About

Michaela Restivo Anderson, MD, MS, is an Assistant Professor of Medicine in the Department of Pulmonary, Allergy and Critical Care at the Hospital of the University of Pennsylvania. She is affiliated with the Perelman School of Medicine at the University of Pennsylvania. Her educational background includes a Bachelor of Arts in Psychology from Northwestern University, an MD from SUNY Stony Brook School of Medicine, and a Master of Science in Biostatistics and Patient Oriented Research from Columbia University’s Mailman School of Public Health. Her research focuses on pulmonary medicine, with a particular emphasis on critical care and patient outcomes. She has contributed to numerous publications in her field, advancing understanding in areas such as lung transplantation, respiratory failure, and critical care risk assessment.

Research topics

• Pediatrics
• Surgery
• Medicine
• Internal medicine

Selected publications

• CT-adipose measures identify severe SARS-CoV-2 risk beyond traditional obesity metrics: a C4R cohort study

  BMC Pulmonary Medicine · 2026-05-25

  articleOpen accessSenior author
  PublisherDOI

• Latent Class Analysis Identifies Pulmonary Function Trajectory Phenotypes in Lung Transplant Recipients with Chronic Allograft Dysfunction

  medRxiv · 2026-04-23

  articleOpen access

  Background: We aimed to identify data-driven FEV1 trajectory phenotypes post-chronic lung allograft dysfunction (CLAD), relate these phenotypes to patient factors and future graft loss, and develop a classification approach for prospective patients. Methods: We studied adult first lung recipients with probable CLAD from two prospective multicenter cohorts: CTOT-20 (n=206) and LTOG (n=1418). FEV1 trajectories over the first nine months post-CLAD were characterized using joint latent class mixed models, jointly modelling time-to-graft loss to account for informative censoring. Models were fit independently in both cohorts and also only among LTOG bilateral recipients. A classification and regression tree (CART) model was derived in LTOG bilateral recipients and applied to CTOT-20 bilateral recipients. Findings: Four distinct early FEV1 trajectory classes were identified in CTOT-20, with large differences in nine-month graft loss (72·3%, 31·1%, 2·2%, 0%). In LTOG, similar trajectory patterns were reproduced, with an additional class demonstrating early post-CLAD FEV1 improvement. Among bilateral recipients, trajectory classes showed a clear risk gradient, including a high-risk class with 100% graft loss and a low-risk class with no early graft loss. A CART model incorporating clinical and spirometric variables demonstrated good discrimination in LTOG bilateral recipients (multiclass AUC 0·85) and consistent class assignment and trajectory patterns when applied to CTOT-20. Interpretation: We identified reproducible, clinically meaningful early post-CLAD FEV1 trajectory phenotypes with differential graft loss risk. These phenotypes and a pragmatic classification tool may support risk stratification, trial enrichment, and improved prognostication for patients and clinicians. Funding: National Institutes of Health, Cystic Fibrosis Foundation.

  PublisherOA PDFDOI

• Acute lung allograft dysfunction predicts lung allograft failure: Construct validity of the 2026 International Society for Heart and Lung Transplantation spirometric definition

  The Journal of Heart and Lung Transplantation · 2026-04-11

  articleOpen access

  INTRODUCTION: Acute lung allograft dysfunction (ALAD) has been proposed as a screening criterion to identify lung transplant recipients at increased risk for graft loss. ALAD was defined formally in a 2026 International Society for Heart and Lung Transplantation (ISHLT) Delphi consensus statement but has not been empirically evaluated. We sought to test the construct validity of the ISHLT ALAD definition by testing the hypothesis that ALAD is associated with increased risk of graft failure. METHODS: We included 86,885 spirometry measurements from 2,877 participants in the 8-center Lung Transplant Outcomes Group cohort. ALAD was defined as a ≥10% decline in FEV1 from the maximum value over the preceding 180 days and coded along with 90-day follow-up categories of resolved, persistent, progressive, and rapidly progressive. We assessed whether ALAD classifications diverged in predictions of time to death or re-transplantation in multivariable-adjusted time-dependent and landmark Cox proportional hazards models. RESULTS: ALAD had a prevalence of 15%. While resolution was seen in 40%, ALAD conferred a 4.93-fold graft failure hazard (95% CI 4.47-5.45, 7.4 years median follow-up), independent of concurrent chronic or baseline lung allograft dysfunction (CLAD or BLAD) status. Resolved ALAD was not associated with increased graft failure risk, but persistent, progressive, rapidly progressive, and no follow-up FEV1 ALAD categories were associated with increasing hazards for graft failure. A 10-percent threshold for FEV1 decline and a 180-day window to set the FEV1 baseline demonstrated optimal discrimination. CONCLUSION: The 2026 ISHLT spirometric ALAD definitions identify graft failure risk, supporting their relevance in clinical interventions and further research.

