Milagros D. Samaniego, MD

Professor of Internal Medicine
Division of Nephrology
Medical Director, Kidney and Kidney Pancreas Transplantation
University of Michigan
3914D Taubman Center
1500 East Medical Center
Drive Ann Arbor, MI 48109-5364, USA


• (07/1976-03/1984), MD, Degree MD Medicine, Faculty of Medicine, University of Panama, Panama City, Panama


• (04/1984-03/1989), Residency, Internal Medicine, General Hospital of the Social Security Fund, Panama City, Republic of Panama
• (06/1990-06/1991), Internship, Internal Medicine, Baylor College of Medicine, Houston, Texas
• (07/1991-06/1993), Residency, Internal Medicine, Baylor College of Medicine, Houston, Texas
• (07/1993-06/1994), Residency, Chief Medical Resident Internal Medicine, The Methodist Hospital, Department of Medicine, Baylor College of Medicine, Houston, TX
• (07/1994-06/1995), Fellowship, Division of Nephrology, Johns Hopkins Medical School of Medicine, Baltimore, Maryland
• (07/1995-06/1996), Fellowship, Senior Clinical Fellow, The John Hopkins School of Medicine, Baltimore, Maryland
• (07/1996-06/1997), Postdoctoral Research Fellow, Immunopathology, Johns Hopkins School of Medicine, Baltimore, Maryland

Research Interest

Dr. Samaniego clinical and research interests focus on experimental and clinical antibody-Mediated Rejection, Desensitization Protocols, ABO-Incompatible Kidney Transplantation and other treatment options for highly sensitized kidney transplant candidates including Pair-Kidney exchange programs. More recently, she has expanded her work on Anti-HLA antibodies to other solid organ and cellular transplants including Liver, Pancreas and Pancreatic Islets. She is also working in the use of new therapeutic agents such as complement system inhibitors for the treatment of antibody-Mediated Rejection, and the development of treatment protocols for Chronic Active Antibody-Mediated Rejection.

Scientific Activities



• (1984), Valedictorian Class 1984, Faculty of Medicine, University of Panama, Republic of Panama


• (1990), Civilian Award for Humanitarian Service, Department of the Army United States of America
• (1996-1997), Representative, Post-Doctoral Fellows Association, Department of Pathology, The Johns Hopkins University School of Medicine
• (1996-1997), Representative, Womens Task Force Fellows Sub-Committee, Department of Medicine, The Johns Hopkins University School of Medicine
• (1996), ASTP-SANDOZ Fellowship in Transplantation Award, American Society of Transplant Physicians 15th Annual Meeting, May 1996
• (1996), American Society of Nephrology, Blue Ribbon Award, 29th Annual Meeting, New Orleans, Louisiana
• (1999), Young Investigator Award in Basic Science Research, First Annual Meeting Johns Hopkins Comprehensive Transplant Center, Johns Hopkins University, Baltimore, Maryland
• (2000), Investigator Award in Basic Science Research, Second Annual Meeting, Johns Hopkins Comprehensive Transplant Center, Baltimore, Maryland


• (1990-2006), Member, American College of Physicians
• (1995-2004), Member, American Society of Nephrology
• (1996-2009), Member, American Association for the Advancement of Science
• (1998-present), Member, American Society of Transplantation
• (1998-present), Member, National Kidney Foundation
• (2002-present), Member, American Heart Association Scientific Council
• (2004-present), Fellow, American Society of Nephrology
• (2004-present), Member, International Society of Nephrology
• (2006-present), Fellow, American College of Physicians
• (2006-present), Member, American Society of Transplant Surgeons
• (2011-present), Member, Transplantation Society
• Co-Chair-KDIGO Public Policy Committee of National Kidney Foundation
• Member-Education Committee of Transplantation Society



