Scholars@Duke
Joseph Ladowski

Joseph Ladowski

House Staff
Surgery

Selected Publications

Student and Attending Preceptor Perceptions of Longitudinal Clinic as a Surgical Education and Assessment Tool.

Journal Article J Surg Res · November 20, 2024 INTRODUCTION: As undergraduate medical education becomes increasingly longitudinal, particular attention is needed to maintain sufficient exposure to surgical disciplines. While traditional medical student clerkships are isolated 4 to 8-wk blocks on a sing ... 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

Textbook Outcomes in Solid Transplantation: A Systematic Review.

Journal Article Transplant Direct · October 2024 BACKGROUND: The concept of TO is expanding across various surgical disciplines to establish a standardized, comprehensive quality benchmark. Traditional metrics such as 1-y patient and graft survival have been key for evaluating transplant program performa ... Full text Link to item Cite

Prior Teaching Experience and Barriers to Effective Resident Teaching: A Cross-Sectional Study.

Journal Article J Surg Res · September 2024 INTRODUCTION: Resident physicians play an important role in teaching the next generation of health-care providers, yet limited research has explored factors influencing effective teaching, such as preresidency experiences or barriers within residency. This ... Full text Link to item Cite

The Surgical Clerkship in the COVID Era: A Natural Language Processing and Thematic Analysis.

Journal Article J Surg Res · July 2024 INTRODUCTION: Responses to COVID-19 within medical education prompted significant changes to the surgical clerkship. We analyzed the changes in medical student end of course feedback before and after the COVID-19 outbreak. METHODS: Postclerkship surveys fr ... Full text 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

Normothermic Preservation of the Intestinal Allograft.

Journal Article Gastroenterol Clin North Am · June 2024 Intestinal allotransplantation was first described in the 1960s and successfully performed in the 1980s. Since that time, less progress has been made in the preservation of the allograft before transplantation and static cold storage remains the current st ... 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

The Role of Autophagy in Vascular Endothelial Cell Health and Physiology.

Journal Article Cells · May 11, 2024 Autophagy is a highly conserved cellular recycling process which enables eukaryotes to maintain both cellular and overall homeostasis through the catabolic breakdown of intracellular components or the selective degradation of damaged organelles. In recent ... Full text Link to item 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

A pig kidney supporting human physiology.

Journal Article Kidney Int · May 2024 Because of the global shortage of donor kidneys, xenotransplantation emerges as a potential solution for individuals with kidney failure who face challenges in securing a suitable donor kidney. A study featured in this month's issue of Kidney International ... Full text Link to item Cite

Surgical Residents as Clerkship Scholars May Improve Student Perception of the Surgery Clerkship.

Journal Article J Surg Res · February 2024 INTRODUCTION: The surgical clerkship is a formative experience in the medical school curriculum and can leave a lasting impression on students' perception of surgery. Given the historical negative stereotypes of surgeons, the clerkship represents an opport ... 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

Is Allosensitization Detrimental to Pig Organ Xenotransplantation, and Is Xenosensitization Detrimental to Subsequent Organ Allotransplantation? A Debate Organized by the International Xenotransplantation Association (IXA).

Journal Article Xenotransplantation · 2024 This report summarizes the content of a debate sponsored by eGenesis Bio, organized by the International Xenotransplantation Association (IXA), and attended by more than 150 delegates in the context of the IPITA-IXA-CTRMS Joint Congress held in San Diego i ... Full text Link to item Cite

Innate Immune Responses in Transplant Immunity

Journal Article Current Transplantation Reports · December 1, 2023 Purpose of Review: Despite a significant decrease in the rate of acute rejection, long-term solid organ allotransplant success is limited by chronic rejection. Transplant research has historically focused on adaptive immune responses. However, there is a g ... Full text 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

Research Highlights

Journal Article Transplantation · September 1, 2023 Full text 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

A novel low-cost model of superficial abscess for trainee education in incision and drainage.

Journal Article Surg Open Sci · August 2023 BACKGROUND: Proficiency in ultrasound usage is quickly becoming an expectation in multiple residency programs: emergency medicine, obstetrics-gynecology, surgery, and internal medicine. There is a lack of affordable training devices for ultrasound training ... Full text 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

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

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

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

The Influence of an Acting or Subintern on Third-Year Medical School Surgery Clerkship Students.

Journal Article The Journal of surgical research · March 2021 BackgroundPrevious reports demonstrated a positive relationship between the surgical clerkship and student likelihood of pursuing a surgical career, but no studies have examined the influence a peer has on comfort during a surgical clerkship. We h ... Full text Cite

Eplet mismatch scores and de novo donor-specific antibody development in simultaneous pancreas-kidney transplantation.

Journal Article Human immunology · March 2021 Antibody-mediated rejection is the principal cause of allotransplant graft failure. Available studies differ on the impact of de novo donor specific antibody (dnDSA) in pancreas transplants but are limited by patient sample size and sera sample collection. ... Full text Cite

The desirable donor pig to eliminate all xenoreactive antigens.

Journal Article Xenotransplantation · July 2019 The humoral barrier has been the limiting factor in moving xenotransplantation towards the clinic. Improvements in somatic cell nuclear transfer and genome editing, particularly CRISPR-Cas9, have made it possible to create pigs with multiple glycan xenoant ... Full text Cite

Examining the Biosynthesis and Xenoantigenicity of Class II Swine Leukocyte Antigen Proteins.

