareem M Abu-Elmagd
Intestinal Rehabilitation and Transplantation Center, Thomas E Starzl Transplantation Institute, University of Pittsburgh Medical Center, PA, USA
Transpl Int 22:96-109. 2009....
Elevated myeloid: plasmacytoid dendritic cell ratio associates with late, but not early, liver rejection in children induced with rabbit anti-human thymocyte globulinAnkit Gupta
Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15217, USA
Transplantation 88:589-94. 2009..Dendritic cells (DC) play an important role in the induction and regulation of immune responses...
Five hundred intestinal and multivisceral transplantations at a single center: major advances with new challengesKareem M Abu-Elmagd
Thomas E Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
Ann Surg 250:567-81. 2009..To assess the evolution of visceral transplantation in the milieu of surgical technical modifications, new immunosuppressive protocols, and other management strategies...
Proliferative alloresponse of T-cytotoxic cells identifies rejection-prone children with steroid-free liver transplantationChethan Ashokkumar
Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh, Pittsburgh, PA, USA
Liver Transpl 15:978-85. 2009..630, P = 0.007). In conclusion, proliferative alloresponses of Tc cells can identify rejection-prone children receiving LTx. Liver Transpl 15:978-985, 2009. (c) 2009 AASLD...
Proliferative alloresponse of T cytotoxic cells identifies rejection-prone children with small bowel transplantationChethan Ashokkumar
Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15213, USA
Transplantation 89:1371-7. 2010..More than 60% children with small bowel transplantation (SBTx) experience acute cellular rejection...
NOD2 gene polymorphism rs2066844 associates with need for combined liver-intestine transplantation in children with short-gut syndromeMylarappa Ningappa
Hillman Center for Pediatric Transplantation, University of Pittsburgh, Pittsburgh, Pennsylvania 15224, USA
Am J Gastroenterol 106:157-65. 2011....
Allospecific CD154+ B cells associate with intestine allograft rejection in childrenChethan Ashokkumar
Department of Surgery, Children s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
Transplantation 90:1226-31. 2010....
Mucosal plasma cell barrier disruption during intestine transplant rejectionMylarappa Ningappa
Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh of the University of Pittsburgh Medical Center UPMC, Pittsburgh, PA, USA
Transplantation 94:1236-42. 2012..Intestinal allograft mucosa undergoes repopulation with host immunocytes. However, critical changes within key immunocyte subsets are not known...
Long-term survival, nutritional autonomy, and quality of life after intestinal and multivisceral transplantationKareem M Abu-Elmagd
Thomas E Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
Ann Surg 256:494-508. 2012..To assess long-term survival, graft function, and health-related quality of life (QOL) after visceral transplantation...
Allospecific CD154+ T cells identify rejection-prone recipients after pediatric small-bowel transplantationChethan Ashokkumar
Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh, Pittsburgh, PA 15213, USA
Surgery 146:166-73. 2009..Allospecific CD154+ T cells predict liver ACR in children in a novel, 16-hour mixed leukocyte response (MLR) assay, but remain untested in SBTx...
Evolutionary experience with immunosuppression in pediatric intestinal transplantationGeoffrey J Bond
Thomas E Starzl Transplantation Institute, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
J Pediatr Surg 40:274-9; discussion 279-80. 2005..The patients still remain challenging and complex in every aspect; however, these advances offer significant hope to both patients and caregivers alike...
Increased monocyte expression of sialoadhesin during acute cellular rejection and other enteritides after intestine transplantation in childrenChethan Ashokkumar
Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh, and the University of Pittsburgh, Pittsburgh, PA, USA
Transplantation 93:561-4. 2012..Monocyte-derived macrophages prime acute cellular rejection after intestine transplantation (ITx).The purpose of this study was to evaluate whether CD169-expressing activated monocytes associate with or predict ITx rejection...
Pediatric small bowel transplantationNavdeep Nayyar
Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Semin Pediatr Surg 19:68-77. 2010..Finally, inflammatory mechanisms, which predispose the highly immunogenic small bowel allograft to a protracted risk of resistant rejection must be elucidated, in order to ensure durable success...
