By Maggie Lindenberg
Photography by Joshua Franzos
When Aravind Cherukuri first began his clinical nephrology fellowship over a decade ago in England at Leeds Teaching Hospitals, he didn’t intend to work with transplantation—or to conduct research.
But Cherukuri’s path shifted toward clinical transplantation and transplant immunology with the influence and support of his fellowship supervisor—and, later, PhD advisor and lifelong mentor—Richard Baker, an associate professor of medicine and co-lead for clinical governance, National Health Service Blood and Transplant, and President-Elect of the British Transplant Society.
“The more I started working with Richard, the more I understood the value of the tight collaboration between science and clinical medicine,” said Cherukuri, now an assistant professor of medicine, of surgery and of immunology, School of Medicine, and codirector of clinical research at the Thomas E. Starzl Transplantation Institute. “The balance that he could find between all of that enticed me to stay in academia as a transplant physician-scientist.”
As a nephrology trainee under Baker’s supervision, Cherukuri became deeply interested in emerging research on regulatory B (Breg) cells and their role in transplantation tolerance—a rare phenomenon in which transplant recipients require no immunosuppressive medications to prevent rejection. He began studying these cells in clinically stable patients who were still receiving immunosuppression, working under the guidance of his future mentor, advisor, and key collaborator, David Rothstein, the Pittsburgh Steelers Professor of Transplantation and professor of immunology, School of Medicine.
Breg cells are crucial in regulating the immune response, in part by releasing both pro-inflammatory and anti-inflammatory chemical signals. Cherukuri discovered that what mattered most was the balance between these calming and activating signals within specific B-cell groups. When the ratio of anti-inflammatory signals outweighs pro-inflammatory ones, transplanted organs are more likely to be accepted. He also found that a group of immature B cells, called transitional B cells—especially the T1 subset—shows the strongest anti-inflammatory balance, making them particularly important to transplant outcomes.
Cherukuri later joined Rothstein’s lab as a postdoctoral associate to expand this work and evaluate Breg cells systematically in a large patient cohort. Under Rothstein’s mentorship, he developed an early immunological biomarker based on this ratio, published in Science Translational Medicine. Measured three months after a kidney transplant, the biomarker can help predict whether the patient is likely to experience rejection and how the transplant will progress over time.
Beyond his work on Breg cells and biomarker development, Cherukuri collaborated with Fadi Lakkis, former scientific director of the Starzl Transplantation Institute, to identify a key immune system mismatch between kidney donors and recipients involving a protein called SIRPα. When this mismatch occurs, the recipient’s immune system is more likely to attack the transplanted organ, leading to early rejection, long-term scarring and reduced graft survival. The study, published in Science Translational Medicine, showed that this reaction is driven by the body’s fast, innate immune defenses, and helps explain why some transplants fail despite seeming like a good match otherwise.
On Friday, Jan. 16, 2026, Cherukuri will present “Toward Immune-Driven Precision Kidney Transplant Medicine,” for the opening of the 2026 Senior Vice Chancellor Research Seminar Series. (Join the lecture here.)
Ultimately, Cherukuri hopes his work will pave the way for more personalized medicine in transplantation.
“What keeps me going is that nearly every field of medicine is moving toward personalization, but in transplantation, we’ve made relatively little progress in determining which patients need more immunosuppression and which can safely use less,” he explained.
He noted that Pittsburgh remains a meaningful place to pursue this vision.
“This is where Thomas Starzl took the pioneering steps that shaped modern organ transplantation,” he said. “The aspiration that we might one day take the next step—toward personalized treatment approaches—here in Pittsburgh is what continues to inspire me.”