Alexandra P Turner

Interests

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Scholarly Contributions

Chapters

• Turner, A. P., Farris, A. B., Freitas, A. M., & Cendales, L. C. (2014). Histopathological Syndromes of Vascularized Composite Allograft Rejection and Recurrent Disease. In Textbook of Organ Transplantation. John Wiley & Sons, Ltd. doi:10.1002/9781118873434.CH87
• Turner, A., & Turgeon, N. (2014). Patient selection and indications for organ transplantation: pancreas and islet transplantation. In Textbook of Organ Transplantation. Oxford, UK: Wiley Blackwell.
• Turner, A., Farris, A., Freitas, A., & Cendales, L. (2014). Histopathological syndromes of graft rejection and recurrent disease:. In Textbook of Organ Transplantation. Oxford, UK: Wiley Blackwell.

Journals/Publications

• Dill-Macky, A., Hsu, C., Neumayer, L., Nfonsam, V., & Turner, A. (2022). The Role of Implicit Bias in Surgical Resident Evaluations.. J Surg Educ., 761-68. doi:https://doi.org/10.1016/j.jsurg.2021.12.003
• Turner, A. P. (2021).

  The Role of Implicit Bias in Surgical Resident Evaluations

  . Journal of Surgical Education. doi:10.1016/j.jsurg.2021.12.003
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  Implicit bias is a key factor preventing the advancement and retention of women and underrepresented minorities in academic surgery.We examined the role of implicit bias in the technical component of the residency performance evaluation. The Fundamentals of Laparoscopic Surgery (FLS) score, an objective measure of technical performance, was compared to the subjective technical skills (TS) score given by attending surgeons.FLS scores and the average TS scores from chief resident evaluations at a university program were analyzed from 2015 to 2019 (n = 29 residents; female 22%, underrepresented minorities 27%). The average TS score for each resident was calculated, scores dichotomized above and below the mean for the program and analyzed across gender and racial identity.There were no significant differences in FLS or TS scores between male and female trainees or racial identity. The Kappa correlation coefficient between the 2 dichotomized scores was significantly lower for female (-0.50) versus male (0.23) trainees (p < 0.01); it was not significantly different between racial groups (p = 0.34).There was statistically significant difference in agreement between the FLS and TS scores of individual female and male trainees, suggesting the presence of implicit bias in our pilot study. Further research with a larger sample size is warranted.To investigate the presence of implicit bias against women and underrepresented minorities in the technical component of the residency performance evaluation. We hypothesized that women and underrepresented racial minorities would have lower subjective technical skills (TS) scores as compared to their objective FLS scores, relative to the mean for the training program.FLS scores and the average TS scores from chief resident performance evaluations were analyzed from 2015-2019. Both FLS and the average TS scores were dichotomized above and below the mean for the program and analyzed across gender and racial identity. Research was approved by institutional IRB.This study was conducted at the University of Arizona General Surgery Residency Program at Banner University Medical Center in Tucson, Arizona. This is a tertiary care university training program.Educational records of graduated general surgery chief residents from 2015 to 2019 were accessed for the study. We analyzed 37 TS scores from attending performance evaluations and 29 FLS scores reported to the program during the study period (22% female, 27% underrepresented racial minorities).There were no significant differences in FLS or TS scores between male and female trainees or racial identity. The Kappa correlation coefficient between the 2 dichotomized scores was significantly lower for female (-0.50) versus male (0.23) trainees (p < 0.01); it was not significantly different between racial groups (p = 0.34).There was a statistically significant difference in agreement between the FLS and TS score of individual female and male trainees, suggesting the presence of implicit bias in this pilot study. Further research with a larger sample size is warranted.
• Kodali, L., & Turner, A. (2019). When are you too old to get a kidney transplant?. Current Opinion in Nephrology and Hypertension, 28(6), 593-599. doi:10.1097/MNH.0000000000000548