Elevated myeloid: plasmacytoid dendritic cell ratio associates with early acute cellular rejection in pediatric small bowel transplantationAnkit Gupta
Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15213, USA
Transplantation 89:55-60. 2010..Dendritic cells (DCs) are potent antigen-presenting cells, modulate immune responses to gut microbes, and may serve as markers of rejection-prone small bowel transplantation (SBTx)...
Modified "liver-sparing" multivisceral transplant with preserved native spleen, pancreas, and duodenum: technique and long-term outcomeRuy J Cruz
Thomas E Starzl Transplantation Institute, University of Pittsburgh Medical Center, 3459 Fifth Avenue, MUH 7 South, Pittsburgh, PA 15213, USA
J Gastrointest Surg 14:1709-21. 2010..Modification of the originally described multivisceral transplant operation was introduced at our institution 17 years ago. Donor liver was spared, and native spleen along with pancreaticoduodenal complex was preserved...
Analysis of national and single-center incidence and survival after liver transplantation for hepatoblastoma: new trends and future opportunitiesRuy J Cruz
Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
Surgery 153:150-9. 2013..Liver transplantation (LTx) for hepatoblastoma appears to be increasing. Favorable tumor histology is increasingly linked to survival after surgical resection and could also determine posttransplantation outcomes...
Allospecific CD154+ T-cytotoxic memory cells identify recipients experiencing acute cellular rejection after renal transplantationChethan Ashokkumar
Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA, USA
Transplantation 92:433-8. 2011....
Increased expression of peripheral blood leukocyte genes implicate CD14+ tissue macrophages in cellular intestine allograft rejectionChethan Ashokkumar
Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh of University of Pennsylvania Medical Center, Pittsburgh, Pennsylvania, USA
Am J Pathol 179:1929-38. 2011..CCL5 gene up-regulation and CD14(+) macrophages likely prime cellular ITx rejection. Infiltration of reperfused intestine allografts with CD14(+) macrophages may predict rejection events...
Individualizing combination of two antiproliferative immunosuppressants with pharmacodynamic modeling of stimulated lymphocyte responsesVishal Berry
Division of Transplantation, Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15217, USA
Cytometry A 69:95-103. 2006..While this holds promise for drug development efforts, clinical application must await correlation of lymphocyte markers with post-transplant clinical outcomes...
Carcinoma of donor origin after liver-intestine transplantation in a childJoao Seda Neto
Thomas E. Starzl Transplantation Institute, Pittsburgh, PA, USA
Pediatr Transplant 9:244-8. 2005..The mechanism of such regression of tumor may be related to restitution of immunologic competence, but is yet to be determined...
Pediatric intestinal retransplantation: techniques, management, and outcomesGeorge V Mazariegos
Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh, Pittsburgh, PA 15213, USA
Transplantation 86:1777-82. 2008..Intestinal retransplantation (Re-ITx) has historically been associated with high morbidity and mortality...
Persistent donor-specific alloreactivity may portend delayed liver rejection during drug minimization in childrenNandita Khera
University of Pittsburgh, Children s Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15217, USA
Front Biosci 12:660-3. 2007..0048), and 3. experienced greater ACR incidence during minimization of immunosuppression (35% versus 6%, p=0.032). Serial monitoring of immunoreactivity may increase the safety with which immunosuppression is minimized in pediatric LTx...
Immunosuppressant strategies for intestinal transplantation: a review of a tolerogenic regimenBridget Flynn
University of Pittsburgh Medical Center, Pittsburgh, PA, USA
Prog Transplant 15:60-4. 2005..Subsequently, the long-term complications of immunosuppression are significantly reduced with achievement of better long-term survival, and an overall improvement in the quality of life...
Lymphocyte subsets may discern treatment effects in children and young adults with post-transplant lymphoproliferative disorderRyan LeVasseur
Department of Pediatric Transplantation, Children's Hospital, University of Pittsburgh, Pittsburgh, PA 15217, USA
Pediatr Transplant 7:370-5. 2003..Clinical remission with rituximab is accompanied by B-cell depletion. Serial monitoring of PLS from the time of diagnosis of PTLD will be necessary to confirm these observations...