  PublisherDOI

• Abortion Restrictions and Infant Mortality in the United States, 2018–2023

  American Journal of Public Health · 2025-08-21 · 1 citations

  articleOpen access1st authorCorresponding

  Objectives. To evaluate the impact of state-level abortion restrictions enacted between 2018 and 2023 on infant mortality in the United States, comparing mortality trends across restricting and nonrestricting states. Methods. Using a difference-in-differences approach, we drew infant mortality data from the Centers for Disease Control and Prevention’s WONDER (Wide-ranging Online Data for Epidemiologic Research) database and categorized deaths by age and cause, incorporating information on abortion restrictions and legal exceptions from the Center for Reproductive Rights and the Kaiser Family Foundation. We calculated estimates at the state-year level. Results. Infant mortality increased by 7.2% in restricting states. The increase is predominantly attributable to early (aged < 1 day) and late (aged 1 month to 1 year) infant deaths. Effects were largest for perinatal and noncongenital causes of death. Health exceptions did not significantly moderate the effects. Conclusions. Curtailing abortion access increases infant deaths. Fetal and maternal health exceptions do not moderate this effect. Excess deaths are not exclusively attributable to congenital abnormalities. Further work is needed to understand how restrictions contribute to late deaths and the long-term effects of infant deaths on families and communities. ( Am J Public Health. 2025;115(11):1895–1902. https://doi.org/10.2105/AJPH.2025.308228 )

  PublisherOA PDFDOI

• Disparities for Pulmonary Hypertension Patients Are Worse in the CAS Era

  The Journal of Heart and Lung Transplantation · 2025-04-01

  article
  PublisherDOI

• One Year Weight Change and Survival After Lung Transplantation: A Lung Transplant Outcomes Group (LTOG) Study

  The Journal of Heart and Lung Transplantation · 2025-04-01

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Two Physiologic Latent Classes of Acute Hypoxemic Respiratory Failure in Sepsis Are Distinguished by Lung Mechanics and Gas Exchange

  Critical Care Explorations · 2025-09-22 · 1 citations

  articleOpen access

  OBJECTIVES: Physiologic subtypes of acute hypoxemic respiratory failure (AHRF) may confer a differential response to treatments, particularly therapeutic strategies that are specific to pulmonary organ failure. We sought to identify physiologic latent classes of sepsis-associated AHRF defined by respiratory mechanics, oxygenation, ventilation, and radiographic patterns of lung injury, and to determine the association between class membership and 30-day mortality. DESIGN: We performed latent class analysis of patients with AHRF newly requiring mechanical ventilation enrolled in a prospective cohort of patients with sepsis from 2011 to 2020. We used logistic regression adjusted for Acute Physiology and Chronic Health Evaluation to determine the association between class membership and 30-day mortality and examined the distribution of patients classified as "hyperinflammatory" by previously described biomarker-based subphenotyping paradigms. SETTING: Philadelphia, Pennsylvania, United States. PATIENTS: Eight hundred eighty-two patients. MEASUREMENTS AND MAIN RESULTS: We identified two physiologic latent classes. Class 1 (n = 390) was characterized by low static compliance and impaired ventilation when compared with class 2 (n = 432). Mortality at 30 days was higher in the more physiologically severe class 1 when compared with class 2 (adjusted risk difference 0.12, p < 0.001) despite a similar severity of sepsis. Class 1 also contained a higher proportion of female patients and patients with obesity. CONCLUSIONS: We identified two physiologic latent classes of sepsis-associated AHRF. Relative to class 2, class 1 was distinguished by low compliance, impaired ventilation, and higher 30-day mortality independent of the severity of sepsis. The higher percentage of female patients and patients with obesity in class 1 suggests a potential role for body composition in class determination. Physiologic classes were not primarily determined by qualification for acute respiratory distress syndrome or previously described biomarker-based subphenotypes, suggesting a distinct physiologic "axis" of heterogeneity.

  PublisherDOI

• Waitlist outcome differences for pulmonary hypertension patients are worse in the CAS era

