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Imran Anwar

Imran Anwar

House Staff
Surgery

Selected Publications

CD154 blockade effectively controls antibody-mediated rejection in highly sensitized nonhuman primate kidney transplant recipients.

Journal Article Sci Transl Med · January 2025 Current desensitization and maintenance immunosuppression regimens for kidney transplantation in sensitized individuals show limited ability to control the posttransplant humoral response, resulting in high rates of antibody-mediated rejection (ABMR) and g ... Full text Link to item Cite

Transforming the logistics of liver transplantation with normothermic machine perfusion: Clinical impact versus cost.

Journal Article Liver Transpl · December 25, 2024 Normothermic machine perfusion (NMP) facilitates the utilization of marginal liver allografts. It remains unknown whether clinical benefits offset additional costs in the real-world setting. We performed a comparison of outcomes and hospitalization costs f ... Full text Link to item Cite

Animal Models Within Surgical Simulation: A Novel Approach to the 3 Rs.

Journal Article J Surg Res · November 2024 INTRODUCTION: Development of technical skills is a vital component of surgical residency. The use of animal tissues for operative simulation leads to both the loss of animal life and financial costs for the institution. We hypothesized that maximizing tiss ... Full text Link to item Cite

Acoustofluidic-based therapeutic apheresis system.

Journal Article Nat Commun · August 10, 2024 Therapeutic apheresis aims to selectively remove pathogenic substances, such as antibodies that trigger various symptoms and diseases. Unfortunately, current apheresis devices cannot handle small blood volumes in infants or small animals, hindering the tes ... Full text Open Access Link to item Cite

Allosensitisation in NHP results in cross-reactive anti-SLA antibodies not detected by a lymphocyte-based flow cytometry crossmatch.

Journal Article HLA · July 2024 Xenotransplantation is a potential option for individuals for whom an acceptable human allograft is unavailable. Individuals with broadly reactive HLA antibodies due to prior exposure to foreign HLA are potential candidates for a clinical xenotransplant tr ... Full text Link to item Cite

Prolonged xenokidney graft survival in sensitized NHP recipients by expression of multiple human transgenes in a triple knockout pig.

Journal Article Sci Transl Med · June 12, 2024 Genetic modification of porcine donors, combined with optimized immunosuppression, has been shown to improve outcomes of experimental xenotransplant. However, little is known about outcomes in sensitized recipients, a population that could potentially bene ... Full text Link to item Cite

Subnormothermic Oxygenated Machine Perfusion (24 h) in DCD Kidney Transplantation.

Journal Article Transplant Direct · June 2024 BACKGROUND: Ex vivo kidney perfusion is an evolving platform that demonstrates promise in preserving and rehabilitating the kidney grafts. Despite this, there is little consensus on the optimal perfusion conditions. Hypothermic perfusion offers limited fun ... Full text Link to item Cite

Research Highlights

Journal Article Transplantation · June 1, 2024 Full text Cite

Contemporary trends and outcomes after liver transplantation and resection for intrahepatic cholangiocarcinoma.

Journal Article J Gastrointest Surg · May 2024 BACKGROUND: Liver transplantation (LT) has been shown to be superior to resection in highly selected patients with perihilar cholangiocarcinoma (CCA), yet has traditionally been contraindicated for intrahepatic CCA (iCCA). Herein, we aimed to examine conte ... Full text Link to item Cite

The impact of IdeS (imlifidase) on allo-specific, xeno-reactive, and protective antibodies in a sensitized rhesus macaque model.

Journal Article Xenotransplantation · 2024 BACKGROUND: Highly sensitized patients face many barriers to kidney transplantation, including higher rates of antibody-mediated rejection after HLA-incompatible transplant. IdeS, an endopeptidase that cleaves IgG nonspecifically, has been trialed as desen ... Full text Link to item Cite

Immunoproteasome inhibition reduces donor specific antibody production and cardiac allograft vasculopathy in a mouse heart transplantation model.

Journal Article Front Transplant · 2024 OBJECTIVE: Cardiac Allograft Vasculopathy (CAV), a process of vascular damage accelerated by antibody-mediated rejection (AMR), is one of the leading causes of cardiac transplant failure. Proteasome inhibitors (PIs) are utilized to treat AMR, however PI-as ... Full text Link to item Cite

Revisiting Medical Student Expectations on the Surgery Clerkship.

Journal Article J Surg Educ · October 2023 OBJECTIVE: Medical students frequently report ambiguity of expectations in their feedback of the surgery clerkship. Herein, we aimed to gauge general surgery resident and attending expectations of students on their clerkship. DESIGN: Residents and attendin ... Full text Link to item Cite

Design and testing of a humanized porcine donor for xenotransplantation.

