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  1. Article ; Online: EUS-directed transgastric ERCP for management of severe hepatic steatosis and fibrosis in a liver transplantation patient with bypass anatomy.

    Gandhi, Shiv D / Movahedi, Babak / Marya, Neil B / Nasser-Ghodsi, Navine

    Gastrointestinal endoscopy

    2023  Volume 99, Issue 5, Page(s) 845–847

    Language English
    Publishing date 2023-11-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 391583-9
    ISSN 1097-6779 ; 0016-5107
    ISSN (online) 1097-6779
    ISSN 0016-5107
    DOI 10.1016/j.gie.2023.11.023
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  2. Article ; Online: Ex-vivo ureteroscopy, laser lithotripsy, and stone basketing extraction of deceased donor kidney stones during machine perfusion preservation.

    Kunkel, Gregory / Sorokin, Igor / Oster, Michela / Van Horn, Christine / Movahedi, Babak / Pang-Yen, Fan / Martins, Paulo N

    Artificial organs

    2023  Volume 47, Issue 7, Page(s) 1214–1222

    Abstract: The incidence of nephrolithiasis in kidney donors is rare. The timing and treatment of nephrolithiasis in deceased donor kidneys are not well established. While some programs have proposed ex-situ rigid or flexible ureteroscopy treatment before ... ...

    Abstract The incidence of nephrolithiasis in kidney donors is rare. The timing and treatment of nephrolithiasis in deceased donor kidneys are not well established. While some programs have proposed ex-situ rigid or flexible ureteroscopy treatment before transplantation, we report on two cases of kidney stones in the same deceased donor that we treated by flexible ureteroscopy and laser lithotripsy performed during the storage time on a hypothermic perfusion machine. Two deceased donor kidneys were found to have multiple kidney stones discovered on preprocurement CT imaging. The right kidney had less than five 2-3 mm stones, whereas the left had five to ten 1 mm stones with a single 7 mm stone. Both organs were placed on a hypothermic perfusion machine and maintained at a temperature of 4°C. An ex-vivo flexible ureteroscopy with laser lithotripsy and basket extraction was performed while the kidneys were maintained on Lifeport* perfusion machine. The cold ischemia time was 16.9 and 23.1 h. After 12 months of observational follow-up, neither recipient had nephrolithiasis, UTI, or other urologic complications. The creatinine values now are 1.17 and 2.44 mg/dL (103.4 and 215.7 μmol/L), respectively. Ex-vivo flexible ureteroscopy with laser lithotripsy and stone removal on machine-perfused kidneys appears to be safe and offers a good option to treat graft nephrolithiasis and prevent posttransplant complications. Ureteroscopy serves as a minimally invasive treatment option with direct stone removal. Performing this while on machine perfusion minimizes the ischemic time of the kidney and resultant complications or delays in graft function.
    MeSH term(s) Humans ; Lithotripsy, Laser ; Ureteroscopy/adverse effects ; Ureteroscopy/methods ; Kidney Calculi/surgery ; Tissue Donors ; Perfusion ; Treatment Outcome
    Language English
    Publishing date 2023-04-07
    Publishing country United States
    Document type Case Reports
    ZDB-ID 441812-8
    ISSN 1525-1594 ; 0160-564X
    ISSN (online) 1525-1594
    ISSN 0160-564X
    DOI 10.1111/aor.14528
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  3. Article: Delayed referral for liver transplant evaluation worsens outcomes in chronic liver disease patients requiring inpatient transplant evaluation.

    Cooper, Katherine M / Colletta, Alessandro / Hathaway, Nicholas J / Liu, Diana / Gonzalez, Daniella / Talat, Arslan / Barry, Curtis / Krishnarao, Anita / Mehta, Savant / Movahedi, Babak / Martins, Paulo N / Devuni, Deepika

    World journal of transplantation

    2023  Volume 13, Issue 4, Page(s) 169–182

    Abstract: Background: Indications to refer patients with cirrhosis for liver transplant evaluation (LTE) include hepatic decompensation or a model for end stage liver disease (MELD-Na) score ≥ 15. Few studies have evaluated how delaying referral beyond these ... ...

