Publications by authors named "Ankur P Choubey"

13 Publications

  • Page 1 of 1

Disparate Formulations for Machine Perfusion: A Survey of Organ Procurement Organizations' Medication Additives and Outcome Analyses.

Exp Clin Transplant 2021 Nov;19(11):1124-1132

From the Department of Surgery, Rutgers Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA.

Objectives: Machine perfusionfor kidney preservation is a common practice. There is no consensus on the best formula for perfusion solutions. We aimed to discern the additives that organ procurement organizations in the United States include in their perfusate and the impact of these additives on transplant outcomes.

Materials And Methods: A telephone survey of all 58 organ procurement organizations in the United States regarding additives to their perfusion solutions was conducted. The survey data were merged with transplant recipient outcome data from the United Network for Organ Sharing database.The final analysis included perfused kidneys between January 2014 and March 2019. Logistic regressions were performed to investigate whether a particular perfusion formula was associated with delayed graft function, primary nonfunction, or early graft failure.

Results: Additives correlated with decreased rates of graft failure were mannitol in all kidneys and kidneys of lower quality (P < .01) and penicillin/ampicillin in all kidneys (P < .05). Additives associated with increased graft failure regardless of type included verapamil in all kidneys (P < .05) and kidneys of lower quality (P < .01) and arginine with glutathione in all kidneys and low-quality kidneys alone (P < .01).

Conclusions: Further outcomes research and standardized guidelines for additives in machine perfusion of kidneys across all organ procurement organizations are needed.
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http://dx.doi.org/10.6002/ect.2021.0037DOI Listing
November 2021

Transplant surgery departmental leaders do not represent workforce demographics especially among women and underrepresented minorities - A retrospective analysis.

Am J Surg 2021 Nov 14. Epub 2021 Nov 14.

Albany Medical College, NY, USA.

Introduction: The diversity among surgical directors for liver, kidney, and pancreas transplant departments has not been previously evaluated. We aim to quantify the sex and racial demographics of transplant department leaders and assess the impact on patient outcomes.

Methods: Demographics were collected for 116 liver, 192 kidney, and 113 pancreas transplant directors using Organ Procurement and Transplantation Network (OPTN) directory and program websites. Scientific Registry of Transplant Recipients (SRTR) 5-tier program outcomes rankings were obtained for each program and matched to leader demographics. A retrospective analysis of transplant recipients from 2010 to 2019 was performed using the United Network for Organ Sharing (UNOS) database.

Results: 91.5% of transplant surgical directors were male. 55% of departments had a Non-Hispanic White leader. Asian, Hispanic and Black transplant chiefs were at the helm of 23.3%, 9%, and 5% of divisions respectively. Multivariate cox regression analysis did not identify any differences in patient outcomes by transplant director demographics.

Conclusion: There is a paucity of female and URM leaders in transplant surgery. Initiatives to promote research, mentorship, and career advancement opportunities for women and URM are necessary to address the current leadership disparity.
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http://dx.doi.org/10.1016/j.amjsurg.2021.11.008DOI Listing
November 2021

Diversity in American Society of Transplant Surgeons Governance: Equitable but Unequal.

Exp Clin Transplant 2021 Sep 7. Epub 2021 Sep 7.

From the Department of Surgery, University of Toledo Medical Center, Toledo, Ohio, USA.

Objectives: The diversity in the governance of the American Society of Transplant Surgeons has not been described. We aimed to quantify the present state of its leadership as a baseline to inform future research.

Materials And Methods: Lists of leaders on the American Society of Transplant Surgeons Council, the COVID-19 Strike Force, and 20 different American Society of Transplant Surgeons committees were obtained from the Society's website. Demographic and training information for the members were compiled through internet searches and analyzed.

Results: The American Society of Transplant Surgeons Council included 15 members, with 20% women. It was 93.3% non-Hispanic White. The COVID-19 Strike Force included 12 surgeons, 16.7% of whom were female, with 75% non-Hispanic White. Of the 198 committee members, 23.7% were women, 68.7% were nonHispanic White, 16.6% were Asian, 8.1% were Hispanic, and 6.6% were Black. Among female committee members, underrepresented minorities comprised 23.6%. Committee chairs included 23% women, 23% underrepresented minorities, and 2.3% minority women. International medical graduates were more likely men (P = .02).

Conclusions: Representation of women in the American Society of Transplant Surgeons leadership has kept pace with their membership in the transplant surgery workforce. There is a deficiency of female under - represented minorities in leadership positions at the Society. Further interventions are required to recruit underrepresented minorities to transplant surgery, catalog their footprint in the workforce, and champion their role as leaders within the American Society of Transplant Surgeons.
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http://dx.doi.org/10.6002/ect.2021.0111DOI Listing
September 2021

Diversity among transplant surgery fellowship program directors: a call to action.

HPB (Oxford) 2021 Jul 24. Epub 2021 Jul 24.

Albany Medical College, NY, USA.

Background: The diversity among general surgery residency, HPB and other fellowship program directors has been previously analyzed. However, the diversity in abdominal transplant surgery fellowship program directors remains unknown.

Methods: Abdominal transplant fellowship programs and the corresponding program directors were identified from the American Society of Transplant Surgeons website. Demographic and training information for the members was compiled through internet searches and analyzed.

