Publications by authors named "David Woodland"

214 Publications

Looking Back, Looking Forward at the .

Authors:
David L Woodland

J Interferon Cytokine Res 2021 12;41(12):438

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http://dx.doi.org/10.1089/jir.2021.29028.dlwDOI Listing
December 2021

Long-standing donor diabetes and pathologic findings are associated with shorter allograft survival in recipients of kidney transplants from diabetic donors.

Mod Pathol 2022 01 28;35(1):128-134. Epub 2021 Sep 28.

Department of Pathology, Oregon Health & Science University, Portland, OR, USA.

Approximately 6% of deceased kidney donors (DKDs) are diabetic; their kidneys may be associated with worse allograft survival, but published studies suggest that recipient diabetes status has a greater impact on mortality and survival. Since biopsy findings are the most common reason for organ discard, we sought to understand histologic and clinical factors that influence graft survival in patients who receive a kidney from a diabetic DKD. We retrospectively reviewed our institutional experience from 2005 to 2019, and re-evaluated pre-implantation and earliest post-transplant biopsies. Histologic findings were compared against a control cohort of non-diabetic DKD. Of 829 adult DKD transplants, 37 (4.5%) came from diabetic donors. There was no significant difference in diabetic vs. non-diabetic DKD graft survival for all-comers; however, when stratified by duration of donor diabetes, donor diabetes ≥6 years was associated with graft failure. In 25 patients with post-transplant biopsies available, diabetic DKD allografts had significantly greater non-glomerular chronic injury than non-diabetic DKD allografts. Moderate arteriolar hyalinosis (in 24%), moderate tubular atrophy and interstitial fibrosis (IFTA, in 36%), and diabetic glomerulopathy (in 24%) on early post-transplant biopsy were associated with allograft failure. Pre-implantation frozen section discrepancies were more common in long-standing donor diabetes, and arteriolar hyalinosis and IFTA scores on frozen accurately prognosticated graft loss. There was no morphologic improvement in lesions of diabetic nephropathy on short-term follow-up. In conclusion, donor diabetes ≥6 years, and histologic findings on frozen section and early post-transplant biopsy are associated with diabetic DKD allograft loss.
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http://dx.doi.org/10.1038/s41379-021-00927-2DOI Listing
January 2022

Transient-mixed Chimerism With Nonmyeloablative Conditioning Does Not Induce Liver Allograft Tolerance in Nonhuman Primates.

Transplantation 2020 08;104(8):1580-1590

Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY.

Background: Although short-term outcomes for liver transplantation have improved, patient and graft survival are limited by infection, cancer, and other complications of immunosuppression. Rapid induction of tolerance after liver transplantation would decrease these complications, improving survival and quality of life. Tolerance to kidneys, but not thoracic organs or islets, has been achieved in nonhuman primates and humans through the induction of transient donor chimerism. Since the liver is considered to be tolerogenic, we tested the hypothesis that the renal transplant transient chimerism protocol would induce liver tolerance.

Methods: Seven cynomolgus macaques received immune conditioning followed by simultaneous donor bone marrow and liver transplantation. The more extensive liver surgery required minor adaptations of the kidney protocol to decrease complications. All immunosuppression was discontinued on postoperative day (POD) 28. Peripheral blood chimerism, recipient immune reconstitution, liver function tests, and graft survival were determined.

Results: The level and duration of chimerism in liver recipients were comparable to those previously reported in renal transplant recipients. However, unlike in the kidney model, the liver was rejected soon after immunosuppression withdrawal. Rejection was associated with proliferation of recipient CD8 T effector cells in the periphery and liver, increased serum interleukin (IL)-6 and IL-2, but peripheral regulatory T cell (Treg) numbers did not increase. Antidonor antibody was also detected.

Conclusions: These data show the transient chimerism protocol does not induce tolerance to livers, likely due to greater CD8 T cell responses than in the kidney model. Successful tolerance induction may depend on greater control or deletion of CD8 T cells in this model.
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http://dx.doi.org/10.1097/TP.0000000000003263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7541736PMC
August 2020

Survival and renal function after liver transplantation alone in patients meeting the new United Network for Organ Sharing simultaneous liver-kidney criteria.

Clin Transplant 2020 10 17;34(10):e14020. Epub 2020 Jul 17.