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  With the increasing incidence and prevalence of ESRD in the elderly, we are now transplanting more elderly patients. Although we know from previous reports that transplantation provides increased survival advantage and/or quality of life when compared to being on dialysis, we also know that transplantation is not the best option for all patients. In this review, we try to identify the upper age limit (if any) for deceased donor renal transplantation, predictive factors that can identify the risks for transplant outcomes, frailty, and immunosenescence.
• Shiani, A., Lipka, S., Kumar, A., Alsina, A., Kemmer, N., Turner, A., & Brady, P. (2016). Can the Severity of Laboratory Abnormality Predict Presence of Anastomotic Stricture in the Postorthotopic Liver Transplant Population?: 873. The American Journal of Gastroenterology, 111, S382. doi:10.14309/00000434-201610001-00873
• Shiani, A., Wolk, B. C., Lipka, S., Kumar, A., Alsina, A., Kemmer, N., Turner, A., & Brady, P. (2016). Sa1625 Diagnostic Accuracy of MRCP vs ERCP Findings in the Post-Orthotopic Liver Transplant Population. Gastroenterology, 150(4), S1080. doi:10.1016/s0016-5085(16)33639-3
• Roch, A. M., Singh, H., Turner, A. P., Ceppa, E. P., House, M. G., Zyromski, N. J., Nakeeb, A., & Schmidt, C. M. (2015). Extended distal pancreatectomy for pancreatic adenocarcinoma with splenic vein thrombosis and/or adjacent organ invasion. American journal of surgery, 209(3), 564-9.
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  Patients with adenocarcinoma of the pancreatic body/tail and associated vascular thrombosis or adjacent organ invasion are suboptimal candidates for resection. We hypothesized that extended distal pancreatectomy (EDP) for locally advanced adenocarcinoma is associated with a survival benefit.
• Schmidt, H., Kilbane, E. M., Turner, A. P., House, M. G., Zyromski, N. J., Nakeeb, A., Schmidt, C. M., Ceppa, E. P., & Valsangkar, N. P. (2014). Mo1621 Socioeconomic Status and Surgical Outcomes After Regional Pancreatectomy. Gastroenterology, 146(5), S-1068. doi:10.1016/s0016-5085(14)63895-6
• Turner, A., Golas, A. A., Johnson, M. S., Nakeeb, A., Pitt, H. A., & House, M. G. (2014). Su1820 Liver Transplantation for Unresectable Intrahepatic Cholangiocarcinoma: Improved Outcomes With Neoadjuvant Therapy. Gastroenterology, 146(5), S-1044-S-1045. doi:10.1016/s0016-5085(14)63807-5
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  Introduction: Underlying liver disease and portal hypertension limit surgical treatment options for hepatocellular carcinoma (HCC), as these patients are high-risk for complications. We hypothesize that hepatic fibrosis and cirrhosis increase the probability of post-resection 30-day mortality. Methods: The National Cancer Data Base (NCDB) was queried for all cases of HCC from 1998-2011. Hepatic fibrosis was measured using the Ishak scale (0= no fibrosis and 1 = bridging fibrosis and cirrhosis). Comorbid conditions were classified using the
• Lowe, M. C., Badell, I. R., Turner, A. P., Thompson, P. W., Leopardi, F. V., Strobert, E. A., Larsen, C. P., & Kirk, A. D. (2013). Belatacept and sirolimus prolong nonhuman primate islet allograft survival: adverse consequences of concomitant alefacept therapy. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 13(2), 312-9.
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  Calcineurin inhibitors (CNI) and steroids are known to promote insulin resistance, and their avoidance after islet transplantation is preferred from a metabolic standpoint. Belatacept, a B7-specific mediator of costimulation blockade (CoB), is clinically indicated as a CNI alternative in renal transplantation, and we have endeavored to develop a clinically translatable, belatacept-based regimen that could obviate the need for both CNIs and steroids. Based on the known synergy between CoB and mTOR inhibition, we studied rhesus monkeys undergoing MHC-mismatched islet allotransplants treated with belatacept and the mTOR inhibitor, sirolimus. To extend prior work on CoB-resistant rejection, some animals also received CD2 blockade with alefacept (LFA3-Ig). Nine rhesus macaques were rendered diabetic with streptozotocin and underwent islet allotransplantation. All received belatacept and sirolimus; six also received alefacept. Belatacept and sirolimus significantly prolonged rejection-free graft survival (median 225 days compared to 8 days in controls receiving basiliximab and sirolimus; p = 0.022). The addition of alefacept provided no additional survival benefit, but was associated with Cytomegalovirus reactivation in four of six animals. No recipients produced donor-specific alloantibodies. The combination of belatacept and sirolimus successfully prevents islet allograft survival in rhesus monkeys, but induction with alefacept provides no survival benefit and increases the risk of viral reactivation.