    Abstract Background: Indications to refer patients with cirrhosis for liver transplant evaluation (LTE) include hepatic decompensation or a model for end stage liver disease (MELD-Na) score ≥ 15. Few studies have evaluated how delaying referral beyond these criteria affects patient outcomes.
    Aim: To evaluate clinical characteristics of patients undergoing inpatient LTE and to assess the effects of delayed LTE on patient outcomes (death, transplantation).
    Methods: This is a single center retrospective cohort study assessing all patients undergoing inpatient LTE (
    Results: Many patients who require expedited inpatient LTE had delayed referrals. Misconceptions regarding transplant candidacy were a leading cause of delayed referral. Ultimately, delayed referrals negatively affected overall patient outcome and an independent predictor of both death and not receiving a transplant. Delayed referral was associated with a 2.5 hazard risk of death.
    Conclusion: Beyond initial access to an liver transplant (LT) center, delaying LTE increases risk of death and reduces risk of LT in patients with chronic liver disease. There is substantial opportunity to increase the percentage of patients undergoing LTE when first clinically indicated. It is crucial for providers to remain informed about the latest guidelines on liver transplant candidacy and the transplant referral process.
    Language English
    Publishing date 2023-06-21
    Publishing country United States
    Document type Journal Article
    ISSN 2220-3230
    ISSN 2220-3230
    DOI 10.5500/wjt.v13.i4.169
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  4. Article ; Online: Transplanting HCV-Infected Kidneys into Uninfected Recipients.

    Martins, Paulo N / Movahedi, Babak / Bozorgzadeh, Adel

    The New England journal of medicine

    2017  Volume 377, Issue 11, Page(s) 1104–1105

    MeSH term(s) Hepatitis C ; Humans ; Kidney ; Kidney Transplantation
    Language English
    Publishing date 2017--14
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMc1709315
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  5. Article: Bipolar Sealing Device Use in Pancreas Graft Preparation: A Novel Tieless Backtable Surgery Technique.

    Martins, Paulo N / Gillooly, Andrew R / Movahedi, Babak / Bozorgzadeh, Adel

    Transplantation direct

    2018  Volume 4, Issue 10, Page(s) e397

    Abstract: Supplemental digital content is available in the text. ...

    Abstract Supplemental digital content is available in the text.
    Keywords covid19
    Language English
    Publishing date 2018-09-25
    Publishing country United States
    Document type Journal Article
    ISSN 2373-8731
    ISSN 2373-8731
    DOI 10.1097/TXD.0000000000000831
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  6. Article: Successful treatment of complete traumatic transection of the suprahepatic inferior vena cava with veno-venous and cardiopulmonary bypass with hypothermic circulatory arrest.

    Martins, Paulo N / Buchwald, Julianna E / Movahedi, Babak / Torres, Ulises / Emhoff, Timothy / Walker, Jennifer / DeBusk, Michael G / Bozorgzadeh, Adel

    Hepatobiliary & pancreatic diseases international : HBPD INT

    2021  Volume 20, Issue 6, Page(s) 601–610

    MeSH term(s) Carcinoma, Renal Cell/surgery ; Cardiopulmonary Bypass ; Humans ; Kidney Neoplasms ; Vena Cava, Inferior/diagnostic imaging ; Vena Cava, Inferior/surgery
    Language English
    Publishing date 2021-01-06
    Publishing country Singapore
    Document type Letter
    ZDB-ID 2241386-8
    ISSN 1499-3872
    ISSN 1499-3872
    DOI 10.1016/j.hbpd.2020.12.017
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  7. Article: Impact of recipient functional status on 1-year liver transplant outcomes.

