MD, FACP, FASN, FAST, FNKF
University of Missouri-Kansas City
Associate Professor, Medicine (Nephrology)
Kansas City, MO | United States
Main Specialties: Nephrology
Additional Specialties: Nephrology
Dr. Chon is an associate professor of medicine at the University of Missouri-Kansas City and serves as the Medical Director of the Renal Transplant Program at Saint Luke's Health System. He is an experienced transplant nephrologist and is board-certified in Internal Medicine and Nephrology. His research interests include ethics in transplantation, BK virus nephropathy, and vaccinations in transplant patients. He has served as Chairman for the American Society of Transplanation (AST) Trainee and Young Faculty Community of Practice.
Primary Affiliation: University of Missouri-Kansas City - Kansas City, MO , United States
PubMed Central Citations
77PubMed Central Citations
Hum Pathol 2018 Jun 6;76:47-51. Epub 2018 Mar 6.
Department of Pathology, The University of Chicago, Chicago, IL 60637, USA.
Clin Kidney J 2017 04 1;10(2):240-248. Epub 2017 Feb 1.
University of Chicago, Chicago, IL USA; Sharp Memorial Hospital, San Diego, CA, USA.
Anesthesia and Perioperative Care for Organ Transplantation (Springer)
2: e105; doi: 10.1097/TXD.0000000000000609
Objective. The aim of this study was to assess short-term and long-term results of the pancreatic islet transplantation using the Edmonton protocol at the University of Chicago. Materials and Methods. Nine patients underwent pancreatic islet cell trans- plantation using the Edmonton Protocol; they were followed up for 10 years after initial islet transplant with up to 3 separate islet infusions. They were given induction treatment using an IL-2R antibody and their maintenance immunosuppression regimen consisted of sirolimus and tacrolimus. Results. Nine patients received a total of 18 islet infusions. Five patients dropped out in the early phase of the study. Greater than 50% drop-out and noncompliance rate resulted from both poor islet function and recur- rent side effects of immunosuppression. The remaining 4 (44%) patients stayed insulin free with intervals for at least over 5 years (cumulative time) after the first transplant. Each of them received 3 infusions, on average 445 000 islet equivalent per transplant. Immunosuppression regimen required multiple adjustments in all patients due to recurrent side effects. In the long-term follow up, kidney function remained stable, and diabetic retinopathy and polyneuropathy did not progress in any of the patients. Patients' panel reactive antibodies remained zero and anti-glutamic acid decarboxylase 65 antibody did not rise after the transplant. Results of metabolic tests including hemoglobin A1c, arginine stimulation, and mixed meal tolerance test were correlated with clinical islet function. Conclusions. Pancreatic islet transplantation initiated according to Edmonton protocol offered durable long-term insulin-free glycemic control in only highly selected brittle diabetics providing stable control of diabetic neuropathy and retinopathy and without increased sensitization or impaired renal function. Immunosuppression adjustments and close follow-up were critical for patient retention and ultimate success.
Kidney Res Clin Pract. 2016 Sep; 35(3): 176–181
Kidney Research and Clinical Practice
Background: Although early monitoring of BK virus infection in renal transplant patients has led to improved outcomes over the past decade, it remains unclear whether monitoring for viremia is the best screening tool for BK virus nephropathy (BKVN). Methods: We conducted a retrospective review of the medical records of 368 renal transplant recipients who had a minimum of 18 months of posttransplantation follow-up. The relationship between the presence of BK viruria and a composite end point of BK viremia/BKVN was established, and the predictive value of high-grade BK viruria for development of viremia/BKVN was determined. Results: High grade of BK viruria was present in 110 (30.1%) of the renal transplant recipients. BK viremia/BKVN was present in 64 (17.4%) patients and was 50 times more likely to be present in patients with high-grade BK viruria. The risk of developing BK viremia/BKVN was 3 times higher in high-grade viruria patients, and viruria preceded viremia by nearly 7 weeks. Conclusion: The presence of high-grade viruria is an early marker for developing BK viremia/BKVN. Detection of high-grade viruria should prompt early allograft biopsy and/or preemptive reduction in immunosuppression.
