Pediatrics

Research Overview

I am a clinical researcher with interests in chronic renal failure, pediatric kidney transplantation and post-transplant infections. I perform epidemiological analyses of very large national databases to elucidate risk factors for events and the outcomes after events, typically infectious events. These large databases include UNOS, USRDS, NAPRTCS. I also participate in multi-center clinical and mechanistic research trials in the areas of chronic renal insufficiency, dialysis and transplantation. My work gets funding from NIH institutes (NIDDK, NIAID) and industry. I am particularly known for my work related to a post-transplant malignancy called post-transplant lymphoproliferative disorder (PTLD), caused in most cases by Epstein-Barr virus infection. These issues of infection and malignancy post-transplant have received a lot of attention as we gave our patients more immunosuppression in the hopes of reducing acute rejection rates. My collaborators are numerous. For the prospective clinical trials, my collaborators include pediatric nephrology colleagues at various centers such as Harvard, Johns Hopkins, University of Pennsylvania, UCSF, University of Washington and UAB. For my epidemiological studies, I collaborate with an adult nephrologist in the Army, with biostatisticians and epidemiologists at Emmes Corporation and with a biostatistician at UNOS.

About

I obtained my medical degree (MBBS) from the University of Bombay. I also completed a pediatrics residency, leading to an MD degree in Pediatrics, from the same institution. My interest in pediatric nephrology developed during my final year of residency. In my one year as a Junior Faculty member there, I completed and published some studies of kidney size changes with malnutrition and adverse drug reactions in children. I then came to the USA to pursue further training in pediatric nephrology. I initially completed a second partial residency at Children's Hospital of Michigan (Wayne State University). There I worked under one of the giants in pediatric nephrology, Alan Gruskin, who was kind enough to fund my first USA-based study on microalbuminuria in sickle cell disease.

I then went to Children's Hospital Boston for my pediatric nephrology fellowship, where my interest in transplantation was sparked by Bill Harmon and David Briscoe. It was there that I first got involved with PTLD and its devastating implications. From Boston, I came to Gainesville as a Faculty member, and I have been here ever since. In 2007 I completed an MPH in Biostatistics, a skill of direct use in my research. I am currently the division chief, fellowship director and medical director of pediatric kidney transplantation.

Key Publications

As of July 2008, my CV lists 94 peer-reviewed papers, 9 chapters, and 65 conference presentations. I am also first editor of a new book on PTLD, due to come out in early 2009. I am the current chair of the national level Pediatric Community of Practice within the American Society of Transplantation. I am also a member of the training and certification committee and the program committee of the American Society of Pediatric Nephrology.

Additional publications can be found in PubMed.

1. Dharnidharka VR, Araya CE, Wadsworth C, McKinney M, Howard RJ. Assessing the value of ureteral stent placement in pediatric kidney transplant recipients. Transplantation, 2008;85:986-991 (cited and discussed in Nature Clinical Practice Nephrology 2008)
2. Kirk AD, Cherikh WS, Ring M, Burke G, Kaufman D, Knechtle SJ, Potdar S, Shapiro R, Dharnidharka VR, Kauffman HM. Dissociation of depletional induction and post transplant lymphoproliferative disease in kidney recipients treated with alemtuzumab. Am J Transplant, 2007;7:2619-2625
3. Smith JM, Dharnidharka VR, Talley L, Martz K, McDonald RA. BK virus nephropathy in pediatric renal transplant recipients: An analysis of the NAPRTCS registry. Clinical Journal of the American Society of Nephrology, 2007;2:100-106
4. Araya CE, Fennell RS, Neiberger RE, Dharnidharka VR. Hemodialysis catheter related bacteremia in children: increasing antibiotic resistance and changing bacteriological profile. American Journal of Kidney Diseases, 2007;50:119-123. (Study discussed by Reuters Health in news article August 22, 2007)
5. Dharnidharka VR. Pediatric Kidney Transplantation Literature Review- 2006. Pediatric Transplantation, 2007;11:354-365