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Auto-islet Transplant

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https://www.readbyqxmd.com/read/28993044/risk-factors-for-early-readmission-after-total-pancreatectomy-and-islet-auto-transplantation
#1
Rauf Shahbazov, Bashoo Naziruddin, Kunal Yadav, Giovanna Saracino, Gumpei Yoshimatsu, Mazhar A Kanak, Ernest Beecherl, Peter T Kim, Marlon F Levy
BACKGROUND: Little published data exist examining causes of hospital readmission following total pancreatectomy with islet autotransplantation (TPIAT). METHODS: A retrospective analysis was performed of a prospectively collected institutional TPIAT database. Primary outcome was unplanned readmission to the hospital within 30 days from discharge. Reasons and risk factors for readmission as well as islet function were evaluated and compared by univariate and multivariate analysis...
October 6, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28821411/diagnosis-and-treatment-in-chronic-pancreatitis-an-international-survey-and-case-vignette-study
#2
Yama Issa, Hjalmar C van Santvoort, Paul Fockens, Marc G Besselink, Thomas L Bollen, Marco J Bruno, Marja A Boermeester
BACKGROUND: The aim of the study was to evaluate the current opinion and clinical decision-making process of international pancreatologists, and to systematically identify key study questions regarding the diagnosis and treatment of chronic pancreatitis (CP) for future research. METHODS: An online survey, including questions regarding the diagnosis and treatment of CP and several controversial clinical case vignettes, was send by e-mail to members of various international pancreatic associations: IHPBA, APA, EPC, ESGE and DPSG...
November 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28731996/-pancreatitis-genes-and-islet-cells-auto-transplant-updates-and-new-horizons
#3
Edgardo D Rivera Rivera
Pancreatitis is an inflammation of the pancreas that can progress from an acute presentation to an acute recurring presentation and eventually to chronic pancreatitis, which is characterized by irreversible morphological changes and scarring of the pancreas. The entity known as hereditary pancreatitis has been recognized in the literature for years and certainly the discovery of the PRSS1 gene in 1996 marked the beginning of a new era of genetic discoveries associated with the disease. Since then, multiple genes have been described as the causing agents of pancreatitis or disease modifiers, some of the most important ones being the PRSS1, SPINK1, CFTR, CASR, CTRC, CLDN2, and CPA1...
April 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28726153/immunological-issues-after-stem-cell-based-%C3%AE-cell-replacement
#4
REVIEW
Valeria Sordi, Silvia Pellegrini, Lorenzo Piemonti
PURPOSE OF REVIEW: Islet and pancreas transplantation prove that β cell replacement can cure the glycemic derangements in type 1 diabetes (T1D). Induced pluripotent stem cells (iPSCs) can differentiate into functional insulin-producing cells, able to restore normoglycemia in diabetic animal models. iPSCs in particular can be derived from the somatic cells of a person with T1D. This review aims to clarify if it is possible to transplant autologous iPSC-derived β cells without immunosuppression or which are the alternative approaches...
September 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28385584/a-study-of-the-clinical-utility-of-a-20-minute-secretin-stimulated-endoscopic-pancreas-function-test-and-performance-according-to-clinical-variables
#5
Luis F Lara, Morihito Takita, James S Burdick, Daniel C DeMarco, Ronnie R Pimentel, Tolga Erim, Marlon F Levy
BACKGROUND AND AIMS: Direct pancreas juice testing of bicarbonate, lipase, or trypsin after stimulation by secretin or cholecystokinin is used to determine exocrine function, a surrogate for diagnosing chronic pancreatitis (CP). Endoscopic pancreas function tests (ePFTs), where a peak bicarbonate concentration (PBC) ≥80 mEq/L in pancreas juice is considered normal, are now used more frequently. In this ePFT, aspirates start 35 minutes after secretin administration because pancreas output peaks 30 minutes after secretagogue administration...