Division of Abdominal Organ Transplantation, Oregon Health & Science University, Portland, OR, USA.

In 2017, United Network for Organ Sharing (UNOS) implemented a simultaneous liver-kidney transplant (SLK) allocation policy. Our institution uses a more restrictive criteria for SLK; thus, we have a group of patients that would have qualified for SLK under the new allocation policy but received liver transplantation alone (LTA). We compared survival and post-operative renal function in patients that received LTA stratified by whether they met the new UNOS SLK criteria. There was no difference in graft and patient survival. The majority (95%) of LTA patients meeting the UNOS SLK criteria did not need dialysis at 1 year, with a mean eGFR increase from 23 mL/min preoperatively to 48 mL/min at 1 year. Of those with eGFR ≤ 20 mL/min at 1 month after surgery, the majority did regain adequate renal function. The implementation of the UNOS SLK allocation policy was appropriate in the previously unregulated area. This policy provides an excellent framework for those that may benefit from SLK. Our data suggest that a more restrictive policy may be possible in order to promote the best use of donated organs. The current safety net is appropriately positioned to capture patients in need of subsequent kidney transplant.
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http://dx.doi.org/10.1111/ctr.14020DOI Listing
October 2020

Passing the Torch.

Authors:
David L Woodland

Viral Immunol 2020 06 13;33(5):352. Epub 2020 May 13.

Trudeau Institute, Inc., Saranac Lake, New York, USA.

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http://dx.doi.org/10.1089/vim.2020.0078DOI Listing
June 2020

De novo thrombotic microangiopathy in two kidney transplant recipients from the same deceased donor: A case series.

Clin Transplant 2020 07 27;34(7):e13885. Epub 2020 May 27.

Division of Nephrology, Oregon Health and Science University, Portland, OR, USA.

Thrombotic microangiopathy (TMA) is a recognized and serious complication of renal transplantation. Atypical hemolytic uremic syndrome (aHUS), a subset of TMA, occurs in the setting of dysregulation of the alternative complement pathway and can cause disease in native kidneys as well as recurrence in allografts. De novo TMA represents a classification of TMA post-transplant in the absence of clinical or histopathological evidence of TMA or aHUS in the native kidney. De novo TMA is a more heterogeneous syndrome than aHUS and the pathogenesis and risk factors for de novo TMA are poorly understood. The association between calcineurin inhibitors (CNI) and de novo TMA is controversial. Anti-complement blockade therapy with eculizumab is effective in some cases, but more studies are needed to identify appropriate candidates for therapy. We present two cases of de novo TMA occurring immediately in recipients from the same deceased donor and provoking the question of whether deceased donor-related factors could represent risks for developing de novo TMA.
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http://dx.doi.org/10.1111/ctr.13885DOI Listing
July 2020

An Urgent Need for an African Swine Fever Vaccine.

Authors:
David L Woodland

Viral Immunol 2020 03 5;33(2):71. Epub 2019 Dec 5.

Trudeau Institute, Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2019.29045.dlwDOI Listing
March 2020

Two Reviews on the Innate Immune Response to Viral Infection.

Authors:
David L Woodland

Viral Immunol 2019 12 12;32(10):416. Epub 2019 Nov 12.

Trudeau Institute, Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2019.29044.dlwDOI Listing
December 2019

Veterinary Vaccines.

Authors:
David L Woodland

Viral Immunol 2019 11 21;32(9):361. Epub 2019 Oct 21.

Trudeau Institute, Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2019.29043.dlwDOI Listing
November 2019

Uncontrolled Cytomegalovirus Replication.

Authors:
David L Woodland

Viral Immunol 2019 10;32(8):321

Trudeau Institute, Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2019.29041.dlwDOI Listing
October 2019

Letters to the Editor.

Authors:
David L Woodland

Viral Immunol 2019 09 23;32(7):277. Epub 2019 Aug 23.

Trudeau Institute, Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2019.29040.dlwDOI Listing
September 2019

Impact of CMV Reactivation, Treatment Approaches, and Immune Reconstitution in a Nonmyeloablative Tolerance Induction Protocol in Cynomolgus Macaques.

Transplantation 2020 02;104(2):270-279

Columbia Center for Translational Immunology, Department of Medicine, Columbia University Medical Center, New York, NY.

