About

Kara Lynne Calkins is a Clinical Professor in the Department of Pediatrics at UCLA David Geffen School of Medicine. Her research focuses on quantifying body composition and liver disease in children using advanced imaging techniques such as free-breathing MRI and MRE. She has contributed to numerous studies related to pediatric nutrition, neonatal care, and liver elastography, with a particular emphasis on neonatal nutrition management, lipid emulsions, and the effects of nutrition on preterm infants and children with gastrointestinal and liver conditions. Her work includes investigating the impact of fatty acids, parenteral nutrition, and donor milk in neonatal and pediatric populations, as well as exploring the technical performance of liver MRI elastography in children.

Research topics

• Medicine
• Artificial Intelligence
• Internal medicine
• Computer Science
• Pediatrics
• Obstetrics
• Radiology
• Computer vision
• Mathematics
• Nuclear medicine
• Surgery
• Biology

Selected publications

• GAIN: A Multicenter Pilot Protocol for Early Initiation of Enteral Feeds in Neonates with Simple Gastroschisis

  Research Square · 2026-03-25

  preprintOpen access
  PublisherDOI

• Feeding Practices in Simple Gastroschisis: Insights into Practice Variation from a Multidisciplinary Survey

  The Journal of Pediatrics Clinical Practice · 2026-04-17

  articleOpen access

  There is limited evidence to guide feeding practices for neonates with simple gastroschisis. Current management centers on clinician judgment and historic practice patterns. This study aims to characterize practice variability and identify opportunities for standardization to improve patient outcomes. This cross-sectional study surveyed neonatal providers on their feeding practices for simple gastroschisis, focusing on the initiation and advancement of enteral nutrition following abdominal closure. The 27-question survey was administered to members of the American Pediatric Surgical Association and the American Academy of Pediatrics Section of Neonatal-Perinatal Medicine, between October 2024 and January 2025. Data were analyzed using descriptive statistics. Of the 467 respondents, the majority were neonatologists 51% and pediatric surgeons 42% working in academic centers, 75% with level III or IV NICUs, 98%). Participants reported near universal use of an enteric drainage tube after abdominal closure (99%). Half reported no gastroschisis feeding protocols at their institution, and instead, across all respondents, rely on evidence of return of bowel function before starting feeds (84%) typically with human milk (86%), by bottle (60%) and initial volumes of 10-20 mL/kg/day. This study demonstrated variable approaches to feeding hospitalized neonates with simple gastroschisis. Evidence-based and standardized guidelines tailored to this population that support the timely and effective initiation and progression of feeds may help improve clinical outcomes.

  PublisherDOI

• Mo1000: ASSOCIATIONS BETWEEN SOCIAL DETERMINANTS OF HEALTH AND GASTROSCHISIS SEVERITY: A RETROSPECTIVE MULTI-INSTITUTIONAL STUDY

  Gastroenterology · 2025-05-01

  article
  PublisherDOI

• Essential fatty acid deficiency in children treated with long‐term 100% fish‐oil lipid injectable emulsion: A longitudinal descriptive cohort study

  Journal of Parenteral and Enteral Nutrition · 2025-06-19 · 1 citations

  article

  BACKGROUND: To assess severity and risk of an essential fatty acid deficiency in children <2 years with parenteral nutrition-associated cholestasis on long-term 100% fish-oil lipid injectable emulsion. METHODS: This longitudinal descriptive cohort study included patients receiving fish-oil lipid injectable emulsion (1 g/kg/day). Triene: tetraene ratios were monitored for up to 4 years and classified as mildly elevated (≥0.05 and <0.2) or essential fatty acid deficiency (≥0.2). RESULTS: One hundred and twenty-seven patients with a baseline median age of 14 weeks were included. Serum docosahexaenoic acid and eicosapentaenoic acid levels markedly increased, whereas arachidonic acid, linoleic acid, and α-linolenic acid levels decreased before stabilizing. Median triene: tetraene ratios peaked at 0.027 at week 8 and then stabilized within a range of 0.015 and 0.020 from week 16 until the end of the study. Seven patients had mildly elevated triene: tetraene ratio at the end of the study. Three infants had an essential fatty acid deficiency, but none demonstrated clinical signs consistent with this deficiency. One deficiency was attributed to a laboratory error; two were associated with adverse events. All patients resolved with the continuation of fish-oil lipid injectable emulsion. CONCLUSION: Children with parenteral nutrition-associated cholestasis on long-term fish-oil lipid injectable emulsion are at low risk for a clinical or biochemical essential fatty acid deficiency. These findings indicate that despite its low content of linoleic acid and α-linolenic acid, long-term 1 g/kg/day of 100% fish-oil lipid injectable emulsion is not associated with an essential fatty acid deficiency.

