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kidney and pancreas transplant

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https://www.readbyqxmd.com/read/28639386/development-of-immune-response-to-tissue-restricted-self-antigens-in-simultaneous-kidney-pancreas-transplant-recipients-with-acute-rejection
#1
Muthukumar Gunasekaran, Neeta Vachharajani, Joseph P Gaut, Thin Thin Maw, Rowena Delos Santos, Surendra Shenoy, William C Chapman, Jason Wellen, Thalachallour Mohanakumar
Simultaneous kidney-pancreas transplantation (SKP Tx) is a treatment for end-stage kidney disease secondary to diabetes mellitus. We investigated the role of immune responses to donor human leukocyte antigens (HLA) and tissue-restricted kidney and pancreas self-antigens (KSAgs and PSAgs, respectively) in SKP Tx recipients (SKP TxRs). Sera collected from 39 SKP TxRs were used to determine de novo Abs specific for KSAgs (collagen-IV, Col-IV; fibronectin, FN) and PSAgs (insulin, islet cells, glutamic acid decarboxylase, and pancreas-associated protein-1) by ELISA...
June 21, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28636074/optimizing-outcomes-in-pancreas-transplantation-impact-of-organ-preservation-time
#2
Ehren N Rudolph, Ty B Dunn, David E R Sutherland, Raja Kandaswamy, Erik B Finger
Recent changes to pancreas graft allocation policy have increased the number of organs available for regional and distant sharing, which results in a corresponding increase in preservation time. We sought to systematically assess the impact of cold ischemia time (CIT) on outcomes posttransplant. A retrospective review of 1,253 pancreas transplants performed at a single transplant center was performed to correlate CIT to transplant outcomes. The rate of technical failure (TF) increased with 20+ hours of CIT, with a 2...
June 21, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28620674/organ-dysfunction-and-failure-following-brain-death-do-not-preclude-successful-donation
#3
Eno-Obong I Essien, Nehu Parimi, Jennifer Gutwald-Miller, Tyree Nutter, Thomas M Scalea, Deborah M Stein
BACKGROUND: Organ dysfunction is common after neurologic determination of death (NDD) but before organ collection. Reliable markers for graft success following transplant of these organs would be useful. We sought to determine the relationship between the donor after neurologic determination of death (DNDD) pathophysiology and successful organ donation. METHODS: Donor information was obtained through the local organ procurement organization. Donor demographics and clinical data points for cardiovascular, renal, respiratory, hepatic, hematological and neuroendocrine systems were reviewed 12 h before and 12 h after neurologic determination of death was declared...
June 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28618165/herpes-simplex-virus-2-transmission-following-solid-organ-transplantation-donor-derived-infection-and-transplantation-from-prior-organ-recipients
#4
Nenad Macesic, Ian J Abbott, Matthew Kaye, Julian Druce, Allan R Glanville, Paul J Gow, Peter D Hughes, Tony M Korman, William R Mulley, Phillip J O'Connell, Helen Opdam, Miranda Paraskeva, Matthew C Pitman, Stella Setyapranata, William D Rawlinson, Paul D R Johnson
BACKGROUND: Owing to limited availability of donor organs, previous solid organ transplant (SOT) recipients are increasingly considered as potential organ donors. We report donor-derived transmission of herpes simplex virus type-2 (HSV-2) to two clusters of SOT recipients with transmission from the original donor and an HSV-2-infected recipient who subsequently became a donor. METHODS: We reviewed medical records of the donors and recipients in both clusters. Pre-transplant serology and virological features of HSV-2 were characterized...
June 15, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28616377/blue-after-splenectomy
#5
Taaran Cariappa Ballachanda Subbaiah, Jeremy P Feldman
INTRODUCTION: We present a 51 year old, African American, female who presented with persistent hypoxemia. She had been taking dapsone for many years for prophylaxis against Pneumocystic Jiroveci with no symptoms but eventually developed methemoglobinemia only after a splenectomy. From our literature review there are no documented cases that have demonstrated this relationship between dapsone, splenic function and methemoglobin and we hope to share our perplexing case and shed light on the interaction...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28602588/long-term-results-of-organ-procurement-from-burn-victims
#6
Daniel Schmauss, Amir K Bigdeli, Susanne Hellmich, Ana P Barreiros, Thomas Kremer, Günter Germann, Ulrich Kneser, Kai O Megerle
BACKGROUND: With the increasing success of organ transplantation, many traditional contraindications to organ procurement are being reconsidered. Burn disease has constituted a traditional contraindication to solid organ procurement because of concerns that such organs may have been compromised by ischemia secondary to burn shock and contaminated by bacteremia. With the current shortage of solid organs, the transplant community continues to look for ways to increase the number of organ donors, including the use of marginal donors...