April 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28358727/salvage-islet-auto-transplantation-after-relaparatomy
#6
Gianpaolo Balzano, Rita Nano, Paola Maffi, Alessia Mercalli, Raffaelli Melzi, Francesca Aleotti, Francesca Gavazzi, Cesare Berra, Francesco De Cobelli, Massimo Venturini, Paola Magistretti, Marina Scavini, Giovanni Capretti, Alessandro Del Maschio, Antonio Secchi, Alessandro Zerbi, Massimo Falconi, Lorenzo Piemonti
BACKGROUND: To assess feasibility, safety, and metabolic outcome of islet auto transplantation (IAT) in patients undergoing completion pancreatectomy because of sepsis or bleeding after pancreatic surgery. METHODS: From November 2008 to October 2016, approximately 22 patients were candidates to salvage IAT during emergency relaparotomy because of postpancreatectomy sepsis (n = 11) or bleeding (n = 11). Feasibility, efficacy, and safety of salvage IAT were compared with those documented in a cohort of 36 patients who were candidate to simultaneous IAT during nonemergency preemptive completion pancreatectomy through the pancreaticoduodenectomy...
October 2017: Transplantation
https://www.readbyqxmd.com/read/27870552/glycemic-predictors-of-insulin-independence-after-total-pancreatectomy-with-islet-autotransplantation
#7
Michael Quartuccio, Erica Hall, Vikesh Singh, Martin A Makary, Kenzo Hirose, Niraj Desai, Christi Walsh, Daniel Warren, Zhaoli Sun, Ellen Stein, Rita R Kalyani
Context: Total pancreatectomy with islet auto transplantation (TPIAT) is a treatment for medically refractory chronic pancreatitis that can prevent postsurgical diabetes in some patients. Predictors of insulin independence are needed for appropriate patient selection and counseling. Objective: To explore glycemic predictors of insulin independence after TPIAT. Design: A prospective cohort of patients. Methods: We investigated 34 patients undergoing TPIAT from 2011-2016 at Johns Hopkins Hospital, all had a 75-g oral glucose tolerance test (OGTT) administered prior to their TPIAT...
March 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27787618/immunogenicity-of-human-embryonic-stem-cell-derived-beta-cells
#8
Cornelis R van der Torren, Arnaud Zaldumbide, Gaby Duinkerken, Simone H Brand-Schaaf, Mark Peakman, Geert Stangé, Laura Martinson, Evert Kroon, Eugene P Brandon, Daniel Pipeleers, Bart O Roep
AIMS/HYPOTHESIS: To overcome the donor shortage in the treatment of advanced type 1 diabetes by islet transplantation, human embryonic stem cells (hESCs) show great potential as an unlimited alternative source of beta cells. hESCs may have immune privileged properties and it is important to determine whether these properties are preserved in hESC-derived cells. METHODS: We comprehensively investigated interactions of both innate and adaptive auto- and allo-immunity with hESC-derived pancreatic progenitor cells and hESC-derived endocrine cells, retrieved after in-vivo differentiation in capsules in the subcutis of mice...
January 2017: Diabetologia
https://www.readbyqxmd.com/read/27729094/identification-of-donor-origin-and-condition-of-transplanted-islets-in-situ-in-the-liver-of-a-type-1-diabetic-recipient
#9
Cornelis R van der Torren, Jessica S Suwandi, DaHae Lee, Ernst-Jan T Van't Wout, Gaby Duinkerken, Godelieve Swings, Arend Mulder, Frans H J Claas, Zhidong Ling, Pieter Gillard, Bart Keymeulen, Peter In't Veld, Bart O Roep
Transplantation of islet allografts into type 1 diabetic recipients usually requires multiple pancreas donors to achieve insulin independence. This adds to the challenges of immunological monitoring of islet transplantation currently relying on surrogate immune markers in peripheral blood. We investigated donor origin and infiltration of islets transplanted in the liver of a T1D patient who died of hemorrhagic stroke 4 months after successful transplantation with two intraportal islet grafts combining six donors...
January 24, 2017: Cell Transplantation
https://www.readbyqxmd.com/read/27358790/islet-autotransplantation-in-a-patient-with-hypercoagulable-disorder
#10
Chirag S Desai, Khalid M Khan, Wanxing Cui
Total pancreatectomy and islet auto transplantation is a good option for chronic pancreatitis patients who suffer from significant pain, poor quality of life, and the potential of type 3C diabetes and pancreatic cancer. Portal vein thrombosis is the most feared complication of the surgery and chances are increased if the patient has a hypercoagulable disorder. We present a challenging case of islet auto transplantation from our institution. A 29-year-old woman with plasminogen activator inhibitor-4G/4G variant and a clinical history of venous thrombosis was successfully managed with a precise peri- and post-operative anticoagulation protocol...