• Turner, A. P., & Knechtle, S. J. (2013). Induction immunosuppression in liver transplantation: a review. Transplant international : official journal of the European Society for Organ Transplantation, 26(7), 673-83.
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  Antibody therapy for induction is seldom used in liver transplantation in the United States, but continues to be used in approximately 10% of patients. The most commonly used antibody at the current time is basiliximab (Simulect, Novartis) and is used in adults with renal dysfunction at the time of liver transplantation with the intention of delaying introduction of calcineurin-inhibitors. In children, the same antibody is commonly used in order to reduce rates of acute rejection. Most patients, adult and pediatric, are treated with initially higher levels of tacrolimus rather than antibody induction.
• Badell, I. R., Russell, M. C., Cardona, K., Shaffer, V. O., Turner, A. P., Avila, J. G., Cano, J. A., Leopardi, F. V., Song, M., Strobert, E. A., Ford, M. L., Pearson, T. C., Kirk, A. D., & Larsen, C. P. (2012). CTLA4Ig prevents alloantibody formation following nonhuman primate islet transplantation using the CD40-specific antibody 3A8. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 12(7), 1918-23.
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  Islet transplantation to treat type 1 diabetes has been limited in part by toxicities of current immunosuppression and recipient humoral sensitization. Blockade of the CD28/CD80/86 and CD40/CD154 pathways has shown promise to remedy both these limitations, but translation has been hampered by difficulties in translating CD154-directed therapies. Prior CD40-directed regimens have led to prolonged islet survival, but fail to prevent humoral allosensitization. We therefore evaluated the addition of CTLA4Ig to a CD40 blockade-based regimen in nonhuman primate (NHP) alloislet transplantation. Diabetic rhesus macaques were transplanted allogeneic islets using the CD40-specific antibody 3A8, basiliximab induction, and sirolimus with or without CTLA4Ig maintenance therapy. Allograft survival was determined by fasting blood glucose levels and flow cytometric techniques were used to test for donor-specific antibody (DSA) formation. CTLA4Ig plus 3A8, basiliximab and sirolimus was well tolerated and induced long-term islet allograft survival. The addition of CTLA4Ig prevented DSA formation, but did not facilitate withdrawal of the 3A8-based regimen. Thus, CTLA4Ig combines with a CD40-specific regimen to prevent DSA formation in NHPs, and offers a potentially translatable calcineurin inhibitor-free protocol inclusive of a single investigational agent for use in clinical islet transplantation without relying upon CD154 blockade.
• Badell, I. R., Thompson, P. W., Turner, A. P., Russell, M. C., Avila, J. G., Cano, J. A., Robertson, J. M., Leopardi, F. V., Strobert, E. A., Iwakoshi, N. N., Reimann, K. A., Ford, M. L., Kirk, A. D., & Larsen, C. P. (2012). Nondepleting anti-CD40-based therapy prolongs allograft survival in nonhuman primates. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 12(1), 126-35.