June 8, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28598888/long-term-diabetes-complications-after-pancreas-transplantation
#7
Trond Jenssen, Anders Hartmann, Kåre I Birkeland
PURPOSE OF REVIEW: The intention of this study is to summarize present knowledge about adverse effects of hyperglycemia in diabetes, and in this context review more recent data concerning the effects of pancreas transplantation on a wide range of diabetic complications. RECENT FINDINGS: Effective blood glucose control by insulin delays progression of microvascular complications and probably improves survival in type 1 diabetes. A successful pancreas transplantation combined with a kidney graft has recently been found to prevent diabetic kidney lesions, and registry data support improved long-term patient survival...
June 8, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28595751/pancreas-transplantation-50-years-of-experience
#8
Daniel Casanova
In December 1966, the first pancreas transplant ever was performed at the University of Minnesota. R. Lillehei and W. Kelly, transplanted a kidney and a pancreas in a diabetic patient on dialysis, getting function of both organs. Since then, the technical and immunological advances in this transplant have resulted in graft and patient survival results as the rest of the abdominal solid organ transplants. The balance of these 50 years is that more than 50,000 diabetic patients have been transplanted in more than 200 centers around the world...
May 2017: Cirugía Española
https://www.readbyqxmd.com/read/28583543/laparoscopy-assisted-spleen-preserving-distal-pancreatectomy-for-living-donor-pancreas-transplantation
#9
S Date, H Noguchi, K Kaku, K Kurihara, Y Miyasaka, Y Okabe, U Nakamura, T Ohtsuka, M Nakamura
BACKGROUND: Living pancreas transplantation plays an important role in the treatment of patients with severe type 1 diabetes. However, pancreatectomy is very invasive for the donor, and less-invasive surgical procedures are needed. Although some reports have described hand-assisted laparoscopic surgery for distal pancreatectomy in living-donor operations, less-invasive laparoscopy-assisted (LA) procedures are expected to increase the donor pool. We herein report the outcomes of four cases of LA spleen-preserving distal pancreatectomy (Warshaw technique [WT]) in living pancreas donors...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28583526/gene-expression-profiling-of-peripheral-blood-from-kidney-transplant-recipients-for-the-early-detection-of-digestive-system-cancer
#10
M Kusaka, M Okamoto, M Takenaka, H Sasaki, N Fukami, K Kataoka, T Ito, T Kenmochi, K Hoshinaga, R Shiroki
BACKGROUND: Kidney transplant recipients are at increased risk of developing cancer in comparison with the general population. To effectively manage post-transplantation malignancies, it is essential to proactively monitor patients. A long-term intensive screening program was associated with a reduced incidence of cancer after transplantation. This study evaluated the usefulness of the gene expression profiling of peripheral blood samples obtained from kidney transplant patients and adopted a screening test for detecting cancer of the digestive system (gastric, colon, pancreas, and biliary tract)...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28573189/outcome-in-pancreas-grafts-after-bk-virus-viremia-in-simultaneous-pancreas-kidney-transplants-a-single-center-case-report
#11
Claudia Bösmüller, Franka Messner, Christian Margreiter, Michael Rudnicki, Robert Öllinger, Dietmar Öfner, Stefan Schneeberger, Manuel Maglione
No abstract text is available yet for this article.
May 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28560019/post-transplantation-nephroptosis-causing-recurrent-episodes-of-acute-renal-failure-and-hypertension-secondary-to-intermittent-vascular-torsion-of-intraperitoneal-renal-allograft
#12
Austin R Dosch, Madeleine Pahl, Uttam Reddy, Clarence E Foster, Hirohito Ichii
Nephroptosis is a rare complication in renal transplantation, but one with significant associated risk. Due to non-specific clinical features, there may be a substantial delay in diagnosis and loss of the transplanted kidney due to renal pedicle thrombosis. We present a case of post-transplantation nephroptosis after simultaneous pancreas and kidney transplant, which resulted in accelerated hypertension and reversible acute kidney injury >1 year after transplantation. Prompt detection of this rare entity leading to expeditious surgical intervention is necessary to preserve viability of the renal allograft...
May 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28540837/enterovesical-fistula-after-enteric-conversion-of-a-bladder-drained-pancreatic-allograft-a-case-report
#13
Clifford Akateh, Amer Rajab, Mitchell Henry, Ashraf El-Hinnawi
Since the inception of pancreas transplant as a treatment for type 1 diabetes mellitus, there has been considerable debate about the best way to manage exocrine secretions and monitor patients for graft rejection. For patients who undergo bladder exocrine drainage of a pancreatic allograft, a bladder-to-enteric drainage conversion can serve as a rescue procedure in case of anastomotic leaks or other complications. However, this procedure is associated with its own complications, including a rarely described enterovesical fistula...
May 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28538243/bk-virus-as-a-mediator-of-graft-dysfunction-following-kidney-transplantation
#14
Stephanie G Yi, Richard J Knight, Keri E Lunsford
PURPOSE OF REVIEW: BK virus is a significant risk factor for kidney allograft dysfunction and loss among renal transplant recipients. Currently, there is no proven effective treatment except for the reduction of immunosuppression. In this review, we discuss diagnostic challenges and current treatment options for BK in kidney transplant recipients. RECENT FINDINGS: Antiviral and antibiotic therapies have been employed for BK viraemia with variable efficacy. In addition, novel therapeutic regimens such as adoptive transfer of targeted T cells have been described as possible treatment options for recipients with BK nephropathy...
