About

Divya Raghavan, MD, is a Nephrologist and Clinical Associate Professor of Medicine at the University of Utah School of Medicine. She completed her medical schooling at Kilpauk Medical College in India in 2011, followed by her Internal Medicine Residency at the University of Illinois at Urbana-Champaign in 2015. She finished her General Nephrology fellowship at the University of Utah from 2015 to 2017, and then completed a Transplant Nephrology fellowship from 2017 to 2018. In 2018, she joined the Division of Nephrology as a Transplant Nephrologist. Dr. Raghavan is the Program Director for the American Society of Transplant accredited Transplant Nephrology fellowship at the University of Utah. Her clinical interests include addressing barriers to increasing kidney transplantation and improving post-kidney transplant outcomes. She is board certified in Internal Medicine and Nephrology, and her work emphasizes patient-centered care, detailed communication, and expertise in kidney transplantation and nephrology.

Research topics

• Medicine
• Internal medicine
• Immunology
• Virology
• Urology
• Dermatology
• Pathology
• Gastroenterology
• Neuroscience
• Surgery
• Biology
• Intensive care medicine
• Endocrinology
• Family medicine

Selected publications

• Early posttransplant rituximab use in kidney transplant recipients with preexisting donor-specific antibodies

  Renal Failure · 2026-01-25 · 1 citations

  articleOpen access

  DSA occurred in 31% of those who received rituximab versus in 25% of those who did not. Rituximab administration did not result difference in graft and patient survival or rejection rates or recurrence of preexisting DSA.

  PublisherDOI

• Associations of Pretransplant Patient-Reported Outcomes Measurement Information System Physical Function Score With Kidney Transplant Outcomes

  Transplant International · 2025-01-29 · 1 citations

  articleOpen access

  Simple and validated physical function measures are needed for kidney transplant candidates because pretransplant low physical function is a common and potentially modifiable risk factor. This single-center retrospective study investigated the associations between pretransplant physical function assessed by the Patient-Reported Outcomes Measurement Information System ® Physical Function (PROMIS-PF) computer adaptive testing and early posttransplant outcomes. We analyzed 154 adult kidney-alone transplant recipients. The median pretransplant PROMIS-PF score was 43 (interquartile range, 39–47). Patient characteristics were not significantly different across the score category (normal, score ≥45; mild, score of 40–45; and moderate/severe, score <40). The PROMIS-PF score was not associated with length of transplant hospital stay, delayed graft function, 6-month and 12-month graft function, or 12-month patient and graft survival. However, a lower PROMIS-PF score was significantly associated with a higher risk of emergency room visits [adjusted odds ratios compared to normal: mild, 1.68 (95% confidence interval, 0.76–3.83); moderate/severe, 3.23 (1.34–7.79)] and rehospitalization [adjusted odds ratios: mild, 2.61 (1.16–5.90); moderate/severe, 2.53 (1.07–6.00)] within 1 month posttransplant. Results suggest that PROMIS-PF is a practical tool for assessing physical function in kidney transplant candidates. Larger studies are needed to confirm the utility of PROMIS-PF to identify transplant candidates who would benefit from pretransplant prehabilitation.

  PublisherOA PDFDOI

• Development of BK polyomavirus-associated nephropathy risk prediction in kidney transplant recipients

  Renal Failure · 2025-05-29 · 1 citations

  articleOpen access

  BACKGROUND: With the development of potential prevention therapies for BK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN), risk prediction models are needed to identify kidney transplant recipients at high risk for BKPyVAN. METHODS: This single-center retrospective study aimed to develop a risk prediction model and an integer-based risk score for BKPyVAN development, defined as plasma BKPyV-DNA >10,000 copies/mL and/or biopsy-proven BKPyVAN, within 1-year post-transplant, using donor and recipient characteristics at the time of transplantation. We randomly split patients into development and validation cohorts and applied logistic regression with backward selection to identify significant variables. Model performance was evaluated using the area under the receiver-operating characteristic curve (AUC) and calibration plots. RESULTS: This study included 560 patients, of whom 75 (13%) patients had BKPyVAN. Age >50 years, male sex, and prior kidney transplant were selected for the final model. The total integer score ranged from 0 to 4 points, with 1 point assigned for age >50 years and male sex, and 2 points for prior kidney transplant. The AUC was 0.65 in both development and validation cohorts. Calibration plots showed an incremental increase in risk with higher total scores. The integer score indicated that patients with a total score of 2 or higher (i.e. males aged >50 years or those with prior kidney transplants) have a predicted risk of 20% or greater. CONCLUSION: Although the AUC was suboptimal, the results suggest that our model may still be valuable for identifying high-risk patients.