1. Samaniego-Picota MD, Whelton A. Aminoglycoside-Induced Nephrotoxicity in Cystic Fibrosis: A Case Presentation and Review of the Literature. American journal of therapeutics. 1996; 3(3): 248-257.
2. Briggs WA, Gao ZH, Xing JJ, et al. Suppression of lymphocyte interleukin-2 receptor expression by glucocorticoids, cyclosporine, or both. J Clin Pharmacol. 1996; 36(10): 931-937. doi: 10.1002/j.1552-4604.1996.tb04760.x
3. Briggs WA, Gao ZH, Xing JJ, et al. Suppression of dialysis patients lymphocyte IL-2R expression by glucocorticoids and cyclosporine. Cytokine. 1997; 9(8): 624-628. doi: 10.1006/cyto.1997.0210
4. Samaniego M, Baldwin WM, Sanfilippo F. Delayed graft function: immediate and late impact. Curr. Opin. Nephrol. Hypertens. 1997; 6(6): 533-537.
5. Baldwin WM, Samaniego-Picota M, Kasper EK, et al. Complement deposition in early cardiac transplant biopsies is associated with ischemic injury and subsequent rejection episodes. Transplantation. 1999; 68(6): 894-900.
6. Briggs WA, Gimenez LF, Samaniego-Picota M, et al. Relationship between lymphocyte and clinical steroid responsiveness in focal segmental glomerulosclerosis. J Clin Pharmacol. 2000; 40(2): 115-123. doi: 10.1177/00912700022008757
7. Baldwin W M, Qian Z, Ota H, et al. Complement as a mediator of vascular inflammation and activation in allografts. J. Heart Lung Transplant. 2000; 19(8): 723-730. doi:
8. Mandal AK, Kraus ES, Samaniego M, et al. Shorter waiting times for hepatitis C virus seropositive recipients of cadaveric renal allografts from hepatitis C virus seropositive donors. Clin Transplant. 2000; 14(4(2)): 391-396. doi: 10.1034/j.1399-0012.2000.14040602.x
9. Baldwin WM, Armstrong LP, Samaniego MD, et al. Anti-thymocyte globulin treatment is associated with complement deposition in early cardiac transplant biopsies. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. 2001; 20(2): 155-156. doi: 10.1016/j.humimm.2004.05.015
10. Samaniego M, Laszik Z, Nadasdy T. Recurrence of fibrillary glomerulonephritis in renal transplants. Clinical Nephrology. 2001; 55(2): 159-166. doi: 10.1007/s11255-012-0238-5
11. Samaniego M, Nadasdy GM, Laszik Z, Nadasdy T. Outcome of renal transplantation in fibrillary glomerulonephritis. Clin. Nephrol. 2001; 55(2): 159-166.
12. Tan HP, Samaniego MD, Montgomery RA, et al. Donor horseshoe kidneys for transplantation. Transplantation. 2001; 72(5): 869-873.
13. Haas M, Kraus ES, Samaniego-Picota M, Racusen LC, Ni W, Eustace JA. Acute renal allograft rejection with intimal arteritis. histologic predictors of response to therapy and graft survival. Kidney Int. 2002; 61(4): 1516-1526. doi: 10.1046/j.1523-1755.2002.00254.x
14. Jaar BG, Kim HS, Samaniego MD, Lund GB, Atta MG. Percutaneous mechanical thrombectomy: a new approach in the treatment of acute renal-vein thrombosis. Nephrol. Dial. Transplant. 2002; 17(6): 1122-1125. doi: 10.1093/ndt/17.6.1122
15. Sonnenday CJ, Ratner LE, Zachary AA, et al. Preemptive therapy with plasmapheresis/intravenous immunoglobulin allows successful live donor renal transplantation in patients with a positive cross-match. Transplant Proc. 2002; 34(5): 1614-1616. doi:
16. Montgomery R, Ratner L, Samaniego M, et al. Successful transplantation across HLA and ABO sensitization. Hum Immunol. 2002; 63(10): 83.
17. Kopchaliiska D, Lefell M, Montgomery R, Samaniego M, Neu A, Zachary A. Specific downregulation of antibody to donor HLA in renal transplantation. Hum Immunol. 2002; 63(10): 30.
18. Montgomery RA, Cooper M, Kraus E, et al. Renal transplantation at the Johns Hopkins Comprehensive Transplant Center. Clin Transpl. 2003; 199-213.
19. Zachary AA, Montgomery RA, Ratner LE, et al. Specific and durable elimination of antibody to donor HLA antigens in renal-transplant patients. Transplantation. 2003; 76(10): 1519-1525.
20. Wu J, Jaar BG, Briggs WA, et al. High-dose mycophenolate mofetil in the treatment of posttransplant glomerular disease in the allograft: a case series. Nephron Clin Pract. 2004; 98(3): c61-c66. doi: 10.1159/000080674