May 22, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28538038/live-donor-kidney-pak-versus-spk-how-to-decide
#15
Erik Stites, Alexander C Wiseman
PURPOSE OF REVIEW: Patients with type 1 diabetes and end stage renal disease face a complex choice when considering the relative risks and benefits of kidney transplant alone with or without subsequent pancreas after kidney transplant (PAK) or simultaneous kidney pancreas transplant (SPK). RECENT FINDINGS: SPK is considered the optimal treatment regarding long-term patient survival, but when also faced with the option of living donor kidney transplant with the potential for PAK later, the ideal option is less clear...
May 19, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28509373/bk-viremia-surveillance-and-outcomes-in-simultaneous-pancreas-kidney-transplant-recipients
#16
Scott G Westphal, Elizabeth R Lyden, Eric D Langewisch, Clifford D Miles
BACKGROUND: While screening for asymptomatic BK viremia (BKV) has been well studied in isolated kidney transplant recipients, there is a paucity of published outcomes in simultaneous pancreas-kidney (SPK) transplant recipients who underwent BKV screening followed by pre-emptive reduction of immunosuppression. METHODS: This is a single-center, retrospective review of 31 consecutive SPK recipients who were transplanted over a five year period following the initiation of a serum BKV screening protocol...
May 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28500781/pregnancy-outcomes-in-simultaneous-pancreas-and-kidney-transplant-recipients-a-national-french-survey-study
#17
Gabrielle Normand, Flora Brunner, Lionel Badet, Fanny Buron, Marielle Catton, Jérôme Massardier, Laure Esposito, Philippe Grimbert, Georges Mourad, Jean E Serre, Sophie Caillard, Georges Karam, Diego Cantarovich, Emmanuel Morelon, Olivier Thaunat
Simultaneous pancreas and kidney transplantation (SPK) is currently the best therapeutic option for patients with type 1 diabetes and terminal renal failure. Renal transplantation restores fertility enabling women to pursue pregnancies. However, scarcity of available data on pregnancy outcomes in SPK impedes fair medical counseling. Medical files of all pregnancies that lasted ≥3 months among recipients of functional SPK performed between 1990 and 2015 in France were retrospectively analyzed. Twenty-six pregnancies in 22 SPK recipients were identified...
May 13, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28489277/pancreas-after-islet-transplantation-in-nonuremic-type-1-diabetes-a-strategy-for-restoring-durable-insulin-independence
#18
S A Wisel, J M Gardner, G R Roll, J Harbell, C E Freise, S Feng, S M Kang, R Hirose, D B Kaufman, A M Posselt, P G Stock
Islet transplantation offers a minimally invasive approach for β cell replacement in diabetic patients with hypoglycemic unawareness. Attempts at insulin independence may require multiple islet reinfusions from distinct donors, increasing the risk of allogeneic sensitization. Currently, solid organ pancreas transplant is the only remaining surgical option following failed islet transplantation in the United States; however, the immunologic impact of repeated exposure to donor antigens on subsequent pancreas transplantation is unclear...
May 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28480091/duodenal-graft-perforation-after-simultaneous-pancreas-kidney-transplantation
#19
Akihito Sannomiya, Ichiro Nakajima, Yuichi Ogawa, Kotaro Kai, Ichiro Koyama, Shohei Fuchinoue
A 45-year-old woman with type 1 diabetes and chronic renal failure on dialysis underwent simultaneous pancreas-kidney transplantation from a brain dead donor. On postoperative day 15, acute generalized peritonitis was diagnosed and emergency laparotomy was performed. Perforation of the donor duodenum was found, which had apparently resulted from duodenal compression by the tip of the intestinal fistula tube placed for decompression. The perforation was sutured and the intestinal fistula tube was exchanged. Following this, perforation repeatedly recurred at the same site and open repair at laparotomy was required a total of four times...
2017: Case Reports in Transplantation
https://www.readbyqxmd.com/read/28466634/update-on-pancreatic-transplantation-on-the-management-of-diabetes
#20
Carlo Lombardo, Vittorio G Perrone, Gabriella Amorese, Fabio Vistoli, Walter Baronti, Piero Marchetti, Ugo Boggi
Pancreas transplantation is the only therapy that can restore insulin independence in beta-cell penic diabetic recipients. Because of the need for life-long immunosuppression and the intial surgical risk associated with the transplant procedure, Pancreas transplantation is a therapeutic option only in selected diabetic patients. Based on renal function, three main populations of diabetic recipients of a pancreas transplant can be identified: uremic patients, post-uremic patients (following successful kidney transplantation), and non-uremic patients...
May 2, 2017: Minerva Medica
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