Journal Article Journal of immunology (Baltimore, Md. : 1950) · April 2018 Genetically engineered pig organs could provide transplants to all patients with end-stage organ failure, but Ab-mediated rejection remains an issue. This study examines the class II swine leukocyte Ag (SLA) as a target of epitope-restricted Ab binding. Tr ... Full text Cite

Xenotransplantation-the current status and prospects.

Journal Article British medical bulletin · March 2018 IntroductionThere is a continuing worldwide shortage of organs from deceased human donors for transplantation into patients with end-stage organ failure. Genetically engineered pigs could resolve this problem, and could also provide tissues and ce ... Full text Cite

Swine Leukocyte Antigen Class II Is a Xenoantigen.

Journal Article Transplantation · February 2018 BackgroundOver 130 000 patients in the United States alone need a lifesaving organ transplant. Genetically modified porcine organs could resolve the donor organ shortage, but human xenoreactive antibodies destroy pig cells and are the major barrie ... Full text Cite

Efficient generation of targeted and controlled mutational events in porcine cells using nuclease-directed homologous recombination.

Journal Article The Journal of surgical research · May 2017 BackgroundNuclease-based genome editing has rapidly sped the creation of new models of human disease. These techniques also hold great promise for the future of clinical xenotransplantation and cell-based therapies for cancer or immunodeficient pa ... Full text Cite

Humoral Reactivity of Renal Transplant-Waitlisted Patients to Cells From GGTA1/CMAH/B4GalNT2, and SLA Class I Knockout Pigs.

Journal Article Transplantation · April 2017 BackgroundAntipig antibodies are a barrier to clinical xenotransplantation. We evaluated antibody binding of waitlisted renal transplant patients to 3 glycan knockout (KO) pig cells and class I swine leukocyte antigens (SLA).MethodsPeriph ... Full text Cite

Silencing porcine genes significantly reduces human-anti-pig cytotoxicity profiles: an alternative to direct complement regulation.

Journal Article Transgenic research · October 2016 UnlabelledThe future of solid organ transplantation is challenged by an increasing shortage of available allografts. Xenotransplantation of genetically modified porcine organs offers an answer to this problem. Strategies of genetic modification ha ... Full text Cite

Silencing the porcine iGb3s gene does not affect Galα3Gal levels or measures of anticipated pig-to-human and pig-to-primate acute rejection.

Journal Article Xenotransplantation · March 2016 BackgroundThe Galα(1,3)Gal epitope (α-GAL), created by α-1,3-glycosyltransferase-1 (GGTA1), is a major xenoantigen causing hyperacute rejection in pig-to-primate and pig-to-human xenotransplantation. In response, GGTA1 gene-deleted pigs have been ... Full text Cite

Modified glycan models of pig-to-human xenotransplantation do not enhance the human-anti-pig T cell response.

Journal Article Transplant immunology · March 2016 UnlabelledGenetically modified porcine models of pig-to-human xenotransplantation offer the most immediate answer to a growing shortage of available solid organs. Recently a modified porcine glycan model has been discovered that reduces human anti ... Full text Cite

Silencing Porcine CMAH and GGTA1 Genes Significantly Reduces Xenogeneic Consumption of Human Platelets by Porcine Livers.

Journal Article Transplantation · March 2016 BackgroundA profound thrombocytopenia limits hepatic xenotransplantation in the pig-to-primate model. Porcine livers also have shown the ability to phagocytose human platelets in the absence of immune-mediated injury. Recently, inactivation of the ... Full text Cite

The fate of human platelets exposed to porcine renal endothelium: a single-pass model of platelet uptake in domestic and genetically modified porcine organs.

Journal Article The Journal of surgical research · February 2016 BackgroundThrombocytopenia may represent a significant challenge to the clinical application of solid-organ xenotransplantation. When studied in a pig-to-primate model, consumptive coagulopathy has challenged renal xenografts. New strategies of ge ... Full text Cite

Transcatheter Aortic Valve Replacement Versus Aortic Valve Bypass: A Comparison of Outcomes and Economics.

Conference The Annals of thoracic surgery · January 2016 BackgroundTranscatheter aortic valve replacement (TAVR) is currently offered to patients who are high-risk candidates for conventional surgical aortic valve replacement. For the past 37 years, off-pump aortic valve bypass (AVB) has been used in el ... Full text Cite

Recent advances in genome editing and creation of genetically modified pigs.

Journal Article International journal of surgery (London, England) · November 2015 The field of xenotransplantation is benefiting greatly from recent advances in genetic engineering. The efficiency and pace with which new model animals are being created has dramatically sped progress towards clinical relevance. Endonuclease-driven genome ... Full text Cite

Inherent limitations of multiple-choice testing.

Journal Article Academic radiology · October 2013 Full text Cite

Retrospective analysis of bovine pericardium (Vascu-Guard) for patch closure in carotid endarterectomies.

Journal Article Annals of vascular surgery · July 2011 BackgroundIt has been shown that patch closure after carotid endarterectomy (CEA) decreases the rate of recurrent stenosis. This study was designed to evaluate the utility of bovine pericardium patch as an option for patch closure after CEA.Me ... Full text Cite