  JHLT Open · 2025-11-20 · 1 citations

  articleOpen access

  Background: Patients with pulmonary hypertension (PH) have previously experienced worse waitlist outcomes than peers with other diagnoses. In 2021, the Lung Allocation Score (LAS) was revised to improve the prediction of expected survival. The Composite Allocation Score (CAS) was subsequently implemented in 2023. The effects of these changes on waitlist outcomes for patients with PH are not known. Methods: A retrospective analysis of the United Network for Organ Sharing database was performed in 3 eras: LAS Era 1 (November 24, 2017-September 30, 2021), LAS Era 2 (October 1, 2021-March 8, 2023), and CAS Era (March 9, 2023-June 27, 2024). Unadjusted and adjusted competing risks regression analyzed waitlist outcomes within each era comparing diagnosis groups, and for PH patients across eras. Results: Adjusted waitlist mortality for PH patients was worse relative to chronic obstructive pulmonary disease (COPD) and cystic fibrosis in LAS Era 1, not significantly different from other groups in LAS Era 2, and worse relative to COPD and interstitial lung disease in the CAS Era. Waitlist mortality for PH patients was unchanged between the LAS Eras and the CAS Era. Transplantation rate for PH patients was improved in the CAS Era compared to LAS Era 2, when measures of right heart dysfunction were removed from the LAS calculations, but not compared to LAS Era 1. Conclusion: In the CAS Era, PH patients continue to experience increased waitlist mortality relative to non-PH diagnoses. Waitlist mortality for PH patients has not improved in the CAS Era compared to the LAS Eras.

  PublisherDOI

• Higher BMI is Associated With Improved Survival but Greater Fatigue and Dyspnea: A Pulmonary Fibrosis Foundation Registry Study

  American Journal of Respiratory and Critical Care Medicine · 2025-05-01

  article1st authorCorresponding

  Abstract Background: Identifying risk factors for greater symptom burden in patients with interstitial lung disease (ILD), could identify novel treatment targets. Obesity affects one-third of patients with ILD and is associated with longer survival. Whether obesity influences fatigue, dyspnea, or health-related quality (HRQOL) of life over time is unknown. We hypothesized that higher body mass index (BMI) would be associated with longer survival, greater fatigue and dyspnea, worse HRQOL, and greater changes in symptoms over time. Methods We performed a retrospective cohort study of participants in the Pulmonary Fibrosis Foundation Registry (Registry) with available BMI and symptom questionnaire at enrollment. Symptoms were assessed at enrollment, 6, and 12 months using the Fatigue Severity Scale (0-7, higher score indicates more fatigue), the UCSD Shortness of Breath questionnaire (0-120, higher score indicates more dyspnea), and the Short-Form Six-Dimension (SF-6D, 0.29-1.00, higher score indicates better HRQOL). We evaluated survival from enrollment using Cox proportional hazards models. Linear mixed models with random intercept for participant and interaction between time and BMI evaluated whether BMI correlated with symptoms and changes in symptoms over time. We used random-intercept cross-lagged panel models (RI-CLPMs) to evaluate the potential reciprocal relationship between BMI and symptoms. All models were adjusted for baseline age; sex; diagnoses of Idiopathic Pulmonary Fibrosis (IPF), diabetes, hypertension, coronary artery disease, and depression; use of antifibrotics and corticosteroids; and pulmonary function. Mixed models included pulmonary function tests as time-varying covariates. Results In the Registry, 1300 participants met inclusion criteria, of whom 842 (64%) had 12-month data, 38% were female, 61% had IPF, with mean (standard deviation) age of 69 (11) years, percent-predicted FVC of 69% (18%), and BMI of 29.4 (5.9); 74% were using anti-fibrotic therapy. Higher BMI was associated with decreased hazards of death (HR 0.93 per 3 kg/m2 increase in BMI, 95%CI 0.87-0.99). Higher BMI was associated with greater fatigue and dyspnea at enrollment, but not with HRQOL (Table). BMI did not moderate changes in fatigue (p-value=0.16), dyspnea (p-value=0.47), or HRQOL (p-value=0.55) over time. In RI-CLPMs, earlier (T1-2) BMI predicted later fatigue (p-values=[0.5T1,0.02T2]), and vice versa (p-values=[0.03T1, 0.05T2]). Conclusion Higher BMI is associated with improved survival but greater concurrent fatigue and dyspnea in patients with ILD, adjusting for comorbidities and medications. Longitudinally, BMI does not moderate change in these symptoms over time. Further work is required to understand whether use of anti-obesity medications can improve symptom burden in patients with obesity and ILD.

  PublisherDOI

• Breaking Barriers: Enhancing Access, Equity, and Efficiency in Interstitial Lung Disease Clinical Trials

  American Journal of Respiratory and Critical Care Medicine · 2025-08-04

  articleOpen accessSenior author
  PublisherOA PDFDOI

Recent grants

• Role of visceral adipose tissue in frailty among patients with Idiopathic Pulmonary Fibrosis

  NIH · $854k · 2021–2025

Frequent coauthors

• Selim M. Arcasoy

  Columbia University Irving Medical Center

  50 shared

• Luke Benvenuto

  48 shared

• F. D’Ovidio

  Columbia University

  43 shared

• Joshua R. Sonett

  Columbia University Irving Medical Center

  40 shared

• Joseph Costa

  Columbia University

  40 shared

• B.P. Stanifer

  Columbia University Irving Medical Center

  40 shared

• Jason D. Christie

  University of Pennsylvania

  36 shared

• Meghan Aversa

  University Health Network

  33 shared