  PublisherDOI

• Deceased Organ Donor HTLV Screening Practices Postelimination of Universal Screening in the United States

  Transplantation Direct · 2024

  • Medicine
  • Virology
  • Family medicine

  Background: In the United States, universal screening for human T-lymphotropic virus (HTLV) in deceased organ donors was discontinued in 2009. Since then, the transplant guideline suggests considering targeted screening. However, the outcomes of this change in HTLV screening have not been evaluated. Methods: Using the Organ Procurement and Transplantation Network database between 2010 and 2022, we analyzed the HTLV antibody screening frequency and seroprevalence in potential deceased organ donors and their correlations with HTLV infection risks, including race and high-risk behaviors for blood-borne pathogen infection. Although targeted screening has not been established for HTLV, we hypothesized that screening rates should correlate with the proportions of donors with infection risk if screening is targeted. We also evaluated the organ utilization of HTLV-seropositive donors. Results: < 0.001). However, HTLV-1 infection was not attributed as the cause of nonrecovery except for only 1 HTLV-seropositive donor. Conclusions: HTLV screening practices varied across the United States. Our findings suggest that targeted screening was not performed after the elimination of universal screening.

  PublisherDOI

• Mesenteric Desmoid Tumor in a Transplant Patient

  Journal of the American Society of Nephrology · 2024-10-01

  articleSenior author

  Introduction: Desmoid tumors (DTs) are deep, locally aggressive, benign connective tissue neoplasms that originate most commonly in the extremities, intraperitoneal cavity and abdominal and thoracic walls. They are rare with reported incidence of 2–4 per million population per year and account for 0.03% of all neoplasms. DTs have a high rate of local recurrence but do not metastasize. We present an unusual case of a DT found two years after kidney transplant. Case Description: 61 year-old man with end-stage renal disease due to diabetic nephropathy who underwent a deceased donor kidney transplant presents with abdominal pain starting six months after transplant. He underwent robotic inguinal hernia repair without improvement in pain. He reports night sweats, fatigue, and unintentional weight loss of 15lbs over two months. CT abdomen/pelvis showed a mid-abdomen, mesenteric soft tissue mass measuring 5.4 x 3.5 cm which was mildly hypermetabolic on PET-CT. Surgical biopsy of the mass revealed a DT. Resection of the mass was not pursued due to areas of fibrosis along the mesentery suggestive of a more diffuse process. Consequently, the oncology team started Pazopanib with good response. Discussion: The differential diagnosis for an abdominal mass is broad with high concern for post-transplant lymphoproliferative disorder. When suspecting malignancy, tissue diagnosis is always important for diagnosis and guiding treatment. For DT, asymptomatic patients can be managed with active surveillance while symptomatic patients may require surgery, systemic therapy, and/or radiation therapy.

  PublisherDOI

• A Case of Recovery of Native Kidney Function Years after Simultaneous Liver-Kidney Transplant