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  Costimulation blockade of the CD40/CD154 pathway has been effective at preventing allograft rejection in numerous transplantation models. This strategy has largely depended on mAbs directed against CD154, limiting the potential for translation due to its association with thromboembolic events. Though targeting CD40 as an alternative to CD154 has been successful at preventing allograft rejection in preclinical models, there have been no reports on the effects of CD40-specific agents in human transplant recipients. This delay in clinical translation may in part be explained by the presence of cellular depletion with many CD40-specific mAbs. As such, the optimal biologic properties of CD40-directed immunotherapy remain to be determined. In this report, we have characterized 3A8, a human CD40-specific mAb and evaluated its efficacy in a rhesus macaque model of islet cell transplantation. Despite partially agonistic properties and the inability to block CD40 binding of soluble CD154 (sCD154) in vitro, 3A8-based therapy markedly prolonged islet allograft survival without depleting B cells. Our results indicate that the allograft-protective effects of CD40-directed costimulation blockade do not require sCD154 blockade, complete antagonism or cellular depletion, and serve to support and guide the continued development of CD40-specific agents for clinical translation.
• Thompson, P., Badell, I. R., Lowe, M., Turner, A., Cano, J., Avila, J., Azimzadeh, A., Cheng, X., Pierson, R. N., Johnson, B., Robertson, J., Song, M., Leopardi, F., Strobert, E., Korbutt, G., Rayat, G., Rajotte, R., Larsen, C. P., & Kirk, A. D. (2012). Alternative immunomodulatory strategies for xenotransplantation: CD40/154 pathway-sparing regimens promote xenograft survival. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 12(7), 1765-75.
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  Immunosuppressive therapies that block the CD40/CD154 costimulatory pathway have proven to be uniquely effective in preclinical xenotransplant models. Given the challenges facing clinical translation of CD40/CD154 pathway blockade, we examined the efficacy and tolerability of CD40/CD154 pathway-sparing immunomodulatory strategies in a pig-to-nonhuman primate islet xenotransplant model. Rhesus macaques were rendered diabetic with streptozocin and given an intraportal infusion of ≈ 50 000 islet equivalents/kg wild-type neonatal porcine islets. Base immunosuppression for all recipients included maintenance therapy with belatacept and mycophenolate mofetil plus induction with basiliximab and LFA-1 blockade. Cohort 1 recipients (n = 3) were treated with the base regimen alone; cohort 2 recipients (n = 5) were additionally treated with tacrolimus induction and cohort 3 recipients (n = 5) were treated with alefacept in place of basiliximab, and more intense LFA-1 blockade. Three of five recipients in both cohorts 2 and 3 achieved sustained insulin-independent normoglycemia (median rejection-free survivals 60 and 111 days, respectively), compared to zero of three recipients in cohort 1. These data show that CD40/CD154 pathway-sparing regimens can promote xenoislet survival. Further optimization of these strategies is warranted to aid the clinical translation of islet xenotransplantation.
• Turner, A. P., Shaffer, V. O., Araki, K., Martens, C., Turner, P. L., Gangappa, S., Ford, M. L., Ahmed, R., Kirk, A. D., & Larsen, C. P. (2011). Sirolimus enhances the magnitude and quality of viral-specific CD8+ T-cell responses to vaccinia virus vaccination in rhesus macaques. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 11(3), 613-8.
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  Sirolimus is a potent antiproliferative agent used clinically to prevent renal allograft rejection. However, little is known about the effects of maintenance immunosuppressive agents on the immune response to potentially protective vaccines. Here we show that sirolimus paradoxically increases the magnitude and quality of the CD8+ T-cell response to vaccinia vaccination in nonhuman primates, fostering more robust recall responses compared to untreated and tacrolimus-treated controls. Enhancement of both the central and effector memory compartments of the vaccinia-specific CD8+ T-cell response was observed. These data elucidate new mechanistic characteristics of sirolimus and suggest immune applications extending beyond its role as an immunosuppressant.
• Badell, I. R., Russell, M. C., Thompson, P. W., Turner, A. P., Weaver, T. A., Robertson, J. M., Avila, J. G., Cano, J. A., Johnson, B. E., Song, M., Leopardi, F. V., Swygert, S., Strobert, E. A., Ford, M. L., Kirk, A. D., & Larsen, C. P. (2010). LFA-1-specific therapy prolongs allograft survival in rhesus macaques. The Journal of clinical investigation, 120(12), 4520-31.
