Keywords
Last Name

Jean M. Francis, MD

TitleAssistant Professor
InstitutionBoston University School of Medicine
DepartmentMedicine
DivisionNephrology
Address650 Albany St Evans Biomed Research Ctr
Boston MA 02118
Phone(617) 638-7330
ORCID ORCID Icon0000-0002-8706-1548
 Awards and Honors

Start-EndDescription
2014-2015Boston University School of Medicine: Excellence in Teaching Award, Subspeciality Faculty
2015-2016Boston University School of Medicine: Excellence In Teaching Award, Hospital Based Faculty
 Research Expertise & Professional Interests
Thrombotic microangiopathy (TMA) is a rare but very serious condition. It is characterized by widespread microthrombi formation in multiple organs (in its severe and disseminated form) or localized microthrombi in the kidney (in its limited form). TMA is usually characterized by thrombocytopenia, microangiopathic hemolytic anemia (MAHA), and multiple organ injury and dysfunction.

Early detection and accurate diagnosis are essential to implement appropriate therapies, and improve patients’ prognosis and survival. Delay in diagnosis could result in late implementation of appropriate therapies, and this could result in permanent and irreversible organ damage. Left untreated TMA is associated with very high level of morbidity and mortality. TMA presentation could be highly variable making the diagnosis even more difficult. Once the diagnosis of TMA is established, defining the underlying cause is even more challenging due to frequent overlap between the common causes of TMA.

We have a unique multidisciplinary approach to the management of this very rare disease. A TMA team was established at Boston University Medical Center with the primary objective of improving patients care and outcome. Our Team works in close collaboration with the ARC on Thrombosis.

A primary goal of the team is to provide excellent patient care. The TMA team is multidisciplinary involving: nephrologists, hematologists, the director of apheresis, pediatric hematologist and pharmacist. They are always available to manage any patient with suspected TMA. Special protocols and algorithm have been created by the team to help guiding the provider in making an accurate diagnosis of any TMA case.

Another goal of the TMA team is educational. We are actively spreading awareness of this rare disease between our providers at BMC, and also regionally and nationally by organizing lectures and seminars as well as mini-symposia.

A third goal of the TMA team is to advance basic and clinical research related to TMA. We are active in clinical trials addressing the efficacy of newer agents for the treatment of complement mediated HUS a special form of TMA. Our scientists are also trying to understand some underlying pathological mechanisms that could be contributing to TMA.

A link to our team is available at:
http://www.bu.edu/ctsi/support-for-research/bumc-thrombotic-microangiopathy-collaborative-butmac/butmac/