  PublisherDOI

• Standardized Clinical Assessment and Management Plan Enhances Neonatal Outcomes in Prenatally Diagnosed Congenital Heart Disease

  Research Square · 2025-03-28

  preprintOpen access
  PublisherOA PDFDOI

• Polyunsaturated fatty acid balance modulates microglial state in a murine model of oxygen-induced neovascularization

  Research Square · 2025-09-23

  preprintOpen access
  PublisherOA PDFDOI

• Automated Abdominal Adipose Tissue Segmentation and Quantification in Children using Free-Breathing Dixon MRI and 3D Neural Networks

  Proceedings on CD-ROM - International Society for Magnetic Resonance in Medicine. Scientific Meeting and Exhibition/Proceedings of the International Society for Magnetic Resonance in Medicine, Scientific Meeting and Exhibition · 2025-09-16

  article

  Motivation: The volume and fat content of subcutaneous and visceral adipose tissue (SAT, VAT) are associated with risk for cardiometabolic diseases. Although limited studies automatically segmented SAT, VAT on MRI in children, they targeted narrow age ranges and used conventional sequences that are sensitive to motion artifacts. Goal(s): To automatically segment and quantify the volume and fat fraction of abdominal SAT, VAT in children using motion-robust free-breathing radial Dixon MRI and state-of-the-art 3D neural networks. Approach: We enrolled 134 children (6-18 years), then trained 3D nnU-Net and Swin U-Net Transformer. Results: Both networks yielded accurate volume and fat fraction quantification with promising segmentation performance. Impact: We developed 3D neural networks to automatically segment and quantify abdominal subcutaneous and visceral adipose tissue (SAT, VAT) characteristics in children (6-18 years) using free-breathing MRI. These methods can be used to study risk factors for cardiometabolic diseases in children.

  PublisherDOI

• Meconium-related obstruction: Contemporary experience in a multi-institutional consortium

  Journal of Pediatric Surgery · 2025-08-13 · 1 citations

  articleOpen access

  PURPOSE: Neonatal bowel obstruction secondary to inspissated meconium has been historically associated with cystic fibrosis. Increasingly, meconium-related obstruction (MRO) has been observed in preterm infants. We conducted a multicenter mixed-methods study to better characterize the contemporary experience with MRO. METHODS: A retrospective cohort study of infants with MRO was performed at seven children's hospitals from 2018 to 2022. Chi-squared tests, Kruskal-Wallis tests, and logistic regression were used to assess the association of cystic fibrosis, Hirschsprung disease, and prematurity with treatment strategies and clinical outcomes of MRO. Providers were surveyed regarding their management of MRO of prematurity. RESULTS: We identified 105 infants treated for MRO, including 54 (51 %) with MRO of prematurity, 16 (15 %) with Hirschsprung disease, 6 (6 %) with cystic fibrosis, and 29 (28 %) with MRO of the term infant. Overall, 32 % (n = 34) received glycerin suppositories, 25 % (n = 26) rectal irrigation, 79 % (n = 83) contrast enemas, and 6 % (n = 6) retrograde or antegrade N-acetylcysteine. Twenty-seven (26 %) infants required surgery for MRO, of whom 21 (78 %) had MRO of prematurity. For infants with MRO of prematurity, a one-week increase in gestational age was associated with a 23 % decrease in the odds of requiring surgery (OR = 0.77; 95%CI = 0.64-0.93). Survey responses from 42 providers suggested limited institutional treatment algorithms for MRO. CONCLUSION: In this multi-institutional study, most cases of MRO were associated with prematurity. Extent of prematurity was associated with a higher likelihood of requiring surgery. Results from this contemporary cohort study and survey provide a framework for developing a prevention and treatment algorithm for MRO of prematurity.

  PublisherOA PDFDOI

• Association between multioil intravenous lipid emulsion and cholestasis in infants with gastrointestinal disorders: A retrospective cohort study