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  Outcomes in transplantation have been limited by suboptimal long-term graft survival and toxicities associated with current immunosuppressive approaches. T cell costimulation blockade has shown promise as an alternative strategy to avoid the side effects of conventional immunosuppressive therapies, but targeting CD28-mediated costimulation alone has proven insufficient to prevent graft rejection in primates. Donor-specific memory T (TM) cells have been implicated in costimulation blockade-resistant transplant rejection, due to their enhanced effector function and decreased reliance on costimulatory signaling. Thus, we have tested a potential strategy to overcome TM cell-driven rejection by targeting molecules preferentially expressed on these cells, such as the adhesion molecule lymphocyte function-associated antigen 1 (LFA-1). Here, we show that short-term treatment (i.e., induction therapy) with the LFA-1-specific antibody TS-1/22 in combination with either basiliximab (an IL-2Rα-specific mAb) and sirolimus (a mammalian target of rapamycin inhibitor) or belatacept (a high-affinity variant of the CD28 costimulation-blocker CTLA4Ig) prolonged islet allograft survival in nonhuman primates relative to control treatments. Moreover, TS-1/22 masked LFA-1 on TM cells in vivo and inhibited the generation of alloproliferative and cytokine-producing effector T cells that expressed high levels of LFA-1 in vitro. These results support the use of LFA-1-specific induction therapy to neutralize costimulation blockade-resistant populations of T cells and further evaluation of LFA-1-specific therapeutics for use in transplantation.
• Ferrer, I. R., Wagener, M. E., Robertson, J. M., Turner, A. P., Araki, K., Ahmed, R., Kirk, A. D., Larsen, C. P., & Ford, M. L. (2010). Cutting edge: Rapamycin augments pathogen-specific but not graft-reactive CD8+ T cell responses. Journal of immunology (Baltimore, Md. : 1950), 185(4), 2004-8.
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  Recent evidence demonstrating that exposure to rapamycin during viral infection increased the quantity and quality of Ag-specific T cells poses an intriguing paradox, because rapamycin is used in transplantation to dampen, rather than enhance, donor-reactive T cell responses. In this report, we compared the effects of rapamycin on the Ag-specific T cell response to a bacterial infection versus a transplant. Using a transgenic system in which the Ag and the responding T cell population were identical in both cases, we observed that treatment with rapamycin augmented the Ag-specific T cell response to a pathogen, whereas it failed to do so when the Ag was presented in the context of a transplant. These results suggest that the environment in which an Ag is presented alters the influence of rapamycin on Ag-specific T cell expansion and highlights a fundamental difference between Ag presented by an infectious agent as compared with an allograft.
• Miller, W. P., Srinivasan, S., Panoskaltsis-Mortari, A., Singh, K., Sen, S., Hamby, K., Deane, T., Stempora, L., Beus, J., Turner, A., Wheeler, C., Anderson, D. C., Sharma, P., Garcia, A., Strobert, E., Elder, E., Crocker, I., Crenshaw, T., Penedo, M. C., , Ward, T., et al. (2010). GVHD after haploidentical transplantation: a novel, MHC-defined rhesus macaque model identifies CD28- CD8+ T cells as a reservoir of breakthrough T-cell proliferation during costimulation blockade and sirolimus-based immunosuppression. Blood, 116(24), 5403-18.
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  We have developed a major histocompatibility complex-defined primate model of graft-versus-host disease (GVHD) and have determined the effect that CD28/CD40-directed costimulation blockade and sirolimus have on this disease. Severe GVHD developed after haploidentical transplantation without prophylaxis, characterized by rapid clinical decline and widespread T-cell infiltration and organ damage. Mechanistic analysis showed activation and possible counter-regulation, with rapid T-cell expansion and accumulation of CD8(+) and CD4(+) granzyme B(+) effector cells and FoxP3(pos)/CD27(high)/CD25(pos)/CD127(low) CD4(+) T cells. CD8(+) cells down-regulated CD127 and BCl-2 and up-regulated Ki-67, consistent with a highly activated, proliferative profile. A cytokine storm also occurred, with GVHD-specific secretion of interleukin-1 receptor antagonist (IL-1Ra), IL-18, and CCL4. Costimulation Blockade and Sirolimus (CoBS) resulted in