  Journal of the American Society of Nephrology · 2024 · 1 citations

  Senior authorCorresponding
  • Medicine
  • Urology
  • Intensive care medicine

  Introduction: Simultaneous Liver-Kidney (SLK) transplantation is often considered in End Stage Liver Disease (ESLD) patients with significant renal dysfunction. Prior to the implementation of the Organ Procurement and Transplantation Network’s (OPTN) 2017 policy on SLK allocation, criteria were variable and of particular concern was the potential recovery of native renal function following SLK. Here we describe a case of a patient who underwent an SLK transplant and was found to have native renal recovery eight years later. Case Description: A 45-year-old female with ESLD due to autoimmune hepatitis who underwent liver transplant in 2009 with subsequent failure and resulting hepatorenal syndrome (HRS) followed by SLK in 2015 presented to the hospital after unintentional acetaminophen overdose complicated by acute kidney injury (AKI). Ultrasound of her kidney graft showed severe atrophy with a lack of renal cortex blood flow despite patent vessels. She briefly required dialysis for uremia followed by rapid renal recovery. A nuclear medicine (NM) study using Tc99m MAG3 was later performed which found functioning native kidneys with minimal activity in the kidney graft. Immunosuppression decisions were deferred to the liver transplant service in the setting of kidney graft loss. Discussion: Native renal recovery following SLK is a known phenomenon particularly in patients with HRS. NM studies are more commonly done in the post-SLK period and are not usually considered years after SLK. This case features a patient who received an SLK prior to the 2017 SLK policy updates and who was found eight years later to have renal graft loss with recovery of native renal function. Reviewing this patient’s pre-transplant data shows she would not have been an SLK candidate under current criteria. This case illustrates the importance of careful policy decisions regarding SLK allocation.

  PublisherDOI

• Fishing for Zebras: Catching Fabry Disease with Pretransplant Genetic Testing

  Journal of the American Society of Nephrology · 2024-10-01

  articleSenior author

  Introduction: Fabry Disease (FD) is a rare X-linked lysosomal storage disorder whose diagnosis can be particularly challenging in women, who often present atypically. Case Description: A 43-year-old woman with ESRD attributed to hypertension and fibromuscular dysplasia (FMD) presented to renal clinic for pre-transplant evaluation. She had hypertension since age 20, complicated by hemorrhagic stroke at age 33 and an admission for hypertensive urgency at age 34, during which she was told she had FMD based on right renal atrophy and distal right renal artery stenosis, treated with balloon angioplasty. Unfortunately her eGFR declined rapidly over 4 years from 52 to 10 ml/min/1.73m2 without explanation on serology and “no evidence of fibromuscular dysplasia” or re-stenosis on repeat MRA. She started dialysis in 2019 at age 39. Her medical history was also notable for incidental ischemic strokes seen on imaging, memory impairment, complete heart block in 2022, and systolic heart failure in 2024. Due to the patient’s early-onset renal disease (in combination with her cardiac and neurologic history), the transplant nephrologist ordered a kidney gene panel. This revealed a heterozygous, “likely-pathogenic” galactosidase alpha (GLA) gene mutation c.1018T>A (p.Trp340Arg), consistent with FD. She was referred to Medical Genetics who elicited a history of hypohidrosis and diarrhea, but no neuropathic pain, skin lesions, vision/hearing impairment, or known family history of FD. However, her son had neuropathy and her brother died young from heart failure. Enzyme levels showed accumulation of globotriaosylsphingosine (LysoGb3) and she subsequently started enzyme replacement therapy. Family testing revealed the same mutation in her daughter. Discussion: FD demands a high index of suspicion and low threshold for genetic testing in patients with early-onset kidney disease, especially in the setting of cardiac and neurologic manifestations. Panels to identify genetic causes of CKD are now recommended in KDIGO’s recent 2024 CKD evaluation guidelines. Patients with FD stand to benefit as more nephrologists gain access to this testing and can cast a wide net to catch heterozygous or atypical cases earlier. Furthermore, ESRD is not too late to test and drastically improve outcomes for patients and their family members.