Lymphocyte subset reconstitution in pediatric liver recipients induced with steroid-free rabbit anti-human thymocyte globulinAnjan Talukdar
Pediatric Transplantation Laboratory, Hillman Center for Pediatric Transplantation, Childrens Hospital of Pgh and the University of Pittsburgh, Pittsburgh, PA, USA
Pediatr Transplant 12:804-8. 2008..Rejection-prone children demonstrate significantly higher counts of lymphocytes and all subsets prior to liver transplantation, and may exemplify one basis for enhanced baseline immunocompetence...
One thousand consecutive primary liver transplants under tacrolimus immunosuppression: a 17- to 20-year longitudinal follow-upAshokkumar Jain
Division of Abdominal Organ Transplantation, Department of Surgery, Temple University Hospital, Philadelphia, PA, USA
Transplantation 91:1025-30. 2011..Tacrolimus has proven to be a potent immunosuppressive agent in orthotopic liver transplantation (OLT). The aim of this study is to examine its long-term efficacy and safety...
Sclerosing peritonitis after intestinal transplantation in childrenCamila Macedo
Thomas E. Starzl Transplantation Institute, Pittsburgh, PA, USA
Pediatr Transplant 9:187-91. 2005..SP after ITx may be a different manifestation of long-term intestine allograft degeneration. Surgical resection appears to offer palliation...
Causes of mortality beyond 1 year after primary pediatric liver transplant under tacrolimusJonathan A Fridell
Department of Surgery, Children's Hospital of Pittsburgh, and Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
Transplantation 74:1721-4. 2002..Mortality from chronic rejection and noncompliance under tacrolimus has been exceedingly rare...
Graft versus host disease in intestinal transplantationGeorge V Mazariegos
Children s Hospital of Pittsburgh, Thomas E Starzl Transplantation Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
Am J Transplant 4:1459-65. 2004..5% (8/122) in children and 4.7% (6/128) in adults. Successful clinical management requires a high index of suspicion to minimize morbidity and mortality. Diagnostic and treatment strategies based on this experience are proposed...
Preliminary immunosuppression withdrawal strategies with sirolimus in children with liver transplantsRakesh Sindhi
Pediatric Transplantation, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15217, USA
Transplant Proc 34:1972-3. 2002
Intestinal transplantation in children: a review of immunotherapy regimensNavdeep S Nayyar
Hillman Center for Pediatric Transplantation, Childrens Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania 15224, USA
Paediatr Drugs 13:149-59. 2011..Optimization of post-transplant immunosuppression strategies to reduce adverse effects while minimizing acute and chronic graft rejection is a strong clinical and research focus...
Current status of pediatric intestinal failure, rehabilitation, and transplantation: summary of a colloquiumGeorge V Mazariegos
Department of Pediatric Transplantation, Children s Hospital of Pittsburgh of UPMC, University of Pittsburgh Medical Center, Pittsburgh, PA 15224, USA
Transplantation 92:1173-80. 2011..Areas of opportunity such as increased donor recovery, improvement of long-term transplant outcomes, optimization of immune monitoring, and quality-of-life outcomes were reviewed...
Liver and intestinal transplantation in a child with cystic fibrosis: a case reportJonathan A Fridell
Children's Hospital of Pittsburgh, Department of Pediatric Transplantation, Thomas E. Starzl Transplantation Institute, Pittsburgh, PA 15213, USA
Pediatr Transplant 7:240-2. 2003..Extrapolating from the excellent experience of liver transplantation in children with CF, early liver and small intestinal multivisceral transplantation, if indicated, can be performed safely in children with CF...
Pharmacokinetics of sirolimus and tacrolimus in pediatric transplant patientsMarika Schubert
Thomas E Starzl Transplantation Institute of the Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
Am J Transplant 4:767-73. 2004..During conversion of subjects from TAC to combined TAC and SRL, aggressive therapeutic drug monitoring must be used to individualize therapy and avoid serous adverse events...