striking protection against GVHD. At the 30-day primary endpoint, CoBS-treated recipients showed 100% survival compared with no survival in untreated recipients. CoBS treatment resulted in survival, increasing from 11.6 to 62 days (P < .01) with blunting of T-cell expansion and activation. Some CoBS-treated animals did eventually develop GVHD, with both clinical and histopathologic evidence of smoldering disease. The reservoir of CoBS-resistant breakthrough immune activation included secretion of interferon-γ, IL-2, monocyte chemotactic protein-1, and IL-12/IL-23 and proliferation of cytotoxic T-lymphocyte-associated antigen 4 immunoglobulin-resistant CD28(-) CD8(+) T cells, suggesting adjuvant treatments targeting this subpopulation will be needed for full disease control.
• Araki, K., Turner, A. P., Shaffer, V. O., Gangappa, S., Keller, S. A., Bachmann, M. F., Larsen, C. P., & Ahmed, R. (2009). mTOR regulates memory CD8 T-cell differentiation. Nature, 460(7251), 108-12.
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  Memory CD8 T cells are a critical component of protective immunity, and inducing effective memory T-cell responses is a major goal of vaccines against chronic infections and tumours. Considerable effort has gone into designing vaccine regimens that will increase the magnitude of the memory response, but there has been minimal emphasis on developing strategies to improve the functional qualities of memory T cells. Here we show that mTOR (mammalian target of rapamycin, also known as FRAP1) is a major regulator of memory CD8 T-cell differentiation, and in contrast to what we expected, the immunosuppressive drug rapamycin has immunostimulatory effects on the generation of memory CD8 T cells. Treatment of mice with rapamycin following acute lymphocytic choriomeningitis virus infection enhanced not only the quantity but also the quality of virus-specific CD8 T cells. Similar effects were seen after immunization of mice with a vaccine based on non-replicating virus-like particles. In addition, rapamycin treatment also enhanced memory T-cell responses in non-human primates following vaccination with modified vaccinia virus Ankara. Rapamycin was effective during both the expansion and contraction phases of the T-cell response; during the expansion phase it increased the number of memory precursors, and during the contraction phase (effector to memory transition) it accelerated the memory T-cell differentiation program. Experiments using RNA interference to inhibit expression of mTOR, raptor (also known as 4932417H02Rik) or FKBP12 (also known as FKBP1A) in antigen-specific CD8 T cells showed that mTOR acts intrinsically through the mTORC1 (mTOR complex 1) pathway to regulate memory T-cell differentiation. Thus these studies identify a molecular pathway regulating memory formation and provide an effective strategy for improving the functional qualities of vaccine- or infection-induced memory T cells.
• Badell, I. R., Turner, A. P., Cano, J. A., Avila, J. G., Johnson, B. E., Leopardi, F. V., Swygert, S. G., Strobert, E. A., Kirk, A. D., & Larsen, C. P. (2009). A novel calcineurin inhibitor– and sirolimus-free anti-LFA-1-based therapy enhances allogeneic islet survival and function in nonhuman primates. Journal of The American College of Surgeons, 209(3), S56. doi:10.1016/j.jamcollsurg.2009.06.133
• Weaver, T. A., Charafeddine, A. H., Agarwal, A., Turner, A. P., Russell, M., Leopardi, F. V., Kampen, R. L., Stempora, L., Song, M., Larsen, C. P., & Kirk, A. D. (2009). Alefacept promotes co-stimulation blockade based allograft survival in nonhuman primates. Nature medicine, 15(7), 746-9.
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  Memory T cells promote allograft rejection particularly in co-stimulation blockade-based immunosuppressive regimens. Here we show that the CD2-specific fusion protein alefacept (lymphocyte function-associated antigen-3-Ig; LFA -3-Ig) selectively eliminates memory T cells and, when combined with a co-stimulation blockade-based regimen using cytotoxic T lymphocyte antigen-4 (CTLA-4)-Ig, a CD80- and CD86-specific fusion protein, prevents renal allograft rejection and alloantibody formation in nonhuman primates. These results support the immediate translation of a regimen for the prevention of allograft rejection without the use of calcineurin inhibitors, steroids or pan-T cell depletion.