  PublisherDOI

• Implantation Biopsy in Living-Donor Kidney Transplantation: Expectations, Utility, and Limitations

  American Journal of Kidney Diseases · 2024-01-20

  letterOpen accessSenior authorCorresponding
  PublisherOA PDFDOI

• Belatacept Versus Tacrolimus for Kidney Transplant Recipients of Deceased Donors With Acute Kidney Injury: US National Database Study

  Transplantation · 2024 · 6 citations

  • Medicine
  • Urology
  • Internal medicine

  BACKGROUND: It is unclear whether kidney grafts from deceased donors with acute kidney injury (AKI) are more vulnerable to calcineurin inhibitor nephrotoxicity, and whether de novo use of belatacept is more beneficial than tacrolimus for recipients of these types of kidney transplants. METHODS: In this retrospective cohort study using the US Organ Procurement and Transplantation Network database, we created 1:4 matches with highly similar characteristics for recipients of AKI-donor kidneys receiving belatacept versus tacrolimus for initial maintenance immunosuppression and compared outcomes for graft function, patient and graft survival, and rejection. RESULTS: The matched cohort consisted of 567 and 2268 recipients administered belatacept and tacrolimus, respectively. Posttransplant estimated glomerular filtration rate was significantly higher in the belatacept group at 6 mo (58.2 ± 24.2 versus 54.6 ± 21.6 mL/min/1.73 m 2 , P < 0.001); however, the between-group difference did not reach statistical significance at 12 mo (57.2 ± 24.3 versus 55.7 ± 22.2 mL/min/1.73 m 2 , P = 0.057). Median follow-up periods were 3.2 and 3.1 y for patient and graft survival, respectively. There were no significant differences between belatacept versus tacrolimus for mortality (hazard ratio 1.18 [95% confidence interval, 0.95-1.47], P = 0.14) or death-censored graft failure (hazard ratio 1.17 [0.85-1.61], P = 0.33). Rejection rate within 12 mo was significantly higher in the belatacept group (13% versus 7%, P < 0.001). CONCLUSIONS: In this matched cohort study, initial use of belatacept for AKI-donor kidney recipients was associated with small benefits in early graft function when compared with tacrolimus. Although rejection risk was significantly higher in recipients administered belatacept, patient and graft survival were not significantly different between groups.

  PublisherDOI

• Kidney Transplant Outcomes in Amyloidosis: US National Database Study

  Transplantation · 2024 · 4 citations

  • Medicine
  • Internal medicine
  • Gastroenterology

  BACKGROUND: We aimed to assess contemporary transplant outcomes among kidney recipients with amyloidosis, as the treatment and prognosis of amyloidosis have shown improvement over time. METHODS: Using the US Organ Procurement and Transplantation Network database, we initially evaluated the changes in patient and graft survival among kidney recipients with amyloidosis from 2002 to 2021. We then compared transplant outcomes between recipients with amyloidosis versus those with diabetic and nondiabetic causes of kidney failure, creating 1:4 matches with highly similar characteristics separately for deceased donor kidney transplant (DDKT) and living donor kidney transplant (LDKT) during the last decade (2012-2021). RESULTS: We identified 643 kidney recipients with amyloidosis during 2002-2021. Patient and death-censored graft survival improved over time. In the matching analysis for 207 DDKT and 166 LDKT recipients with amyloidosis during 2012-2021, patient survival was not significantly different between amyloidosis and diabetes groups in both DDKT (log-rank, P = 0.057) and LDKT ( P = 0.99). Compared with the nondiabetes group, patient survival in the amyloidosis group was not significantly different for DDKTs ( P = 0.56) but was significantly lower for LDKTs ( P = 0.04). Death-censored graft failure risk was not significantly different between amyloidosis and diabetes or nondiabetes groups for both DDKTs ( P = 0.78 and 0.75) and LDKTs ( P = 0.40 and 0.24). CONCLUSIONS: In this well-matched cohort study, we found no significant differences in patient and graft survival between kidney recipients with amyloidosis and those with diabetes. Similarly, these outcomes were not significantly different between those with amyloidosis versus nondiabetic causes, except for patient survival of LDKT recipients.

  PublisherDOI

Frequent coauthors

• Isaac E. Hall

  University of Utah

  15 shared

• Miklos Z. Molnar

  12 shared

• Şuayp Oygen

  University of Utah

  9 shared

• Fuad S. Shihab

  University of Utah

  8 shared

• Sarah Gilligan

  8 shared

• Junji Yamauchi

  National Center for Global Health and Medicine

  7 shared

• Josephine Abraham

  6 shared

• Duha A. Jweehan

  5 shared