Marcelo Kugelmas
Anschutz Medical Campus
Network
Latest external collaboration on country level. Dive into details by clicking on the dots.
Publication
Featured researches published by Marcelo Kugelmas.
Liver Transplantation | 2004
Paul H. Hayashi; James F. Trotter; Lisa M. Forman; Marcelo Kugelmas; Tracy Steinberg; Paul D. Russ; Michael Wachs; Thomas Bak; Igal Kam; Gregory T. Everson
The allocation system based on the Model for End‐stage Liver Disease (MELD) has led to more patients diagnosed with hepatocellular carcinoma (HCC) being transplanted. We hypothesized that more patients misdiagnosed with HCC are also being transplanted, leading to inappropriate organ allocation. Therefore, we retrospectively analyzed all liver transplants at our center from July 14, 2000, to October 22, 2002 (N = 172; 129 pre‐MELD, 43 post‐MELD), comparing pretransplant HCC diagnosis to explant histology. Thirty patients met the United Network for Organ Sharing (UNOS) diagnostic criteria for pretransplant HCC diagnosis. There were 25 men (median age, 52.5 yr), and 80% had hepatitis C. The proportion of patients transplanted who had an HCC diagnosis increased from 12% (15/129) pre‐MELD to 35% (15/43) post‐MELD implementation (P < 0.01). Three of 15 (20%) transplanted pre‐MELD and 5 of 15 (33%) transplanted post‐MELD lacked HCC in the explant (P = 0.10). Of the three false‐positives pre‐MELD, one was Status 2B already, and two received living‐donor livers. Of the 5 false‐positives post‐MELD, three had score upgrades that led to early transplantation (13 to 29, 20 to 29, and 9 to 24) while two had MELD scores of 35 and 36 already. The percentage of organs that could have gone to patients with more advanced liver disease without HCC increased from 0% (0/129) pre‐MELD to 7% (3/43) post‐MELD (P < 0.01). Since the implementation of MELD, the proportion of patients transplanted who had an HCC diagnosis nearly tripled, and a small but significant proportion of organs are now going to patients misdiagnosed with HCC. More stringent HCC diagnostic criteria will be required to decrease the effect that misdiagnosis has on organ allocation. (Liver Transpl 2004;10:42–48.)
Journal of Cystic Fibrosis | 2002
Kristin Wallick; Matthew Dickinson; David S. James; Marcelo Kugelmas; Nancy E. Madinger; David M. Rodman
We report a case of P. aeruginosa cholangitis in an adult with cystic fibrosis (CF). The patient had a past history of cholecystectomy and a new finding of intrahepatic biliary duct stricture. Evaluation and treatment with endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous biliary tract drainage was complicated by post-procedure pain and fever. The only organism recovered from biliary drainage was P. aeruginosa. Southern blot analysis of respiratory and biliary cultures confirmed that the isolates were identical. Despite aggressive antibiotic therapy and drainage, persistent cholangitis and infection have not been eradicated after 6 months. The most likely mechanism of infection of the biliary tract was direct introduction of the upper respiratory tract pathogen during the diagnostic procedure.
Hepatology | 2003
Marcelo Kugelmas; Daniell B. Hill; Beverly Vivian; Luis Marsano; Craig J. McClain
Seminars in Liver Disease | 1999
Craig J. McClain; Shirish Barve; Ion V. Deaciuc; Marcelo Kugelmas; Daniell B. Hill
Liver Transplantation | 2001
James F. Trotter; Michael Talamantes; Mary McClure; Michael Wachs; Thomas Bak; Thomas Trouillot; Marcelo Kugelmas; Gregory T. Everson; Igal Kam
Liver Transplantation | 2001
Thomas Bak; Michael Wachs; James F. Trotter; Gregory T. Everson; Thomas Trouillot; Marcelo Kugelmas; Tracy Steinberg; Igal Kam
Liver Transplantation | 2003
Marcelo Kugelmas; Purnima Spiegelman; Michael J. Osgood; David A. Young; James F. Trotter; Tracy Steinberg; Michael Wachs; Thomas Bak; Igal Kam; Gregory T. Everson
Liver Transplantation | 2003
Paul H. Hayashi; Lisa M. Forman; Tracy Steinberg; Thomas Bak; Michael Wachs; Marcelo Kugelmas; Gregory T. Everson; Igal Kam; James F. Trotter
Liver Transplantation | 2001
James F. Trotter; Michael Wachs; Thomas Trouillot; Thomas Bak; Marcelo Kugelmas; Igal Kam; Gregory T. Everson
Liver Transplantation | 2002
James F. Trotter; Nancy Stolpman; Michael Wachs; Thomas Bak; Marcelo Kugelmas; Igal Kam; Gregory T. Everson