    Dolgin, Natasha H / Movahedi, Babak / Anderson, Frederick A / Brüggenwirth, Isabel Ma / Martins, Paulo N / Bozorgzadeh, Adel

    World journal of transplantation

    2019  Volume 9, Issue 7, Page(s) 145–157

    Abstract: Background: The Karnofsky Performance Status (KPS) scale has been widely validated for clinical practice for over 60 years.: Aim: To examine the extent to which poor pre-transplant functional status, assessed using the KPS scale, is associated with ... ...

    Abstract Background: The Karnofsky Performance Status (KPS) scale has been widely validated for clinical practice for over 60 years.
    Aim: To examine the extent to which poor pre-transplant functional status, assessed using the KPS scale, is associated with increased risk of mortality and/or graft failure at 1-year post-transplantation.
    Methods: This study included 38278 United States adults who underwent first, non-urgent, liver-only transplantation from 2005 to 2014 (Scientific Registry of Transplant Recipients). Functional impairment/disability was categorized as severe, moderate, or none/normal. Analyses were conducted using multivariable-adjusted Cox survival regression models.
    Results: The median age was 56 years, 31% were women, median pre-transplant Model for End-Stage for Liver Disease score was 18. Functional impairment was present in 70%; one-quarter of the sample was severely disabled. After controlling for key recipient and donor factors, moderately and severely disabled patients had a 1-year mortality rate of 1.32 [confidence interval (CI): 1.21-1.44] and 1.73 (95%CI: 1.56-1.91) compared to patients with no impairment, respectively. Subjects with moderate and severe disability also had a multivariable-adjusted 1-year graft failure rate of 1.13 (CI: 1.02-1.24) and 1.16 (CI: 1.02-1.31), respectively.
    Conclusion: Pre-transplant functional status is a useful prognostic indicator for 1-year post-transplant patient and graft survival.
    Language English
    Publishing date 2019-12-05
    Publishing country United States
    Document type Journal Article
    ISSN 2220-3230
    ISSN 2220-3230
    DOI 10.5500/wjt.v9.i7.145
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  8. Article ; Online: Supervised preoperative walking on increasing early postoperative stamina and mobility in older adults with frailty traits: A pilot and feasibility study.

    Rampam, Sanjeev / Sadiq, Hammad / Patel, Jay / Meyer, David / Uy, Karl / Yates, Jennifer / Schanzer, Andres / Movahedi, Babak / Lindberg, James / Crawford, Sybil / Gurwitz, Jerry / Mazor, Kathleen / Stefan, Mihaela / White, Daniel / Walz, Matthias / Kapoor, Alok

    Health science reports

    2022  Volume 5, Issue 4, Page(s) e738

    Abstract: Background and aims: Frail older adults are more than twice as likely to experience postoperative complications. Preoperative exercise may better prepare these patients through improved stamina and mobility experienced in the days following surgery. We ... ...

    Abstract Background and aims: Frail older adults are more than twice as likely to experience postoperative complications. Preoperative exercise may better prepare these patients through improved stamina and mobility experienced in the days following surgery. We measured the impact of a walking intervention using an activity tracker and coaching on postoperative stamina, and mobility in older adults with frailty traits.
    Methods: We included patients aged 60+ and scoring 4+ on the Edmonton Frailty Scale. We then randomized patients to intervention versus control stratified by anticipated hospital stay (1 night vs. 2+ night) and baseline stamina (i.e., 6-min walk distance [6MWD]). Intervention patients received an activity tracker and linked smart phone. An athletic trainer (AT) prescribed a daily step count goal and titrated this up after checking in with patients during weekly telephone calls. Controls received general walking recommendations. We then measured postoperative 6MWD 1-3 days after surgery. We also assessed postoperative mobility by measuring steps walked the day after surgery using a thigh-worn monitor. Because many patients could not walk postoperatively, we compared intervention-control difference in both 6MWD and steps using Wilcoxon rank testing and Tobit and ordinal logistic regression adjusting for several patient characteristics.
    Results: We randomized 104 eligible patients; 80 patients remained for final analysis. There was no difference in intervention versus control postoperative 6MWD (median 72 vs. 74 m Wilcoxon
    Conclusion: Our intervention consisting of goal setting with an activity tracker and telephonic coaching by an AT did not appear to improve stamina or mobility measured in the days after surgery. Small sample size limited our ability to examine this impact in subsets defined by surgical specialty or baseline stamina.
    Language English
    Publishing date 2022-07-20
    Publishing country United States
    Document type Journal Article
    ISSN 2398-8835
    ISSN (online) 2398-8835
    DOI 10.1002/hsr2.738
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  9. Article ; Online: Liver Transplantation for Unresectable Colorectal Cancer Liver Metastases: A Paradigm Change?