Background: Cytomegalovirus (CMV) infection is a serious complication in immunosuppressed patients, specifically transplant recipients. Here, we describe the development and use of an assay to monitor the incidence and treatment of CMV viremia in a Cynomolgus macaque model of bone marrow transplantation (BMT) for tolerance induction. We address the correlation between the course of viremia and immune reconstitution.

Methods: Twenty-one animals received a nonmyeloablative conditioning regimen. Seven received cyclosporine A for 28 days and 14 received rapamycin. A CMV polymerase chain reaction assay was developed and run twice per week to monitor viremia. Nineteen recipients were CMV seropositive before BMT. Immune reconstitution was monitored through flow cytometry and CMV viremia was tracked via quantitative polymerase chain reaction.

Results: Recipients developed CMV viremia during the first month post-BMT. Two animals developed uncontrollable CMV disease. CMV reactivation occurred earlier in cyclosporine A-treated animals compared with those receiving rapamycin. Post-BMT, T-cell counts remained significantly lower compared with pretransplant levels until CMV reactivation, at which point they increased during the viremic phase and approached pretransplant levels 3 months post-BMT. Management of CMV required treatment before viremia reached 10 000 copies/mL; otherwise clinical symptoms were observed. High doses of ganciclovir resolved the viremia, which could subsequently be controlled with valganciclovir.

Conclusions: We developed an assay to monitor CMV in Cynomolgus macaques. CMV reactivation occurred in 100% of seropositive animals in this model. Rapamycin delayed CMV reactivation and ganciclovir treatment was effective at high doses. As in humans, CD8 T cells proliferated during CMV viremia.
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http://dx.doi.org/10.1097/TP.0000000000002893DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994365PMC
February 2020

Dengue Vaccines.

Authors:
David L Woodland

Viral Immunol 2019 Jul/Aug;32(6):235. Epub 2019 Jul 2.

Trudeau Institute, Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2019.29039.dlwDOI Listing
July 2020

Eosinophils and Respiratory Viruses.

Authors:
David L Woodland

Viral Immunol 2019 06 20;32(5):197. Epub 2019 May 20.

Trudeau Institute, Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2019.29038.dlwDOI Listing
June 2019

Hand, Foot, and Mouth Disease.

Authors:
David L Woodland

Viral Immunol 2019 05 30;32(4):159. Epub 2019 Apr 30.

1 Editor-in-Chief, Viral Immunology.

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http://dx.doi.org/10.1089/vim.2019.29037.dlwDOI Listing
May 2019

Measles on the March: A Call to Action.

Authors:
David L Woodland

Viral Immunol 2019 05 3;32(4):160. Epub 2019 Apr 3.

1 Editor-in-Chief, Viral Immunology.

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http://dx.doi.org/10.1089/vim.2019.29036.dlwDOI Listing
May 2019

Regulation of Host Susceptibility to Postinfluenza Bacterial Superinfections.

Authors:
David L Woodland

Viral Immunol 2019 04 19;32(3):111. Epub 2019 Mar 19.

Trudeau Institute, Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2019.29035.dlwDOI Listing
April 2019

Characterization, biology, and expansion of regulatory T cells in the Cynomolgus macaque for preclinical studies.

Am J Transplant 2019 08 29;19(8):2186-2198. Epub 2019 Mar 29.

Columbia Center for Translational Immunology, Department of Medicine, Columbia University Medical Center, New York, New York.

Reliable in vitro expansion protocols of regulatory T cells (Tregs) are needed for clinical use. We studied the biology of Mauritian Cynomolgus macaque (MCM) Tregs and developed four in vitro Treg expansion protocols for translational studies. Tregs expanded 3000-fold when artificial antigen presenting cells (aAPCs) expressing human CD80, CD58 and CD32 were used throughout the culture. When donor peripheral blood mononuclear cells (PBMCs) were used as the single source of APCs followed by aAPCs, Tregs expanded 2000-fold. Tregs from all protocols suppressed the proliferation of anti-CD2CD3CD28 bead-stimulated autologous PBMCs albeit with different potencies, varying from 1:2-1:4 Treg:PBMC ratios, up to >1:32. Reculture of cryopreserved Tregs permitted reexpansion with improved suppressive activity. Occasionally, CD8 contamination was observed and resolved by resorting. Specificity studies showed greater suppression of stimulation by anti-CD2CD3CD28 beads of PBMCs from the same donor used for stimulation during the Treg cultures and of autologous cells than of third-party PBMC responders. Similar to humans, the Treg-specific demethylated region (TSDR) within the Foxp3 locus correlated with suppressive activity and expression of Foxp3. Contrary to humans, FoxP3 expression did not correlate with CD45RA or CD127 expression. In summary, we have characterized MCM Tregs and developed four Treg expansion protocols that can be used for preclinical applications.
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http://dx.doi.org/10.1111/ajt.15313DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658340PMC
August 2019

Respiratory Syncytial Virus.