  Journal of Parenteral and Enteral Nutrition · 2025-06-03 · 1 citations

  articleOpen accessSenior authorCorresponding

  BACKGROUND: Infants with gastrointestinal (GI) disorders are at risk for parenteral nutrition-associated cholestasis. A multioil intravenous lipid emulsion (MO ILE) contains less phytosterols and more arachidonic and docosahexaenoic acid (DHA) than 100% soybean oil lipid emulsion (SO ILE). This study compares parenteral nutrition-associated cholestasis, growth, and fatty acids in infants with GI disorders who received MO ILE or SO ILE. METHODS: This retrospective cohort study included 48 infants with GI disorders born between 2014 and 2022 who received an intravenous lipid emulsion for ≥14 days. Cholestasis was defined as serum conjugated bilirubin ≥2 mg/dl; growth was assessed by z score changes. Gas chromatography and mass spectrometry was used to measure fatty acid content in the erythrocyte cell membrane. RESULTS: The incidence of parenteral nutrition-associated cholestasis was similar (MO ILE 30% vs SO ILE 29%, P > 0.99). However, compared with infants who received parenteral nutrition >28 days and SO ILE, infants who received parenteral nutrition >28 days and MO ILE experienced a slower rise in conjugated bilirubin (0.1 ± 0.03 vs 0.26 ± 0.38 mg/dl, P interaction < 0.001). Weight z score decline (discharge to birth) was less in the MO ILE group vs SO ILE group (-1.0 [-2.0, -0.4] vs -0.4 [-0.9, 0], P = 0.04). Although the MO ILE group demonstrated improved DHA status at weeks 1-3 (P < 0.05 for all), arachidonic acid and DHA decreased over time in both groups and there was no difference in the rate of change (P interaction > 0.3 for both). CONCLUSION: In infants with GI disorders, MO ILE was associated with improved growth. MO ILE was well tolerated and hepatoprotective in infants who required prolonged parenteral nutrition.

  PublisherOA PDFDOI

• Meconium-Related Obstruction and Clinical Outcomes in Term and Preterm Infants

  JAMA Network Open · 2025-02-14 · 4 citations

  articleOpen access

  Importance: Textbooks attribute 80% of meconium-related small bowel obstructions to cystic fibrosis and 15% of colonic obstructions to Hirschsprung disease. It is unknown whether these estimates are accurate, particularly among preterm infants, whose immature bowel predisposes them to meconium-related obstruction (MRO). Objective: To estimate the incidence of MRO by type and to assess its association with clinical outcomes. Design, Setting, and Participants: This retrospective cohort study of live-born infants included in the National Inpatient Sample from January 1, 2016, to December 31, 2020, used survey weighting methods to estimate the national incidence of MRO by etiology. Data were analyzed from November 27, 2023, to November 12, 2024. Exposure: MRO. Main Outcomes and Measures: The primary outcome was diagnosis with MRO. Secondary outcomes included mortality, need for abdominal surgery, hospitalization duration, and cost. Multivariable regression models were developed to evaluate characteristics associated with MRO and to assess the association of MRO of prematurity with clinical outcomes after adjusting for demographic and clinical covariates. Results: Of 3 550 796 infants, 51.2% were male and 46.7% were privately insured. Overall, 9.1% (n = 322 499) were born preterm. Of 1844 (0.1%) infants treated for MRO, 41 (2.2%) had cystic fibrosis, 60 (3.3%) had Hirschsprung disease, and 1743 (94.5%) had neither predisposing condition. Preterm infants were at highest risk for MRO, with 4.7 MRO cases per 100 000 births associated with cystic fibrosis, 4.7 MRO cases per 100 000 births associated with Hirschsprung disease, and 187.3 MRO cases per 100 000 births associated with neither predisposing condition. Among infants with neither cystic fibrosis nor Hirschsprung disease, those with gestational ages from 28 weeks to 31 weeks 6 days were most likely to develop MRO compared with term infants (adjusted odds ratio, 6.08 [95% CI, 4.27-8.67]). Among preterm infants, having an MRO was associated with a 4.2 percentage point increase in the probability of abdominal surgery (95% CI, 3.1-5.4 percentage points), a 7.3-day increase in length of stay (95% CI, 5.8-8.8 days), and a $23 215 increase in hospitalization costs (95% CI, $17 739-$28 690) compared with infants who did not have an obstruction, with no change in mortality rate (0.1 percentage point change [95% CI, -0.6 to 0.8 percentage points]). Conclusions and Relevance: In this cohort study of over 3.5 million infants, MRO was most likely to occur among preterm infants without cystic fibrosis or Hirschsprung disease. These infants more frequently required surgery and had longer and more costly hospitalizations, indicating a need for dedicated prevention and treatment pathways for this understudied disease.

  PublisherOA PDFDOI

Recent grants

• NIH Grant M01RR000865

  NIH · $41.8M · 2011

Frequent coauthors

• Holden H. Wu

  20 shared

• Katie M. Strobel

  University of Washington

  19 shared

• Tristan Grogan

  University of California, Los Angeles

  18 shared

• Robert S. Venick

  16 shared

• Muralidhar H. Premkumar

  Texas Children's Hospital

  16 shared

• Stephen B. Shew

  Lucile Packard Children's Hospital

  15 shared

• Sevgi Gökçe Kafalı

  15 shared

• Shahnaz Ghahremani

  15 shared

Education

• Masters of Science Clinical Research

  University of California Los Angeles

  2014

• MD

  University of California Irvine

  2003

• BS

  University of California Davis

  1998