Transplantation 2016 05;100(5):977-8
1 Section of Nephrology, Department of Medicine, University of Chicago, Chicago, IL.
Int J Clin Med, 2016; 7 (3):204-216
International Journal of Clinical Medicine
Background: Rapid steroid withdrawal (RSW) is used increasingly in kidney transplantation but long-term outcomes in African-American (AA) recipients are not well known. We compared 1 and 5 year transplant outcomes in a large cohort of AA patients who were maintained on continued steroid therapy (CST) to those who underwent RSW. Methods: Post-transplant courses of A as receiving kidney allografts from 2003-2011 at two urban transplant centers in Chicago were followed. Prior to outcome analysis, we used Inverse Probability of Treatment Weights (IPTW) to match the two groups on a set of baseline risk factors. Graft and patient survival, GFR at 1 and 5 years, incidence and type of rejection, incidence of post-transplant diabetes mellitus (PTDM), delayed graft function, CMV and BK viremia were compared. Results: There were 150 AA recipients in the CST analytic group and 157 in the RSW analytic group. Graft and patient survival was similar between the two groups. Rates of CMV viremia were higher in the RSW compared to the CST analytic group at 1 year. Biopsy-proven acute rejection and PTDM were similar between the RSW and CST groups. Conclusions: In AA recipients, RSW has similar long-term outcomes to CST.
World J Transplant 2015 Dec;5(4):292-9
Stephanie M McGregor, Anthony Chang, Department of Pathology, University of Chicago Hospitals, Chicago, IL 60637, United States.
Case Reports in Nephrology and Dialysis
Case Rep Transplant 2014 30;2014:754256. Epub 2014 Jun 30.
University of Chicago, 5841 S Maryland Avenue, MC 5100, Chicago, IL 60637, USA.
Transplantation 2014 Apr;97(8):846-53
1 Department of Surgery, The University of Chicago, Chicago, IL. 2 Department of Medicine, The University of Chicago, Chicago, IL. 3 Department of Pathology, The University of Chicago, Chicago, IL. 4 Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA. 5 Atlanta Research and Education Foundation, Atlanta, GA. 6 Address correspondence to: Anita S. Chong, Ph.D., The University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637.
In: UpToDate, Rose, BD (Ed)
Am J Transplant, 2013 May; 13: 1149-1158
Am J Transplant
Health researchers and policy-makers increasingly urge both patient and clinician engagement in shared decision making (SDM) to promote patient-centered care. Although SDM has been examined in numerous clinical settings, it has received little attention in solid organ transplantation. This paper describes the application of SDM to the kidney transplantation context. Several distinctive features of kidney transplantation present challenges to SDM including fragmented patient-provider relationships, the time-sensitive and unpredictable nature of deceased organ offers, decision-making processes by transplant providers serving as both organ guardians (given the organ scarcity) versus advocates for specific patients seeking transplantation, variable clinical practices and policies among transplant centers, and patients' potentially compromised cognitive status and literacy levels. We describe potential barriers to and opportunities for SDM, and posit that SDM is feasible, warranting encouragement in kidney transplantation. We propose strategies to promote and overcome obstacles to SDM in kidney transplantation. We contend that engagement in SDM can be facilitated by re-organization of clinical care, communication and education of providers and patients.
Clin Kidney J. 2012 Oct; 5(5):434-437
Clinical Kidney Journal
Longer wait times for deceased donor kidney transplant have prompted newer initiatives to expedite the process. Reuse of a previously transplanted kidney might be appropriate in certain circumstances. However, one must also consider the unique issues that may arise after such transplants. We describe our experience in one such case where the donor kidney had lesions of focal and segmental glomerulosclerosis and signs of alloreactivity (positive C4d staining) prior to transplantation and the recipient developed ganciclovir-resistant cytomegalovirus (CMV) infection, which was perhaps transmitted from the donor. Despite the challenges, the allograft function remained stable 5 years after reuse.
Am J Kidney Dis 2010 May;55(5):817-9