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Browsing by Author "Mujtaba, Muhammad A."
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Item Deceased donor organ procurement injuries in the United States(Baishideng Publishing Group Co (World Journal of Transplantation), 2016-06-24) Taber, Tim E.; Neidlinger, Nikole A.; Mujtaba, Muhammad A.; Eidbo, Elling E.; Cauwels, Roxane L.; Hannan, Elizabeth M.; Miller, Jennifer R.; Paramesh, Anil S.; Department of Medicine, IU School of MedicineAIM: To determine the incidence of surgical injury during deceased donor organ procurements. METHODS: Organ damage was classified into three tiers, from 1-3, with the latter rendering the organ non-transplantable. For 12 consecutive months starting in January of 2014, 36 of 58 organ procurement organization's (OPO)'s prospectively submitted quality data regarding organ damage (as reported by the transplanting surgeon and confirmed by the OPO medical director) seen on the procured organ. RESULTS: These 36 OPOs recovered 5401 of the nations's 8504 deceased donors for calendar year 2014. A total of 19043 organs procured were prospectively analyzed. Of this total, 59 organs sustained damage making them non-transplantable (0 intestines; 4 pancreata; 5 lungs; 6 livers; 43 kidneys). The class 3 damage was spread over 22 (of 36) reporting OPO's. CONCLUSION: While damage to the procured organ is rare with organ loss being approximately 0.3% of procured organs, loss of potential transplantable organs does occur during procurement.Item Existing Transplant Nephrology Compensation Models and Opportunities for Equitable Pay(Wolters Kluwer, 2022) Josephson, Michelle A.; Wiseman, Alexander C.; Tucker, J. Kevin; Segal, Mark S.; Schmidt, Rebecca J.; Mujtaba, Muhammad A.; Gurley, Susan B.; Gaston, Robert S.; Doshi, Mona D.; Brennan, Daniel C.; Moe, Sharon M.; Medicine, School of MedicineThe American Society of Nephrology (ASN) formed the ASN Task Force on Academic Nephrologist Compensation and Productivity in 2020 to understand how the subspecialty is evolving and where there are needs for alignment in compensation in US transplant centers. The task force's review of the roles and responsibilities of transplant nephrologists is in the companion perspective (1). Transplant nephrologists are required for successful kidney transplantation, the ideal treatment from a survival and quality-of-life perspective for patients with kidney failure (2,3). Unfortunately, work relative value unit (wRVU) requirements for compensation models vary tremendously across institutions and limit the ability to adequately staff programs. This article addresses transplant nephrology models of care, how different models affect funds flow and compensation, and opportunities to more equitably compensate transplant nephrologists.Item A National Survey of Practice Patterns for Accepting Living Kidney Donors With Prior COVID-19(Science Direct, 2021-08-01) Jan, Muhammad Y.; Jawed, Areeba T.; Barros, Nicolas; Adebiyi, Oluwafisayo; Diez, Alejandro; Fridell, Jonathan A.; Goggins, William C.; Yaqub, Muhammad S.; Anderson, Melissa D.; Mujtaba, Muhammad A.; Taber, Tim E.; Mishler, Dennis P.; Kumar, Vineeta; Lentine, Krista L.; Sharfuddin, Asif A.; Medicine, School of MedicineIntroduction A critical question facing transplant programs is whether, when, and how to safely accept living kidney donors (LKDs) who have recovered from COVID-19 infection. The purpose of the study is to understand current practices related to accepting these LKDs. Methods We surveyed US transplant programs from 3 September through 3 November 2020. Center level and participant level responses were analyzed. Results A total of 174 respondents from 115 unique centers responded, representing 59% of US LKD programs and 72.4% of 2019 and 72.5% of 2020 LKD volume (Organ Procurement and Transplantation Network-OPTN 2021). In all, 48.6% of responding centers had received inquiries from such LKDs, whereas 44.3% were currently evaluating. A total of 98 donors were in the evaluation phase, whereas 27.8% centers had approved 42 such donors to proceed with donation. A total of 50.8% of participants preferred to wait >3 months, and 91% would wait at least 1 month from onset of infection to LD surgery. The most common reason to exclude LDs was evidence of COVID-19−related AKI (59.8%) even if resolved, followed by COVID-19−related pneumonia (28.7%) and hospitalization (21.3%). The most common concern in accepting such donors was kidney health postdonation (59.2%), followed by risk of transmission to the recipient (55.7%), donor perioperative pulmonary risk (41.4%), and donor pulmonary risk in the future (29.9%). Conclusion Practice patterns for acceptance of COVID-19−recovered LKDs showed considerable variability. Ongoing research and consensus building are needed to guide optimal practices to ensure safety of accepting such donors. Long-term close follow-up of such donors is warranted.Item The Importance of Transplant Nephrology to a Successful Kidney Transplant Program(Wolters Kluwer, 2022) Moe, Sharon M.; Brennan, Daniel C.; Doshi, Mona D.; Gaston, Robert S.; Gurley, Susan B.; Mujtaba, Muhammad A.; Schmidt, Rebecca J.; Segal, Mark S.; Tucker, J. Kevin; Wiseman, Alexander C.; Josephson, Michelle A.; Medicine, School of MedicineNephrologists are responsible for the care of patients with a diverse array of systemic diseases, comorbidities, and kidney issues across a variety of service locations (clinic, inpatient, dialysis unit). As the field of nephrology becomes increasingly complex, there has been a need for advanced training and subspecialization, similar to the transformation cardiology experienced with heart failure, electrophysiology, and interventional cardiology. As a result, the American Society of Nephrology (ASN) formed the ASN Task Force on Academic Nephrologist Compensation and Productivity to begin to understand the needed transformation, especially as it relates to assessing clinical productivity and compensation. Members of the task force included nephrology division chiefs, transplant program directors, and transplant nephrologists, representing academic and community transplant programs across the United States. The group met virtually throughout 2021 to discuss specific job functions, roles, responsibilities, and compensation models, and the discussion and conclusions follow. The flow of transplant funds from the hospital to the physician and transplant nephrology models of care are further discussed in a companion Perspective.