June 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/27345954/autotransplantation-of-pancreatic-islets-a-single-center-first-experience
#11
Paolo Magistri, Sara Andreani, Domenico Lo Conte, Giovanni Carlo Ferrari, Antonello Forgione, Raffaele Pugliese
INTRODUCTION: Islets auto-transplantation (IAT) is a well-known procedure that may improve glycemic control after total or completion pancreatectomy compared to insulin therapy alone. CASE REPORT: We herein report our experience in IAT with the case of a sixty years old woman underwent completion pancreatectomy for recurrent pancreatitis. She received IAT by percutaneous trans-hepatic intra-portal injection. The patient recovered well, except for a surgical wound infection that was treated with vacuum therapy...
2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27341355/clinical-chronic-pancreatitis
#12
Walter G Park
PURPOSE OF REVIEW: To summarize observations in clinical chronic pancreatitis in the past year. RECENT FINDINGS: A predisposing genetic mutation was identified in 67% of cases of pediatric chronic pancreatitis. A novel susceptibility gene involving a hybrid allele is associated with idiopathic chronic pancreatitis. ABO blood type B and FUT2 nonsecretor status is associated with asymptomatic hyperlipasemia and chronic pancreatitis. Alcohol consumption impairs cystic fibrosis transmembrane conductance regulator (CFTR) activity leading to decreased bicarbonate secretion and patients with susceptible CFTR mutations can develop clinical pancreatitis...
June 22, 2016: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/27327404/single-centre-experience-of-extending-indications-for-percutaneous-intraportal-islet-autotransplantation-pipiat-after-pancreatic-surgery-to-prevent-diabetes-feasibility-radiological-aspects-complications-and-clinical-outcome
#13
Massimo Venturini, Claudio Sallemi, Caterina Colantoni, Giulia Agostini, Gianpaolo Balzano, Antonio Esposito, Antonio Secchi, Francesco De Cobelli, Massimo Falconi, Lorenzo Piemonti, Paola Maffi, Alessandro Del Maschio
OBJECTIVE: Islet allotransplantation is a less invasive alternative to surgical pancreas transplantation for Type 1 diabetes, while percutaneous intraportal islet autotransplantation (PIPIAT) is usually performed after pancreatic surgery to prevent diabetes. Our aim was to assess the feasibility, radiological aspects, complications and clinical outcome of PIPIAT following pancreatic surgery for not only chronic pancreatitis but also benign and malignant nodules. METHODS: From 2008 to 2012, 41 patients were enrolled for PIPIAT 12-48 h after pancreatic surgery (extended pancreatic surgery for chronic pancreatitis and benign/malignant neoplasms)...
August 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27053238/sources-of-beta-cells-inside-the-pancreas
#14
REVIEW
Sofie De Groef, Willem Staels, Naomi Van Gassen, Marie Lemper, Yixing Yuchi, Mozhdeh Sojoodi, Leen Bussche, Yves Heremans, Gunter Leuckx, Nico De Leu, Mark Van de Casteele, Luc Baeyens, Harry Heimberg
The generation of beta(-like) cells to compensate for their absolute or relative shortage in type 1 and type 2 diabetes is an obvious therapeutic strategy. Patients first received grafts of donor islet cells over 25 years ago, but this procedure has not become routine in clinical practice because of a donor cell shortage and (auto)immune problems. Transplantation of differentiated embryonic and induced pluripotent stem cells may overcome some but not all the current limitations. Reprogramming exocrine cells towards functional beta(-like) cells would offer an alternative abundant and autologous source of beta(-like) cells...
September 2016: Diabetologia
https://www.readbyqxmd.com/read/26878183/hereditary-pancreatitis
#15
Edgardo D Rivera Rivera, Ankur Chugh, Jonathon Cordova, Sona Young
A 13-year-old boy with a strong family history of hereditary pancreatitis was found to have a PRSS1 mutation after being tested at age 5 years during his first documented incident of pancreatitis. Since then, a multidisciplinary team has been treating him for the diagnosis of hereditary pancreatitis. His pain episodes increased in severity over the past several months such that the pain began to severely interfere with his daily life. After extensive discussion, a total pancreatectomy with auto islet cell transplant was performed...