Modeling individual variation in biomarker response to combination immunosuppression with stimulated lymphocyte responses-potential clinical implicationsRakesh Sindhi
Children s Hospital of Pittsburgh, Room 4A 459, 3705 Fifth Avenue, PA 15213, USA
J Immunol Methods 272:257-72. 2003..This is not known for multiple-agent combinations...
Transient posttransplant graft-versus-host lymphadenopathyLaurentia Nodit
Department of Pathology, Children's Hospital of Pittsburgh and the University of Pittsburgh School of Medicine, 3705 Fifth Avenue, Pittsburgh, PA 15213, USA
Pediatr Dev Pathol 7:533-7. 2004..Circulating donor cells fell to 2.5% by day 62, and the child has been rejection free on low-dose immunosuppression...
Clinical tolerance following liver transplantation: long term results and future prospectsGeorge V Mazariegos
Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
Transpl Immunol 17:114-9. 2007....
Liver transplantation in children with cystic fibrosis: a long-term longitudinal review of a single center's experienceJonathan A Fridell
Department of Pediatric Transplantation, Thomas E. Starzl Transplantation Institute, Children's Hospital of Pittsburgh, Pittsburgh, PA 15213, USA
J Pediatr Surg 38:1152-6. 2003....
Review of outcomes of primary liver cancers in children: our institutional experience with resection and transplantationMarcus M Malek
Division of Pediatric General and Thoracic Surgery, University of Pittsburgh Medical Center, Children s Hospital of UPMC, Pittsburgh, PA 15224, USA
Surgery 148:778-82; discussion 782-4. 2010..This is a review of our institution's experience with operative management of pediatric liver cancer over an 18-year period...
Liver transplantation for classical maple syrup urine disease: long-term follow-up in 37 patients and comparative United Network for Organ Sharing experienceGeorge V Mazariegos
University of Pittsburgh Medical Center, Pittsburgh, PA, USA
J Pediatr 160:116-21.e1. 2012..To assess clinical and neurocognitive function in children who have undergone liver transplantation for classical maple syrup urine disease (MSUD)...
Posttransplant lymphoproliferative disorders in liver transplantation: a 20-year experienceAshok Jain
Thomas E. Starzl Transplantation Institute, the Divisions of Transplantation Surgery and Transplantation Pathology, and the Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA
Ann Surg 236:429-36; discussion 436-7. 2002..While it is too early to assess the impact of new advances in prophylaxis, diagnosis, and treatment, such approaches are based on an increased knowledge of the pathophysiology of PTLD...
Right diaphragmatic hernia after liver transplant in pediatrics: A case report and review of the literatureHwai Ding Lam
Starzl Transplantation Institute, Hillman Center for Pediatric Transplantation, Children s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
Pediatr Transplant 17:E77-80. 2013..For pediatric patients with otherwise unexplained respiratory or gastrointestinal symptoms after a left lateral segment liver transplant, right-sided diaphragmatic hernias should always be high in the differential diagnosis...
Pharmacodynamics of sirolimus in transplanted children receiving tacrolimusRakesh Sindhi
Pediatric Transplantation, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15217, USA
Transplant Proc 34:1960. 2002
Intestinal transplantation under tacrolimus monotherapy after perioperative lymphoid depletion with rabbit anti-thymocyte globulin (thymoglobulin)Jorge Reyes
Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Thomas E. Starzl Transplantation Institute, USA
Am J Transplant 5:1430-6. 2005..This strategy of immunosuppression minimized maintenance TAC exposure, facilitated the long-term control of rejection, decreased the incidence of opportunistic infections, and resulted in a high rate of patient and graft survival...
Sirolimus pharmacokinetic differences between children and adultsRaman Venkataramanan
Pediatr Transplant 10:872-4. 2006
HSV infection and immunosuppressionRakesh Sindhi
Liver Transpl 12:1906-7. 2006
Preventing acute and chronic rejection after diagnosis of post-transplantation lymphoproliferative disorderRakesh Sindhi
Pediatr Transplant 7:339-41. 2003
Isolated liver transplantation in infants with short gut syndrome: is less better?George V Mazariegos
Liver Transpl 12:1040-1. 2006
PELD allocation and acute liver/graft failureRakesh Sindhi
Liver Transpl 13:776-7. 2007