21. Shepherd JC, Subramanian A, Montgomery RA, et al. West Nile virus encephalitis in a kidney transplant recipient. Am. J. Transplant. 2004; 4(5): 830-833. doi: 10.1111/j.1600-6143.2004.00410.x
22. Sonnenday CJ, Warren DS, Cooper M, et al. Plasmapheresis, CMV hyperimmune globulin, and anti-CD20 allow ABO-incompatible renal transplantation without splenectomy. Am. J. Transplant. 2004; 4(8): 1315-1322. doi: 10.1111/j.1600-6143.2004.00507.x
23. King KE, Warren DS, Samaniego-Picota M, Campbell-Lee S, Montgomery RA, Baldwin WM. Antibody, complement and accommodation in ABO-incompatible transplants. Curr. Opin. Immunol. 2004; 16(5): 545-549. doi: 10.1016/j.coi.2004.07.004
24. Baldwin WM, Armstrong LP, Samaniego-Picota M, et al. Anti thymocyte globulin is associated with complement deposition in cardiac transplant biopsies. Hum. Immunol. 2004; 65(11): 1273-1280. dio: 10.1016/j.humimm.2004.05.015
25. Melamed ML, Kim HS, Jaar BG, Molmenti E, Atta MG, Samaniego MD. Combined percutaneous mechanical and chemical thrombectomy for renal vein thrombosis in kidney transplant recipients. Am J Transplant. 2005; 5(3): 621-626. doi: 10.1111/j.1600-6143.2004.00696.x
26. Samaniego M, Mezrich J, Torrealba J, et al. C4d-positive acute antibody-mediated rejection due to anti-HLA-DP antibody: a tale of one patient and a review of the University of Wisconsin experience. Clin Transpl. 2006; 503-507.
27. Djamali A, Samaniego M, Muth B, et al. Medical care of kidney transplant recipients after the first post transplant year. Clin J Am Soc Nephrol. 2006; 1(4): 623-640. doi: 10.2215/CJN.01371005
28. Becker YT, Samaniego-Picota M, Sollinger HW. The emerging role of rituximab in organ transplantation. Transpl. Int. 2006; 19(8): 621-628. doi: 10.1111/j.1432-2277.2006.00345.x
29. Djamali A, Sadowski EA, Samaniego-Picota M, et al. Noninvasive assessment of early kidney allograft dysfunction by blood oxygen level-dependent magnetic resonance imaging. Transplantation. 2006; 82(5): 621-628. doi: 10.1097/
30. Samaniego M, Becker BN, Djamali A. Drug insight: maintenance immunosuppression in kidney transplant recipients. Nat Clin Pract Nephrol. 2006; 2(12): 688-699. doi: 10.1038/ncpneph0343
31. Djamali A, Sadowski EA, Muehrer RJ, et al. BOLD-MRI assessment of intrarenal oxygenation and oxidative stress in patients with chronic kidney allograft dysfunction. Am. J. Physiol. Renal Physiol. 2007; 292(2): F513-F522. doi: 10.1152/ajprenal.00222.2006
32. Pascual J, Mezrich JD, Djamali A, et al. Alemtuzumab induction and recurrence of glomerular disease after kidney transplantation. Transplantation. 2007; 83(11): 1429-1434. doi: 10.1097/
33. Pascual J, Djamali A, Muth B, Hofmann RM, Samaniego M, Becker B. New Considerations for Chronic Milagros Dalgir. Samaniego-Picota. 2014; 18-24.
33. Pascual J, Djamali A, Muth B, Hofmann RM, Samaniego M, Becker B. New Considerations for Chronic Kidney Allograft Injury. Trends in Transplant. 2007; 1: 95-103.
34. Pascual J, Torrealba J, Myers J, et al. Collapsing focal segmental glomerulosclerosis in a liver transplant recipient on alendronate. Osteoporos Int. 2007; 18(10): 1435-1438. doi: 10.1007/s00198-007-0361-9
35. Smavatkul C, Pascual J, Desai AG, Samaniego M, Becker BN, Djamali A. Disease progression and outcomes in type 1 diabetic kidney transplant recipients based on posttransplantation CKD staging. Am J Kidney Dis. 2007; 50(4): 631-640. doi:
36. Kukla A, Adulla M, Pascual J, et al. CKD stage-to-stage progression in native and transplant kidney disease. Nephrol. Dial. Transplant. 2008; 23(2): 693-700. doi: 10.1093/ndt/gfm590
37. Pascual J, Samaniego MD, Torrealba JR, et al. Antibody-mediated rejection of the kidney after simultaneous pancreas-kidney transplantation. J Am Soc Nephrol. 2008; 19(4): 812-824. doi: 10.1681/ASN.2007070736
38. Conley E, Muth B, Samaniego M, et al. Bisphosphonates and bone fractures in long-term kidney transplant recipients. Transplantation. 2008; 86(2): 231-237. doi: 10.1097/TP.0b013e318176b40f