    Martins, Paulo Ney Aguiar / Movahedi, Babak / Bozorgzadeh, Adel

    Annals of surgery

    2015  Volume 262, Issue 1, Page(s) e12

    MeSH term(s) Colorectal Neoplasms/pathology ; Female ; Humans ; Liver Neoplasms/secondary ; Liver Neoplasms/surgery ; Liver Transplantation ; Male
    Language English
    Publishing date 2015-07
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000000483
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  10. Article: Outcomes After Stereotactic Body Radiation Therapy as a Bridging Modality to Liver Transplantation for Hepatocellular Carcinoma.

    Garg, Rashi / Foley, Kimberly / Movahedi, Babak / Masciocchi, Mark J / Bledsoe, Jacob R / Ding, Linda / Rava, Paul / Fitzgerald, Thomas J / Sioshansi, Shirin

    Advances in radiation oncology

    2020  Volume 6, Issue 1, Page(s) 100559

    Abstract: Purpose: For patients with hepatocellular carcinoma awaiting liver transplantation (LT), stereotactic body radiation therapy (SBRT) has emerged as a bridging treatment to ensure patients maintain priority status and eligibility per Milan criteria. In ... ...

    Abstract Purpose: For patients with hepatocellular carcinoma awaiting liver transplantation (LT), stereotactic body radiation therapy (SBRT) has emerged as a bridging treatment to ensure patients maintain priority status and eligibility per Milan criteria. In this study, we aimed to determine the efficacy and safety of SBRT in such situations.
    Methods and materials: A retrospective analysis was conducted of the outcomes of 27 patients treated with SBRT who were listed for LT at 1 institution. Among these, 20 patients with 26 tumors went on to LT and were the focus of this study. Operative reports and postoperative charts were evaluated for potential radiation-related complications. The explant pathology findings were correlated with equivalent dose in 2 Gy fractions and tumor size.
    Results: Median pretreatment tumor size was 3.05 cm. Median total dose of radiation was 50 Gy delivered in 5 fractions. Pathologic complete response (pCR) was achieved in 16 tumors (62%). Median interval from end of SBRT to transplant was 287 days. Of the 21 tumors imaged before transplant, 16 or 76% demonstrated a clinical complete response based on modified Response Evaluation Criteria in Solid Tumors criteria. There was no significant correlation between pCR rate and increasing tumor size (odds ratio [OR], 0.95; 95% confidence interval, 0.595-1.53) or pCR rate and equivalent dose in 2 Gy fractions (OR, 1.03; 95% confidence interval, 0.984-1.07.) No patients experienced radiation-related operative or postoperative complications. Of the 27 patients who were listed for transplant, the dropout rate was 22%. Two of the 5 patients with Child-Pugh score 10 died of liver failure.
    Conclusions: These data demonstrate that SBRT as a bridging modality is a feasible option, with a pCR rate comparable to that of other bridging modalities and no additional radiation-related operative or postoperative complications. There was no dose dependence nor size dependence for pCR rate, which may indicate that for the tumor sizes in this study, the radiation doses delivered were sufficiently high.
    Language English
    Publishing date 2020-09-14
    Publishing country United States
    Document type Journal Article
    ISSN 2452-1094
    ISSN 2452-1094
    DOI 10.1016/j.adro.2020.08.016
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