February 2016: Pediatric Annals
https://www.readbyqxmd.com/read/26164684/fatal-non-thrombotic-pulmonary-embolization-in-a-patient-with-undiagnosed-factitious-disorder
#16
Younghoon Kwon, Ryan J Koene, Caroline Cross, Jennifer McEntee, Jaime S Green
BACKGROUND: Factitious fever is extremely challenging to diagnose in patients with complicated chronic medical problems, and represents as much as 10% of fevers of unknown origin. Factitious fever caused by self-injecting oral medications through indwelling central catheters is a diagnostic challenge. CASE PRESENTATION: We present a 32-year-old Caucasian female with history of short gut syndrome, malnutrition requiring total parental nutrition, and pancreatic auto-islet transplant with fever of unknown origin...
July 12, 2015: BMC Research Notes
https://www.readbyqxmd.com/read/25986058/delayed-gastric-emptying-dge-following-total-pancreatectomy-with-islet-auto-transplantation-in-patients-with-chronic-pancreatitis
#17
George K John, Vikesh K Singh, Pankaj J Pasricha, Amitasha Sinha, Elham Afghani, Daniel Warren, Zhaoli Sun, Niraj Desai, Christi Walsh, Rita R Kalyani, Erica Hall, Kenzo Hirose, Martin A Makary, Ellen M Stein
BACKGROUND: The prevalence and factors associated with delayed gastric emptying (DGE) in patients undergoing total pancreatectomy with islet auto transplantation (TP-IAT) for chronic pancreatitis are unknown. METHODS: A retrospective study of all patients who underwent TP-IAT at Johns Hopkins Hospital (JHH) from August 2011 to November 2014 was performed. The International Study Group of Pancreatic Surgery (ISGPS) clinical grading of DGE was used in this study. KEY RESULTS: A total of 39 patients with chronic pancreatitis underwent TP-IAT during the study period...
July 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/25814187/hepatic-steatosis-after-islet-transplantation-can-ultrasound-predict-the-clinical-outcome-a-longitudinal-study-in-108-patients
#18
Massimo Venturini, Paola Maffi, Giulia Querques, Giulia Agostini, Lorenzo Piemonti, Sandro Sironi, Francesco De Cobelli, Paolo Fiorina, Antonio Secchi, Alessandro Del Maschio
Percutaneous intra-portal islet transplantation (PIPIT) is a less invasive, safer, and repeatable therapeutic option for brittle type 1 diabetes, compared to surgical pancreas transplantation. Hepatic steatosis is a consequence of the islet engraftment but it is curiously present in a limited number of patients and its meaning is controversial. The aims of this study were to assess hepatic steatosis at ultrasound (US) after PIPIT investigating its relationship with graft function and its role in predicting the clinical outcome...
August 2015: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/25640776/total-pancreatectomy-and-islet-cell-autotransplantation-outcomes-controversies-and-new-techniques
#19
Michal Radomski, Amer H Zureikat
Chronic pancreatitis is a challenging disease; the constellation of chronic abdominal pain and metabolic derangements present unique difficulties to the treating physician. Initial treatment revolves around lifestyle modification, pain control, and management of exocrine insufficiency. In refractory cases, total pancreatectomy with islet cell auto transplantation (TP-IAT) is an option for patients with diffuse disease not amenable to subtotal pancreatectomy or a decompressive (drainage) operation. This procedure aspires to alleviate pain and avoid surgically induced brittle diabetes, a morbid complication of total pancreatectomy alone...
January 31, 2015: JOP: Journal of the Pancreas
https://www.readbyqxmd.com/read/25512776/b7-h4-as-a-protective-shield-for-pancreatic-islet-beta-cells
#20
REVIEW
Annika C Sun, Dawei Ou, Dan S Luciani, Garth L Warnock
Auto- and alloreactive T cells are major culprits that damage β-cells in type 1 diabetes (T1D) and islet transplantation. Current immunosuppressive drugs can alleviate immune-mediated attacks on islets. T cell co-stimulation blockade has shown great promise in autoimmunity and transplantation as it solely targets activated T cells, and therefore avoids toxicity of current immunosuppressive drugs. An attractive approach is offered by the newly-identified negative T cell co-signaling molecule B7-H4 which is expressed in normal human islets, and its expression co-localizes with insulin...
December 15, 2014: World Journal of Diabetes
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