39. Torrealba JR, Samaniego M, Pascual J, et al. C4d-positive interacinar capillaries correlates with donor-specific antibody-mediated rejection in pancreas allografts. Transplantation. 2008; 86(12): 1849-1856. doi: 10.1097/TP.0b013e3181902319
40. Pascual J, Pirsch JD, Odorico JS, et al. Alem tuzumab Induction and Antibody-Mediated Kidney Rejection After Simultaneous Pancreas-Kidney Transplantation. Transplantation. 2009; 87(1): 125-132. doi: 10.1097/TP.0b013e31818c6db0
41. Huang E, Samaniego-Picota M, McCune T, et al. DNA Testing For Live Kidney Donors At Risk For Autosomal Dominant Polycystic Kidney Disease. Transplantation. 2009; 87(1): 133-137. doi: 10.1097/TP.0b013e318191e729
42. Singh N, Pirsch J, Samaniego M. Antibody-mediated rejection: treatment alternatives and outcomes. Transplant Rev (Orlando). 2009; 23(1): 34-46. doi: 10.1016/j.trre.2008.08.004
43. Stuckey LJ, Kamoun M, Wadhwa A, et al. Acute rejection in a highly sensitized lung transplant recipient with pre-formed donor-directed anti-HLA class II antibodies: role of bortezomib therapy. Clin Transpl. 2009; 471-474.
44. Huang E, Samaniego-Picota M, McCune T, et al. DNA testing for live kidney donors at risk for autosomal dominant polycystic kidney disease. Transplantation. 2009; 87(1): 133-137. doi: 10.1097/TP.0b013e318191e729
45. Pascual J, Pirsch JD, Odorico JS, et al. Alemtuzumab induction and antibody-mediated kidney rejection after simultaneous pancreas-kidney transplantation. Transplantation. 2009; 87(1): 125-132. doi: 10.1097/TP.0b013e31818c6db0
46. Chan MR, Thomas CP, Torrealba JR, et al. Recurrent atypical hemolytic uremic syndrome associated with factor I mutation in a living related renal transplant recipient. Am. J. Kidney Dis. 2009; 53(2): 321-326. doi: 10.1053/j.ajkd.2008.06.027
47. Samaniego MD. Promoting pre-emptive or early kidney transplantation. Nephrol News Issues. 2009; 23(3): 54-55.
48. Bloom D, Chang Z, Pauly K, et al. BAFF is increased in renal transplant patients following treatment with alemtuzumab. Am. J. Transplant. 2009; 9(8): 1835-1845. doi: 10.1111/j.1600-6143.2009.02710.x
49. Djamali A, Samaniego M. Fibrogenesis in kidney transplantation: potential targets for prevention and therapy. Transplantation. 2009; 88(10): 1149-1156.
50. Luan FL, Samaniego M. Transplantation in diabetic kidney failure patients: modalities, outcomes, and clinical management. Semin Dial. 2010; 23(2): 198-205. doi: 10.1111/j.1525-139X.2010.00708.x
51. Djamali A, Samaniego M, Torrealba J, Pirsch J, Muth BL. Increase in proteinuria>200 mg/g after late rejection is associated with poor graft survival. Nephrol. Dial. Transplant. 2010; 25(4): 1300-1306. doi: 10.1093/ndt/gfp613
52. Glassock RJ, Bargman JM, Palmer BF, Samaniego M, Fervenza FC. Nephrology Quiz and Questionnaire. Clinical journal of the American Society of Nephrology (CJASN). 2010; 5(6): 1141-1160.
53.Luan FL, Samaniego M, Kommareddi M, Park JM, Ojo AO. Choice of induction regimens on the risk of Milagros Dalgir. Samaniego-Picota. 2009.
53. Luan FL, Samaniego M, Kommareddi M, Park JM, Ojo AO. Choice of induction regimens on the risk of cytomegalovirus infection in donor-positive and recipient-negative kidney transplant recipients. Transplant infectious disease. An official journal of the Transplantation Society. 2010. doi: 0.1111/j.1399-3062.2010.00532.x
54. Hanish SI, Samaniego M, Mezrich JD, et al. Outcomes of simultaneous liver/kidney transplants are equivalent to kidney transplant alone: a preliminary report. Transplantation. 2010; 90(1): 52-60. doi: 10.1097/TP.0b013e3181e17014
55. Singh N, Lorentzen D, Pirsch J, et al. Low Level Donor Specific Antibodies Detected By Single Antigen Bead Luminex Assay As Predictors Of Kidney Transplant Outcomes. Transplantation in press: in press. 2010.
56. Luan FL, Kommareddi M, Cibrik DM, Samaniego M, Ojo AO. Influence of recipient race on the outcome of simultaneous pancreas and kidney transplantation. Am J Transplant. 2010; 10(9): 2074-2081.doi: 10.1111/j.1600-6143.2010.03211.x