 Self-Described Keywords
  • Organ transplants
  • Kidney transplantation
  • Pancreas transplantation
  • Kidney diseases
  • Thrombotic microangiopathy
  • Glomerular diseases
  • Complement mediated kidney diseases
  • Recurrent glomerular diseases after kidney transplant
  • BK virus infection
  • Bone diseases after kidney transplant
 Publications
Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Faculty can login to make corrections and additions.
List All   |   Timeline
  1. Reddy YN, Siedlecki AM, Francis JM. Breaking down the complement system: a review and update on novel therapies. Curr Opin Nephrol Hypertens. 2017 Mar; 26(2):123-128. PMID: 27977428.
    View in: PubMed
  2. Gordon CE, Vantzelfde S, Francis JM. Acetazolamide in Lithium-Induced Nephrogenic Diabetes Insipidus. N Engl J Med. 2016 11 17; 375(20):2008-2009. PMID: 27959610.
    View in: PubMed
  3. Shashar M, Siwak J, Tapan U, Lee SY, Meyer RD, Parrack P, Tan J, Khatami F, Francis J, Zhao Q, Hartshorn K, Kolachalama VB, Rahimi N, Chitalia V. c-Cbl mediates the degradation of tumorigenic nuclear ß-catenin contributing to the heterogeneity in Wnt activity in colorectal tumors. Oncotarget. 2016 11 01; 7(44):71136-71150. PMID: 27661103.
    View in: PubMed
  4. Toth-Manikowski SM, Francis JM, Gautam A, Gordon CE. Outcomes of bisphosphonate therapy in kidney transplant recipients: a systematic review and meta-analysis. Clin Transplant. 2016 Sep; 30(9):1090-6. PMID: 27327448.
    View in: PubMed
  5. Francis JM, Beck LH, Salant DJ. Membranous Nephropathy: A Journey From Bench to Bedside. Am J Kidney Dis. 2016 Jul; 68(1):138-47. PMID: 27085376.
    View in: PubMed
  6. Ding Y, Francis J, Kalish J, Deshpande A, Quillen K. Recurrent focal segmental glomerulosclerosis apparently resistant to plasmapheresis improves after surgical repair of arteriovenous fistula aneurysms. Clin Kidney J. 2016 Jun; 9(3):408-10. PMID: 27274825.
    View in: PubMed
  7. Al-Rabadi L, Francis JM, Henderson J, Ghai S. Proliferative glomerulonephritis with monoclonal immunoglobulin in renal allografts. Clin Kidney J. 2015 Dec; 8(6):722-8. PMID: 26613031.
    View in: PubMed
  8. Shivanna S, Kolandaivelu K, Shashar M, Belghasim M, Al-Rabadi L, Balcells M, Zhang A, Weinberg J, Francis J, Pollastri MP, Edelman ER, Sherr DH, Chitalia VC. The Aryl Hydrocarbon Receptor is a Critical Regulator of Tissue Factor Stability and an Antithrombotic Target in Uremia. J Am Soc Nephrol. 2016 Jan; 27(1):189-201. PMID: 26019318.
    View in: PubMed
  9. Shivanna S, Harrold I, Shashar M, Meyer R, Kiang C, Francis J, Zhao Q, Feng H, Edelman ER, Rahimi N, Chitalia VC. The c-Cbl ubiquitin ligase regulates nuclear ß-catenin and angiogenesis by its tyrosine phosphorylation mediated through the Wnt signaling pathway. J Biol Chem. 2015 May 15; 290(20):12537-46. PMID: 25784557.
    View in: PubMed
  10. Shashar M, Francis J, Chitalia V. Thrombosis in the uremic milieu--emerging role of "thrombolome". Semin Dial. 2015 Mar-Apr; 28(2):198-205. PMID: 24962903.
    View in: PubMed
  11. Gordon CE, Francis J. Hepatitis C treatment in dialysis patients: is a new dawn approaching? Am J Kidney Dis. 2014 Aug; 64(2):178-80. PMID: 24797524.
    View in: PubMed
  12. Garg N, Weinberg J, Ghai S, Bradauskaite G, Nuhn M, Gautam A, Kumar N, Francis J, Chen JL. Lower magnesium level associated with new-onset diabetes and pre-diabetes after kidney transplantation. J Nephrol. 2014 Jun; 27(3):339-44. PMID: 24609888.
    View in: PubMed
  13. Roseman DA, Kabbani D, Kwah J, Bird D, Ingalls R, Gautam A, Nuhn M, Francis JM. Strongyloides stercoralis transmission by kidney transplantation in two recipients from a common donor. Am J Transplant. 2013 Sep; 13(9):2483-6. PMID: 23919410.
    View in: PubMed
  14. Cohen JB, Gordon CE, Balk EM, Francis JM. Cinacalcet for the treatment of hyperparathyroidism in kidney transplant recipients: a systematic review and meta-analysis. Transplantation. 2012 Nov 27; 94(10):1041-8. PMID: 23069843.
    View in: PubMed
  15. Francis JM, Palmer MR, Donohoe K, Curry M, Johnson SR, Karp SJ, Evenson AR, Pavlakis M, Hanto DW, Mandelbrot DA. Evaluation of native kidney recovery after simultaneous liver-kidney transplantation. Transplantation. 2012 Mar 15; 93(5):530-5. PMID: 22245875.
    View in: PubMed
  16. Chen JL, Francis J. Pyridoxamine, advanced glycation inhibition, and diabetic nephropathy. J Am Soc Nephrol. 2012 Jan; 23(1):6-8. PMID: 22158434.
    View in: PubMed
  17. Palmer MR, Donohoe KJ, Francis JM, A Mandelbrot D. Evaluation of relative renal function for patients who had undergone simultaneous liver-kidney transplants using Tc-99m-MAG3 scintigraphy with attenuation correction from anatomical images and SPECT/CT. Nucl Med Commun. 2011 Aug; 32(8):738-44. PMID: 21659910.
    View in: PubMed
  18. Gautam A, Patel V, Pelletier L, Orozco J, Francis J, Nuhn M. Routine BK virus surveillance in renal transplantation--a single center's experience. Transplant Proc. 2010 Dec; 42(10):4088-90. PMID: 21168634.
    View in: PubMed
  19. Francis JM, Geller D. Renal Glucosuria. Encyclopedia of Molecular mechanisms of Diseases: An Encyclopedic reference. Editor F. Lang (ISBN-10: 3-540-67136-6). 2009.
  20. Francis JA, Simon DB, Jeurgensen P, Finkelstein FO. Calcimimetics for the Treatment of Secondary Hyperparathyroidism in Peritoneal Dialysis Patients. Perit Dial Int. 2008; 28:S42–S46.
  21. Granja CA, Francis JM, Simon DB, Bushinsky D, Finkelstein FO. Calcium Balance with Automated Peritoneal Dialysis. Perit Dial Int. 2008; 28:S38– S41.
  22. Granja CA, Tailor PT, Gorban-Brennan N, Francis J, Bekui A, Finkelstein FO. Brain natriuretic peptide and impedance cardiography to assess volume status in peritoneal dialysis patients. Adv Perit Dial. 2007; 23:155-60. PMID: 17886624.
    View in: PubMed
  23. Beyzaei A, Francis J, Knight H, Simon DB, Finkelstein FO. Metabolic lung disease: diffuse metastatic pulmonary calcifications with progression to calciphylaxis in end-stage renal disease. Adv Perit Dial. 2007; 23:112-7. PMID: 17886615.
    View in: PubMed
  24. Francis J, Zhang J, Farhi A, Carey H, Geller DS. A novel SGLT2 mutation in a patient with autosomal recessive renal glucosuria. Nephrol Dial Transplant. 2004 Nov; 19(11):2893-5. PMID: 15496564.
    View in: PubMed
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