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5 results on '"Karthik Santhanakrishnan"'

1. Extracorporeal photopheresis (ECP) in the treatment of chronic lung allograft dysfunction (CLAD): a prospective, multicentre, open-label, randomised controlled trial studying the addition of ECP to standard care in the treatment of bilateral lung transplant patients with CLAD (E-CLAD UK)

Author

Martin Carby, Jasvir Parmar, Andrew Bryant, Thomas Chadwick, Luke Vale, Catherine Exley, Andrew J Fisher, Helen Hancock, Richard Thompson, Joanne Lally, Andrew R Gennery, Michelle Bardgett, Siân Russell, Michael White, James MS Wason, Nicola Goudie, Anneka Kershaw, Julia Phillipson, Alex Bevin-Nicholls, Hesther Smith, Laura Frisby, Rebecca Errington, and Karthik Santhanakrishnan

Subjects
Medicine, Diseases of the respiratory system, RC705-779
Abstract

Background Long-term survival after lung transplantation is limited compared with other organ transplants. The main cause is development of progressive immune-mediated damage to the lung allograft. This damage, which can develop via multiple immune pathways, is captured under the umbrella term chronic lung allograft dysfunction (CLAD). Despite the availability of powerful immunosuppressive drugs, there are presently no treatments proven to reverse or reliably halt the loss of lung function caused by CLAD. The aim of the E-CLAD UK trial is to determine whether the addition of immunomodulatory therapy, in the form of extracorporeal photopheresis (ECP), to standard care is more efficacious at stabilising lung function in CLAD compared with standard care alone.Methods and analysis E-CLAD UK is a Phase II clinical trial of an investigational medicinal product (Methoxsalen) delivered to a buffy coat prepared via an enclosed ECP circuit. Target recruitment is 90 bilateral lung transplant patients identified as having CLAD and being treated at one of the five UK adult lung transplant centres. Participants will be randomised 1:1 to intervention plus standard of care, or standard of care alone. Intervention will comprise nine ECP cycles spread over 20 weeks, each course involving two treatments of ECP on consecutive days. All participants will be followed up for a period of 24 weeks.The primary outcome is lung function stabilisation derived from change in forced expiratory volume in one second and forced vital capacity at 12 and 24 weeks compared with baseline at study entry. Other parameters include change in exercise capacity, health-related quality of life and safety. A mechanistic study will seek to identify molecular or cellular markers linked to treatment response and qualitative interviews will explore patient experiences of CLAD and the ECP treatment.A patient and public advisory group is integral to the trial from design to implementation, developing material to support the consent process and interview materials.Ethics and dissemination The East Midlands—Derby Research Ethics Committee has provided ethical approval (REC 22/EM/0218). Dissemination will be via publications, patient-friendly summaries and presentation at scientific meetings.Trial registration number EudraCT number 2022-002659-20; ISRCTN 10615985.

Published
2024
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3. Organ transplantation from deceased donors with vaccine-induced thrombosis and thrombocytopenia

Author

Lisa Mumford, Quentin A. Hill, Muhammad Arslan Khurram, Rommel Ravanan, Sanjay Mehra, George H. B. Greenhall, Gavin J. Pettigrew, Ismail H. Mohamed, Reza Motallebzadeh, Nicholas Torpey, Chris J. Callaghan, Hemant Sharma, Gabriel C Oniscu, David J. Roberts, M. Thamara P. R. Perera, Gareth Jones, Ian Currie, Beverley Hunt, Jorge Mascaro, Darius F. Mirza, Marius Berman, Sue Pavord, Douglas Thorburn, Nicos Kessaris, Olive McGowan, Jay Nath, Sue Madden, Debabrata Roy, Karthik Santhanakrishnan, Sern Lim, Hermien Hartog, Aileen Marshall, Marc Clancy, Christopher J.E. Watson, Francis Calder, John Forsythe, Joerg-Matthias Pollok, and Ines Ushiro-Lumb