Presentations

• Turner, A. (2021, Spring). "The Role of Implicit Bias in Surgical Resident Evaluations". 16th Annual Academic Surgical Congress. Virtual.
• Lowe, M., Badell, I., Turner, A., Thompson, P., Weaver, T., Leopardi, F., Strobert, E., Larsen, C., & Kirk, A. (2011, April / Spring). Alefacept improves efficacy of costimulation blockade in nonhuman primate islet allograft survival. American Transplant Conference.
• Badell, I., Russell, M., Turner, A., Avila, J., Cano, J., Johnson, B., Strobert, E., Kirk, A., & Larsen, C. (2009, May / Summer). A Novel Anti-LFA-1-Based Therapy Enhances Allogeneic Islet Survival and Function in Nonhuman Primates. American Transplant Congress.
• Badell, I., Turner, A., Russell, M., Avila, J., Cano, J., Johnson, B., Strobert, E., Kirk, A., & Larsen, C. (2009, October / Fall). A novel calcineurin inhibitor and sirolimus-free anti- LFA-1-based therapy enhances allogeneic islet survival and function in nonhuman primates. American College of Surgeons Clinical Congress.
• Russell, M. C., Cardona, K., Olivia, V. L., Turner, A., Cano, J., Avila, J., Jiang, W., Leopardi, F., Johnson, B., Scott, E., Strobert, E., Pearson, T. C., Kirk, A. D., & Larsen, C. P. (2008, May / Summer). A novel costimulation blockade regimen for engraftment and function of allogeneic islets in diabetic rhesus macaques. American Transplant Congress.
• Turner, A., Weaver, T. A., Badell, I. R., Cano, J., Avila, J., Turner, P. L., Leopardi, F. V., Strobert, E., Larsen, C. P., & Kirk, A. D. (2009, May / Summer). LFA-3-Ig (alefacept) prolongs allograft survival by targeting costimulation blockade resistant T effector memory (TEM) cells in non-human primate islet transplantation. American Transplant Congress.

