Anushka Das
Clinical Instructor, Pediatrics - Cardiology
Clinical Focus
- Hospitalist
Professional Education
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Board Certification: American Board of Pediatrics, Pediatrics (2024)
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Residency: MedStar Georgetown University Pediatrics Program (2023) DC
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Medical Education: Louisiana State University Health and Sciences Center Registrar (2020) LA
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Graduate, Tulane University School of Medicine, M.S. in Medical Genetics (2015)
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B.S., Tulane University, Molecular Biology (2014)
All Publications
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Assessing the adequacy of immunosuppression in pediatric liver transplantation with immune Monitoring: Are we there yet?
Human immunology
2025; 86 (5): 111580
Abstract
Current approaches used for pediatric liver transplant (LT) surveillance have diagnostic limitations. We used pleximmune™ immune reactivity index (IRI) and anti-HLA donor specific antibody (DSA) to predict the adequacy of immunosuppression (IS) relative to risk of acute cellular rejection (ACR) at 1-year post LT. This is a retrospective chart review of children who underwent LT between January 1, 2016, through December 31, 2020, and had at least one pleximmuneTM measurement performed within 60-days of a liver biopsy. There were 45 liver biopsies with accompanying pleximmuneTM in 31 children. An inverse correlation was observed between tacrolimus level and IRI (R = -0.34; p = 0.039). The sensitivity, specificity, positive and negative predictive values of IRI for diagnosis of ACR was 55 %, 65 %, 33 % and 81 % respectively. The combination of DSA and IRI had a specificity of 92 % and negative predictive value of 89 % for ACR. In conclusion, a high IRI identifies recipients with low tacrolimus levels. Thus, the associations observed in this non-standardized cohort support the use of pleximmuneTM IRI in combination with DSA, for hypothesis generation in future studies involving post liver transplant graft immune surveillance.
View details for DOI 10.1016/j.humimm.2025.111580
View details for PubMedID 40912176