Journal Article Nature · October 2023 Recent human decedent model studies1,2 and compassionate xenograft use3 have explored the promise of porcine organs for human transplantation. To proceed to human studies, a clinically ready porcine donor must be engineered and its xenograft successfully t ... Full text Link to item Cite

The anti-CD40L monoclonal antibody AT-1501 promotes islet and kidney allograft survival and function in nonhuman primates.

Journal Article Sci Transl Med · August 30, 2023 Prior studies of anti-CD40 ligand (CD40L)-based immunosuppression demonstrated effective prevention of islet and kidney allograft rejection in nonhuman primate models; however, clinical development was halted because of thromboembolic complications. An ant ... Full text Link to item Cite

Xenorecognition and costimulation of porcine endothelium-derived extracellular vesicles in initiating human porcine-specific T cell immune responses.

Journal Article Am J Transplant · July 2023 Porcine vascular endothelial cells (PECs) form a mechanistic centerpiece of xenograft rejection. Here, we determined that resting PECs release swine leukocyte antigen class I (SLA-I) but not swine leukocyte antigen class-II DR (SLA-DR) expressing extracell ... Full text Open Access Link to item Cite

Desensitization and belatacept-based maintenance therapy in pregnancy-sensitized monkeys receiving a kidney transplant.

Journal Article Sci Adv · May 19, 2023 Among sensitized patients awaiting a transplant, females are disproportionately represented, partly because of pregnancy-induced sensitization. Using female NHPs sensitized by pregnancy alone, we examined the efficacy of costimulation blockade and proteaso ... Full text Link to item Cite

Incidence of Postreperfusion Hyperfibrinolysis in Liver Transplantation by Donor Type and Observed Treatment Strategies.

Journal Article Anesth Analg · March 1, 2023 BACKGROUND: Hyperfibrinolysis is a possible complication during liver transplantation, particularly immediately after reperfusion. METHODS: We performed a retrospective study to examine the incidence, treatment, and resolution of postreperfusion hyperfibri ... Full text Open Access Link to item Cite

Attitudes of patients with renal disease on xenotransplantation: A systematic review.

Journal Article Xenotransplantation · March 2023 BACKGROUND: Recent years have seen major advancements in xenotransplantation: the first pig-to-human heart transplant, the development of a brain-dead recipient model for kidney xenotransplantation, and the registration of the first xenokidney clinical tri ... Full text Link to item Cite

AAV9-mediated gene delivery to liver grafts during static cold storage in a rat liver transplant model.

Journal Article Front Transplant · 2023 INTRODUCTION: Recombinant adeno-associated virus (rAAV) is a novel strategy used clinically for gene delivery, but has not been characterized in the context of organ transplantation. We sought to determine the efficacy of rAAV-mediated gene delivery during ... Full text Link to item Cite

Belatacept and carfilzomib-based treatment for antibody-mediated rejection in a sensitized nonhuman primate kidney transplantation model.

Journal Article Front Transplant · 2023 INTRODUCTION: One-third of HLA-incompatible kidney transplant recipients experience antibody mediated rejection (AMR) with limited treatment options. This study describes a novel treatment strategy for AMR consisting of proteasome inhibition and costimulat ... Full text Link to item Cite

A novel method for in vitro culture and expansion of nonhuman primate B cells.

Journal Article J Immunol Methods · December 2022 BACKGROUND: Given the role of B cells in sensitization and antibody-mediated rejection pathogenesis, the ability to identify, isolate, and study B cells in vitro is critical for understanding these processes and developing novel therapeutics. While in vivo ... Full text Link to item Cite

Addition of interleukin-6 receptor blockade to carfilzomib-based desensitization in a highly sensitized nonhuman primate model.

Journal Article Am J Transplant · December 2022 Sensitized patients, those who had prior exposure to foreign human leukocyte antigens, are transplanted at lower rates due to challenges in finding suitable organs. Desensitization strategies have permitted highly sensitized patients to undergo kidney tran ... Full text Link to item Cite

Liver Transplantation as a New Standard of Care in Patients With Perihilar Cholangiocarcinoma? Results From an International Benchmark Study.

Journal Article Ann Surg · November 1, 2022 OBJECTIVE: To define benchmark values for liver transplantation (LT) in patients with perihilar cholangiocarcinoma (PHC) enabling unbiased comparisons. BACKGROUND: Transplantation for PHC is used with reluctance in many centers and even contraindicated in ... Full text Link to item Cite

Research Highlights

Journal Article Transplantation · November 1, 2022 Full text Cite

Shifting Clinical Trial Endpoints in Kidney Transplantation: The Rise of Composite Endpoints and Machine Learning to Refine Prognostication.