Poster Presentations

• Turner, A., Vargas, K., Hsu, C., & Harland, R. (2023, June). Native American Disparities in Access to Kidney Transplantation. American Transplant Congress 2023. San Diego, California: American Society of Transplantation, American Society of Transplant Surgeons.
• Turner, A. (2021, Summer). "Frailty and Short-Term Outcomes in Kidney Transplantation". 2021 American Transplant CongressAmerican Society of Transplantation.
• Turner, A. (2021, Summer). "The Edge Of Glory: Determinants Of Success And Failure For Prolonged Cold Ischemia In Kidney Transplantation". 2021 American Transplant Congress. Seattle, WA: American Society of Transplant Surgeons.
• Shiani, A., Wolk, B., Lipka, S., Kumar, A., Alsinia, A., Kemmer, N., Turner, A., & Brady, P. (2016, May / Spring). Diagnostic Accuracy of MRCP vs. ERCP Findings in the Post-Orthotopic Liver Transplant Population. Digestive Disease Week. San Diego, CA.
• Wolk, B., Shiani, A., Lipka, S., Kumar, A., Kemmer, N., Pinkas, H., Alsina, A., Brady, P., & Turner, A. (2016, June / Summer). Is Early Endoscopic Retrograde Cholangiopancreatography (ERCP) Safe Post Liver Transplant?. American Transplant Congress. Boston, MA.
• Kemmer, N., Franco, E., Turner, A., Albers, C., Horkan, J., Parkinson, E., Cece, E., & Alsina, A. (2015, May / Spring). The impact of HCV on post transplant biliary strictures. American Transplant Congress. Philadelphia, PA: American Society of Transplant Surgeons.
• Schmidt, H., Kilbane, E. M., Turner, A., House, M. G., Zyromski, N. J., Nakeeb, A., & Schmidt, E. P. (2014, February / Winter). Socioeconomic status and surgical outcomes after total pancreatectomy. Americas Hepato-Pancreato-Biliary Association Annual Meeting.
• Turner, A., Golas, A., Johnson, M. S., Nakeeb, A., Pitt, H. A., & House, M. G. (2014, May/Spring). Liver transplantation for unresectable intrahepatic cholangiocarcinoma: improved outcomes with neoadjuvant therapy. The Society for Surgery of the Alimentary Tract Annual Meeting,. Chicago, IL: Society for Surgery of the Alimentary Tract.
• Agarwal, A., Avila, J. G., Turgeon, N. A., Sears, M. H., Turner, A., Russell, M. C., Sarmiento, J., Kirk, A. D., Pearson, T. C., & Larsen, C. P. (2009, May / Summer). Total Pancreatectomy and Autologous Islet Transplantation for Chronic Pancreatitis: Long Term Assessment of Graft Function. American Transplant Congress.
• Avila, J. G., Agarwal, A., Turgeon, N., Cano, J. A., Turner, A., Russell, M. C., Kirk, A. D., Pearson, T., & Larsen, C. P. (2009, May / Summer). Identification of Critical Factors Leading to Successful Islet Isolations and Transplantation. American Transplant Congress.
• Avila, J. G., Cano, J. A., Agarwal, A., Iwakoshi, N., Matar, A., Russell, M. C., Turner, A., Badell, I. R., Korbutt, G., Rayat, G., Rajotte, R. V., Pearson, T., Kirk, A. D., & Larsen, C. P. (2009, May / Summer). Time Profiles of Specific Physiologic and Genetic Parameters of Neonatal Porcine Pancreatic Islets. American Transplant Conference.
• Turner, A., Shaffer, V. O., Martens, C., Turner, P. L., Hendrix, R., Stempora, L., Gangappa, S., Kirk, A. D., & Larsen, C. P. (2009, May / Summer). Rapamycin enhances the magnitude and quality of viral-specific CD8+ T cell responses to vaccinia virus vaccination in the rhesus macaque.. American Transplant Congress.
• Turner, A., Weaver, T. A., Stempora, L., Iwakoshi, N., Ford, M. L., Kirk, A. D., & Larsen, C. P. (2009, May / Summer). Distribution of alloreactivity within CD8+ T cell subsets in the rhesus macaque. American Transplant Congress.
• Weaver, T., Charafeddine, A., Turner, A., Agarwal, A., Russell, M., Badell, I., Stempora, L., Larsen, C., & Kirk, A. (2009, May / Summer). Selective Targeting of Antigen Experienced Memory T Cells with LFA3-Ig: The Role of CD2 Cell Surface Density. American Transplant Conference.
• Avila, J., Cano, J., Holbrook, E., Russell, M., Iwakoshi, N., Turner, A., Agarwal, A., Kirk, A., & Larsen, C. (2008, May / Summer). Development of a neonatal porcine islet isolation procedure with successful transplantation outcomes. American Transplant Congress.
• Turner, A., Shaffer, V. O., Turner, P. L., Gangappa, S., & Larsen, C. P. (2008, May / Summer). Characterization of the magnitude and quality of response to vaccinia virus vaccination in immunosuppressed rhesus macaques. American Transplant Congress.

Other Teaching Materials

• Buff, M., & Turner, A. (2019. Hepatic failure and Hepatorenal Syndrome. SCORE.

Others

• Ferrer, I. R., Wagener, M. E., Robertson, J. M., Turner, A., Kirk, A. D., Larsen, C. P., & Ford, M. L. (2010, May). Rapamycin augments pathogen-specific but not donor-reactive CD8+T Cell responses. American Transplant Congress.