Authors:
David L Woodland

Viral Immunol 2019 03 1;32(2):75. Epub 2019 Feb 1.

Trudeau Institute, Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2019.29034.dlwDOI Listing
March 2019

Contribution of Vaccination to Human Health.

Authors:
David L Woodland

Viral Immunol 2018 12 21;31(10):647-648. Epub 2018 Nov 21.

Trudeau Institute, Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2018.29033.dlwDOI Listing
December 2018

Epstein-Barr Virus and Grave's Disease.

Authors:
David L Woodland

Viral Immunol 2018 10;31(8):539

Trudeau Institute , Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2018.29031.dlwDOI Listing
October 2018

Facets of Innate Immunity to Viral Infection.

Authors:
David L Woodland

Viral Immunol 2018 11 10;31(9):595. Epub 2018 Oct 10.

Trudeau Institute , Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2018.29032.dlwDOI Listing
November 2018

Viral Epitope Escape in Acute HIV-1 Infection.

Authors:
David L Woodland

Viral Immunol 2018 09 17;31(7):485. Epub 2018 Aug 17.

Trudeau Institute , Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2018.29030.dlwDOI Listing
September 2018

Advances in Influenza Research.

Authors:
David L Woodland

Viral Immunol 2018 Jul/Aug;31(6):405-406

Trudeau Institute , Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2018.29029.dlwDOI Listing
October 2018

Porcine Reproductive and Respiratory Syndrome Virus and Porcine Circovirus 2 in Albania.

Authors:
David L Woodland

Viral Immunol 2018 06 16;31(5):345. Epub 2018 May 16.

Trudeau Institute , Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2018.29028.dlwDOI Listing
June 2018

Building a Better Flu Vaccine.

Authors:
David L Woodland

Viral Immunol 2018 05 17;31(4):277. Epub 2018 Apr 17.

Trudeau Institute, Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2018.29027.dlwDOI Listing
May 2018

Complications of HIV Infection.

Authors:
David L Woodland

Viral Immunol 2018 04 20;31(3):205. Epub 2018 Mar 20.

Trudeau Institute , Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2018.29026.dlwDOI Listing
April 2018

Routine chest X-ray is unnecessary after ultrasound-guided central venous line placement in the operating room.

J Crit Care 2018 08 28;46:13-16. Epub 2018 Mar 28.

Columbia University Department of Surgery, United States.

Background: Central venous catheters (CVC) can be useful for perioperative monitoring and insertion has low complication rates. However, routine post insertion chest X-rays have become standard of care and contribute to health care costs with limited impact on patient management.

Methods: 200 patient charts who underwent pancreaticoduodenectomy with central line placement and early line removal were reviewed for clinical complications related to central line placement as well as radiographic evidence of malpositioning. A cost analysis was performed to estimate savings if CXR had not been performed across routine surgical procedures requiring central access.

Results: In 200 central line placements for Whipple procedures, 198 lines were placed in the right internal jugular and 2 were placed in the subclavian. No cases of pneumothorax or hemothorax were identified and 30 (15.3%) of CVCs were improperly positioned. Only 1 (0.5%) of these was deemed clinically significant and repositioned after the CXR was performed.

Conclusion: Routine CXR consumes valuable time and resources (≅$155,000 annually) and rarely affects management. Selection should be guided by clinical factors.
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http://dx.doi.org/10.1016/j.jcrc.2018.03.027DOI Listing
August 2018

The Challenge of Emerging Viruses.

Authors:
David L Woodland

Viral Immunol 2017 12 17;30(10):681. Epub 2017 Nov 17.

Trudeau Institute , Saranac Lake, New York.

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http://dx.doi.org/10.1089/vim.2017.29024.dlwDOI Listing
December 2017
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