Journal Article Transplantation · August 1, 2022 The measurement of outcomes in kidney transplantation has been more accurately documented than almost any other surgical procedure result in recent decades. With significant improvements in short- and long-term outcomes related to optimized immunosuppressi ... Full text Link to item Cite

Harnessing the B Cell Response in Kidney Transplantation - Current State and Future Directions.

Journal Article Front Immunol · 2022 Despite dramatic improvement in kidney transplantation outcomes over the last decades due to advent of modern immunosuppressive agents, long-term outcomes remain poor. Antibody-mediated rejection (ABMR), a B cell driven process, accounts for the majority o ... Full text Link to item Cite

Gene Therapy: Will the Promise of Optimizing Lung Allografts Become Reality?

Journal Article Front Immunol · 2022 Lung transplantation is the definitive therapy for patients living with end-stage lung disease. Despite significant progress made in the field, graft survival remains the lowest of all solid organ transplants. Additionally, the lung has among the lowest of ... Full text Link to item Cite

Complement-targeted therapies in kidney transplantation-insights from preclinical studies.

Journal Article Front Immunol · 2022 Aberrant activation of the complement system contributes to solid-organ graft dysfunction and failure. In kidney transplantation, the complement system is implicated in the pathogenesis of antibody- and cell-mediated rejection, ischemia-reperfusion injury, ... Full text Link to item Cite

Complement-targeting therapeutics for ischemia-reperfusion injury in transplantation and the potential for ex vivo delivery.

Journal Article Front Immunol · 2022 Organ shortages and an expanding waitlist have led to increased utilization of marginal organs. All donor organs are subject to varying degrees of IRI during the transplant process. Extended criteria organs, including those from older donors and organs don ... Full text Link to item Cite

Liver Transplantation for Hepatocellular Carcinoma after Downstaging or Bridging Therapy with Immune Checkpoint Inhibitors.

Journal Article Cancers (Basel) · December 15, 2021 Liver transplantation offers excellent outcomes for patients with HCC. For those who initially present within the Milan criteria, bridging therapy is essential to control disease while awaiting liver transplant. For those who present beyond the Milan crite ... Full text Link to item Cite

Interaction between TRPV1-expressing neurons in the hypothalamus.

Journal Article Journal of neurophysiology · January 2019 Transient receptor potential vanilloid type 1 (TRPV1) is a ligand-gated ion channel expressed in the peripheral and central nervous systems. TRPV1-dependent mechanisms take part in a wide range of physiological and pathophysiological pathways including the ... Full text Cite

Sex-Specific Mechanisms of Resistance Vessel Endothelial Dysfunction Induced by Cardiometabolic Risk Factors.

Journal Article Journal of the American Heart Association · February 2018 BackgroundThe incidence of obesity is rising, particularly among women. Microvascular dysfunction is more common with female sex, obesity, and hyperlipidemia and predicts adverse cardiovascular outcomes, but the molecular mechanisms are unclear. B ... Full text Cite

The endothelial mineralocorticoid receptor: mediator of the switch from vascular health to disease.

Journal Article Current opinion in nephrology and hypertension · March 2017 Purpose of reviewEndothelial dysfunction is an early feature of vascular disease induced by cardiovascular risk factors (CRFs). In growing populations with obesity, diabetes, hypertension, and heart failure, mineralocorticoid receptor antagonism i ... Full text Cite

Brain stem as a target site for the metabolic side effects of olanzapine.

Journal Article Journal of neurophysiology · March 2016 Olanzapine, an atypical antipsychotic, is widely prescribed for the treatment of schizophrenia and bipolar disorder despite causing undesirable metabolic side effects. A variety of mechanisms and brain sites have been proposed as contributors to the side e ... Full text Cite

Elevation of cardiovascular risk by non-steroidal anti-inflammatory drugs.

Journal Article Trends in cardiovascular medicine · November 2015 Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most frequently used medications. NSAIDs profoundly modify prostaglandin homeostasis through inhibition of the enzyme, cyclooxygenase (COX), especially COX-2. COX-2 inhibition is associated with ... Full text Cite

Regulation of leptin receptor-expressing neurons in the brainstem by TRPV1.

Journal Article Physiological reports · September 2014 The central nervous system plays a critical role in the regulation of feeding behavior and whole-body metabolism via controlling the autonomic output to the visceral organs. Activity of the parasympathetic neurons in the dorsal motor nucleus of the vagus ( ... Full text Cite

TRPV1-dependent regulation of synaptic activity in the mouse dorsal motor nucleus of the vagus nerve.

Journal Article Frontiers in neuroscience · January 2013 The dorsal motor nucleus of the vagus (DMV) is a key integrative point of the parasympathetic neuronal network localized in the dorsal vagal complex. Activity of neurons in the DMV is closely regulated by synaptic inputs, and regulation of excitatory and i ... Full text Cite