57. Dahlberg R, Muth B, Samaniego M, Hofmann RM, Pirsch J, Djamali A. One-year serum albumin is an independent predictor of outcomes in kidney transplant recipients. J Ren Nutr. 2010; 20(6): 392-397. doi: 10.1053/j.jrn.2010.03.008
58. Singh N, Djamali A, Lorentzen D, et al. Pretransplant donor-specific antibodies detected by single-antigen bead flow cytometry are associated with inferior kidney transplant outcomes. Transplantation. 2010; 90(10): 1079-1084. doi: 10.1097/TP.0b013e3181f6a07b
59. Lee DD, Gooden CW, Nadig SN, et al. Living donor kidney transplantation at the University of Michigan. Clin Transpl. 2011; 77-89.
60. Niederhaus SV, Muth B, Lorentzen DF, et al. Luminex-based desensitization protocols: the university of wisconsin initial experience. Transplantation. 2011; 92(1): 12-17. doi: 10.1097/TP.0b013e31821c93bb
61. Lamattina JC, Foley DP, Mezrich JD, et al. Chronic kidney disease stage progression in liver transplant recipients. Clin J Am Soc Nephrol. 2011; 6(8): 1851-1857. doi: 10.2215/CJN.00650111
62. Drachenberg CB, Torrealba JR, Nankivell BJ, et al. Guidelines for the diagnosis of antibody-mediated rejection in pancreas allografts-updated Banff grading schema. Am J Transplant. 2011; 11(9): 1792-1802. doi: 10.1111/j.1600-6143.2011.03670.x
63. Anand S, Samaniego M, Kaul DR. Pneumocystis jirovecii pneumonia is rare in renal transplant recipients receiving only one month of prophylaxis. Transpl Infect Dis. 2011; 13(6): 570-574. doi: 10.1111/j.1399-3062.2011.00692.x
64. Huang Y, Ramon D, Luan FL, Sung R, Samaniego M. Incidences of preformed and de novo donor-specific HLA antibodies and their clinicohistological correlates in the early course of kidney transplantation. Clin Transpl. 2012; 247-256.
65. Luan FL, Kommareddi M, Cibrik DM, Samaniego M, Ojo AO. The time interval between kidney and pancreas transplantation and the clinical outcomes of pancreas after kidney transplantation. Clin Transplant. 2012; 26(3): 403-410.
66. Samaniego-Picota M, Patel A, Davis C. Live Kidney Donation: Gaps Remain Adv Chronic. Kidney Dis. 2012; 19(4): 205-206. doi: 10.1053/j.ackd.2012.05.005
67. Abecassis M, Bridges ND, Clancy CJ, et al. Solid-organ transplantation in older adults: current status and future research. Am J Transplant. 2012; 12(10): 2608-2622. doi: 10.1111/j.1600-6143.2012.04245.x
68. Huang Y, Samaniego M. Preemptive kidney transplantation: Has it come of age?. Nephrol. Ther. 2012; 8(6): 428-432. doi: 10.1016/j.nephro.2012.06.004
69. Barrantes F, Luan FL, Kommareddi M, et al. A history of chronic opioid usage prior to kidney transplantation may be associated with increased mortality risk. Kidney Int. 2013; 84(2): 390-396. doi: 10.1038/ki.2013.136
70. Djamali A, Kaufman DB, Ellis TM, Zhong W, Matas A, Samaniego M. Diagnosis and management of antibody-mediated rejection: current status and novel approaches. American journal of transplantation, Official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 2014; 14(2): 255-271. doi: 10.1111/ajt.12589
71. Samaniego M, Perrone RD. Living donor transplantation: should we advocate for it?. Nephrology news & Issues. 2014; 28(2): 22-23.
72. Luan F, Barrantes F, Roth R, Samaniego M. Early Hospital Readmissions Post Kidney Transplantation Are Associated with Inferior Clinical Outcomes. Clinical transplantation. 2014. doi: 10.1111/ctr.12347
73. Gabr AH, Sung RS, Samaniego-Picota MD, He C, Wolf JS Jr. Ureteral complications after hand-assisted laparoscopic living donor nephrectomy. Transplantation. 2014; 97(7): 788-792. doi: 10.1097/01.TP.0000437559.41514.96
74. Kulshrestha S, Barrantes F, Samaniego M, Luan FL. Chronic Opioid Analgesic Usage Post-Kidney Transplantation and Clinical Outcomes. Clinical transplantation. 2014. doi: 10.1111/ctr.12414
75. Singh N, Samaniego M. Renal Failure in a Kidney Transplant Recipient-BK Virus Nephropathy or Rejection?. American journal of transplantation. Official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 2014; 14(9): 2189-2191. doi: 10.1111/ajt.12790