Results: 72 program directors were included. 83.33% were male. 63.9% were non-Hispanic White, 25% were Asian, along with 5.56% Hispanic and Black each. Male program directors were more likely to be Associate Professor (p = 0.041), while females were more likely to be Assistant Professor (p = 0.021). 66% of female program directors were non-Hispanic White.

Conclusion: Transplant surgery fellowship programs are primarily led by male and non-Hispanic White surgeons. Female representation as leaders is on par with their membership in the transplant surgery workforce. There is a deficiency of both male and female underrepresented minorities in program director positions.
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http://dx.doi.org/10.1016/j.hpb.2021.07.006DOI Listing
July 2021

Kidney transplant surgical director training: Urologists represent a functional alternative to general surgeons.

Clin Transplant 2021 08 22;35(8):e14385. Epub 2021 Jun 22.

Department of Surgery, Albany Medical Center, Albany, New York, USA.

Introduction: Kidney transplant (KT) directors are general surgeons or urologists. All KT centers must meet established performance standards. However, it has not been established if general surgery and urology led programs have disparate outcomes.

Methods: Transplant outcomes and donor-recipient characteristics by director training were investigated. Organ Procurement and Transplantation Network (OPTN) directory, program websites were analyzed for surgical director demographics. Scientific Registry of Transplant Recipients (SRTR) 1-year kidney survival and deceased donor (DD) wait-time rankings were evaluated. A retrospective analysis of 142 157 KT recipients from 2010 to 2019 was performed using the United Network for Organ Sharing (UNOS) database.

Results: One hunderd and seventy three (90.6%) KT programs were led by general surgeons. There were no significant differences in gender, ethnicity, region, credentials, or fellowship completion. Recipients undergoing KT with urology led programs were older (P = .002) and had longer wait-times (P < .001). These centers used higher KDPI (.47 vs. .45, P < .001) and higher HLA mismatch (3.92 vs. 3.89, P = .02) kidneys. Urology led centers utilized living donors less frequently (32.1% vs. 35.8%, P < .001) and had longer CIT (15.44 vs. 12.21, P < .001). Both had similar SRTR ranking of 1-year survival and DD wait-time.

Conclusion: Most directors were general surgeon. Patient outcomes did not differ by transplant director training. Urologists represent a viable option for KT leadership and recruitment should be encouraged.
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http://dx.doi.org/10.1111/ctr.14385DOI Listing
August 2021

Letter Regarding: Gender Differences in Authorship Among Transplant Physicians: Are We Bridging the Gap?

J Surg Res 2021 10 31;266:352. Epub 2021 May 31.

Department of Surgery, Albany Medical Center, Albany, New York.

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http://dx.doi.org/10.1016/j.jss.2021.02.058DOI Listing
October 2021

Letter Regarding: Gender Equity at Surgical Conferences: Quantity and Quality.

J Surg Res 2021 10 25;266:319. Epub 2021 May 25.

Department of Surgery, Albany Medical Center, Albany, New York.

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http://dx.doi.org/10.1016/j.jss.2021.01.051DOI Listing
October 2021

Women's footprint in hepatopancreaticobiliary surgery.

HPB (Oxford) 2021 Jun 29;23(6):979. Epub 2021 Jan 29.

Department of Surgery, Albany Medical Center, Albany, NY, USA.

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http://dx.doi.org/10.1016/j.hpb.2021.01.008DOI Listing
June 2021

Donation after circulatory death liver recovery-Time for consensus.

Clin Transplant 2021 02 12;35(2):e14168. Epub 2020 Dec 12.

Department of Surgery, Albany Medical Center, Albany, NY, USA.

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http://dx.doi.org/10.1111/ctr.14168DOI Listing
February 2021

Kidney Transplants From a Deceased Donor After 11 Days of Venovenous Hemodialysis.

Exp Clin Transplant 2021 Nov 7;19(11):1224-1227. Epub 2020 Aug 7.

From the Department of Surgery, University of Toledo Medical Center, Toledo, Ohio, USA.

There have been several studies exploring the viability of kidneys procured from extended criteria donors with acute kidney injury. Previous publications have evaluated the long-term outcomes of kidneys after acute kidney injury. We describe the case of 2 transplants from a donor with acute renal failure after a motor vehicle accident. The donor required 11 days of venovenous hemodialysis before procurement. There have not been any previous reports of donations following such a prolonged period of dialysis. The kidneys were shared across organ procurement organization service areas and had cold ischemia times of 32 hours and 26 hours. Both recipients had delayed graft function. One recipient had several complications that required multiple readmission for treatment. At last follow-up, both transplanted organs were functioning adequately and producing urine. This case report presents a novel opportunity to understand the extent of possible kidney transplant after acute kidney injury.
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http://dx.doi.org/10.6002/ect.2020.0003DOI Listing
November 2021

Atorvastatin-Induced Eosinophilia.

Am J Ther 2020 Jan 22;28(6):e811-e812. Epub 2020 Jan 22.

Department of Hematology and Oncology, University of Toledo Medical Center, Toledo, OH.

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http://dx.doi.org/10.1097/MJT.0000000000001143DOI Listing
January 2020
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