Subjects
kidney transplantation/nephrology, Organ transplantation, Immunology and Allergy, Pharmacology (medical), Letter to the Editor, media_common, Brain dead, Vaccines, biology, Vaccination, Brain, Heparin, Thrombosis, Tissue Donors, infection and infectious agents – viral: influenza, Antibody, medicine.drug, 2019-20 coronavirus outbreak, medicine.medical_specialty, Tissue and Organ Procurement, COVID-19 Vaccines, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), media_common.quotation_subject, clinical research/practice, Letter to the Editors, Insult, medicine, Humans, donors and donation: donor follow‐up, Platelet activation, Letters to the Editor, Transplantation, SARS-CoV-2, business.industry, Autoantibody, COVID-19, Organ Transplantation, medicine.disease, Thrombocytopenia, coagulation and hemostasis, Immunology, biology.protein, Etiology, business, liver transplantation/hepatology, autoantibody, Platelet factor 4
Abstract

Vaccine-induced thrombosis and thrombocytopenia (VITT) may follow immunisation with the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2. Autoantibodies to platelet factor 4 (PF4) may mediate VITT through antibody-dependent platelet activation, though the underlying etiology is uncertain. Anti-PF4 antibodies are also seen in heparin-induced thrombocytopenia, though most cases of VITT do not have prior heparin exposure. More than 20 million people in the United Kingdom (UK) have received the ChAdOx1 nCoV-19 vaccine.

Published
2021

4. Hypereosinophilic syndrome secondary to strongyloides infection: a case of recurrent asthma exacerbations

Author

Waseem Asrar Khan and Karthik Santhanakrishnan

Subjects
Adult, Disease, Article, Diagnosis, Differential, Hypereosinophilic Syndrome, medicine, Humans, Asthma, Autoimmune disease, Asthma exacerbations, Hypereosinophilic syndrome, business.industry, food and beverages, General Medicine, Eosinophil, medicine.disease, Strongyloidiasis, medicine.anatomical_structure, Immunology, Disease Progression, Female, Differential diagnosis, business, Tomography, X-Ray Computed
Abstract

Hypereosinophilic syndrome is a disease characterised by a persistently elevated eosinophil count. The syndrome can be reactive to infections, autoimmune disease, cancers, etc. Multiple organ involvement can occur including cardiomyopathies, pulmonary involvement and neuropathies. We describe a case of a patient who presented with signs and symptoms of asthma with recurrent asthma exacerbations, but in fact proved to be hypereosinophilic syndrome secondary to strongyloides infection.

Published
2013

5. Successful stenting of anastomotic stenosis of the left pulmonary artery after single lung transplantation

Author

Karthik Santhanakrishnan, L. Shapiro, Sandip Banerjee, J. Dunning, J. Parmar, and S. Tsui

Subjects
Pulmonary and Respiratory Medicine, lcsh:RC705-779, medicine.medical_specialty, Lung, Arterial stenosis, business.industry, medicine.medical_treatment, Bronchiolitis obliterans, Left pulmonary artery, lcsh:Diseases of the respiratory system, medicine.disease, Surgery, Transplantation, Stenosis, medicine.anatomical_structure, Internal medicine, Correspondence, medicine, Cardiology, Pulmonary angiography, Lung transplantation, business
Abstract

To the Editors: Lung transplantation is an established therapy for a variety of end-stage lung diseases. Successful transplantation improves prognosis and quality of life in most recipients. In the current setting where lung donors are scarce, single-lung transplantation allows for more extensive utilisation of the limited donor organ pool [1]. Although forced expiratory volume in 1 s (FEV1) recovery is lower and the risk of bronchiolitis obliterans syndrome is higher, single lung transplant recipients still have comparable exercise tolerance and quality-of-life scores when compared to bilateral lung transplant recipients [2]. Fortunately, vascular anastomotic stenoses are an uncommon event following lung transplantation. There are two types of vascular complications: either pulmonary arterial stenosis or pulmonary venous stenosis. The structures affected determine the clinical manifestations: arterial obstruction leads to pulmonary ischaemia and infarction, and venous obstruction leads to pulmonary oedema. The diagnosis should be considered in the presence of unexplained exertional hypoxaemia and persistent pulmonary hypertension. The diagnosis can be confirmed with computed tomography pulmonary angiogram (CTPA) and pulmonary angiography. As the complication is rare there are no clear treatment algorithms. In the very early phase (1 week), surgical treatment of the stenosis is the preferred option but may still carry a poor prognosis. However, later the options are broader …

Published
2011

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