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https://www.readbyqxmd.com/read/29929812/-fulminant-hepatic-failure-after-simultaneous-kidney-pancreas-transplantation-a-case-report
#1
Jimmy L Moss, Benjamin W Brown, Sher-Lu Pai, Klaus D Torp, Stephen Aniskevich
We describe an unusual case of hyperacute hepatic failure following general anesthesia in a patient receiving a simultaneous kidney-pancreas transplant. Despite an aggressive evaluation of structural, immunological, viral, and toxicological causes, a definitive cause could not be elucidated. The patient required a liver transplant and suffered a protracted hospital course. We discuss the potential causes of fulminant hepatic failure and the perioperative anesthesia management of her subsequent liver transplantation...
June 18, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29929552/anterior-hypopituitarism-in-a-patient-with-amyloidosis-secondary-to-crohn-s-disease-a-case-report
#2
Natacha Verbeke, Nathalie Pirson, Arnaud Devresse, Raluca Furnica, Thierry Duprez, Dominique Maiter
BACKGROUND: Amyloid infiltration of endocrine glands has been reported, mostly in the thyroid, pancreas, adrenals, and testes, but affected patients do not frequently exhibit overt endocrine insufficiency. Here we report the case of a patient with complete anterior hypopituitarism probably due to a known systemic amyloidosis. CASE PRESENTATION: Our male Caucasian patient was diagnosed with Crohn's disease at the age of 22 years. At the age of 37, he developed secondary renal amyloidosis, which resulted in end-stage renal failure...
June 22, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29916848/pancreas-transplantation-in-type-2-diabetes-expanding-the-criteria
#3
Talal M Al-Qaoud, Jon S Odorico, Robert R Redfield
PURPOSE OF REVIEW: Pancreas transplantation in type 2 diabetes mellitus (T2DM) candidates remains disproportionately lower than in type 1 diabetes mellitus (T1DM); however, outcomes in carefully selected patients mirrors that of T1DM. Despite the 2014 United Network for Organ Sharing (UNOS) eligibility criteria for simultaneous pancreas/kidney transplant (SPK) transplantation in T2DM patients, an expected increase in the number of transplants was not observed. RECENT FINDINGS: In an updated International Pancreas and Transplant Registry (IPTR) analysis, 1514 primary deceased donor pancreas transplants were performed in T2DM recipients [1995-2015, SPK 88%, pancreas after kidney (PAK) 9%, pancreas transplant alone (PTA) 3%]...
June 18, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29893956/pancreas-outcomes-between-living-and-deceased-kidney-donor-in-pancreas-after-kidney-transplantation-patients
#4
Pedro Ventura-Aguiar, Joana Ferrer, Ignacio Revuelta, David Paredes, Erika de Sousa-Amorim, Jordi Rovira, Enric Esmatjes, Juan Carlos Garcia-Valdecasas, Josep M Campistol, Federico Oppenheimer, Fritz Diekmann, Maria José Ricart
Background: Pancreas outcomes in pancreas after kidney transplantation (PAK) patients have been reported as being inferior to those of patients who receive simultaneous pancreas and kidney transplantation (SPK). The influence of the kidney donor (i.e. living versus deceased) has never been previously addressed. Methods: We retrospectively analysed all pancreas transplants performed in a single centre since 2007 and compared the outcomes between those patients who had previously received a living-donor kidney transplant (pancreas transplantation after living-donor kidney transplantation, PAldK; n = 18) or a deceased-donor kidney transplant (pancreas transplantation after deceased-donor kidney transplantation, PAddK; n = 28), using SPK (n = 139) recipients as a reference...
June 8, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29880375/preoperative-muscle-volume-predicts-graft-survival-after-pancreas-transplantation-a-retrospective-observational-cohort-study
#5
H Noguchi, Y Miyasaka, K Kaku, K Kurihara, U Nakamura, Y Okabe, T Ohtsuka, K Ishigami, M Nakamura
BACKGROUND: Several studies have suggested that decreased muscle volume is associated with attenuation of immune function. The recipient's immune system is responsible for rejection of transplanted organs, which is a major cause of graft loss after transplantation. We aimed to determine whether muscle volume is correlated with graft survival after pancreas transplantation (PT). METHODS: Forty-three patients underwent PT for type 1 diabetes mellitus at our institution from August 2001 to May 2016...
June 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29880374/pancreas-transplantation-at-a-single-latin-american-center-overall-results-with-type-1-and-type-2-diabetes-mellitus
#6
G E Gondolesi, N F Aguirre, D A Ramisch, F A Mos, N F Pedraza, M R Fortunato, L M Gutiérrez, H Fraguas, R Marrugat, G E Rabin, C Musso, P A Farinelli, P H L Barros Schelotto, P M Raffaele
BACKGROUND: Simultaneous pancreas-kidney transplantation (SPK) has become the treatment of choice for type 1 diabetes mellitus (T1DM) patients with chronic renal failure. Type 2 diabetes mellitus (T2DM), was once considered to be a contraindication for pancreas transplantation; however, it has been accepted as a new indication, under strict criteria. Although favorable results have increase the indication for T2DM in developed countries, there have been no reports of long-term results for this indication from Latin American centers...
June 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29880371/long-term-effects-of-pregnancy-on-renal-graft-function-in-women-after-kidney-transplantation-compared-with-matched-controls
#7
S Svetitsky, R Baruch, I F Schwartz, D Schwartz, R Nakache, Y Goykhman, P Katz, A Grupper
BACKGROUND: An important benefit associated with kidney transplantation in women of child-bearing age is increased fertility. We retrospectively evaluated the maternal and fetal complications and evolution of graft function associated with 22 pregnancies post-kidney and kidney-pancreas transplantation, compared with controls without pregnancy post-transplantation, who were matched for gender, year of transplantation, type of donor, age at transplantation, number of transplants, type of transplant (kidney vs kidney-pancreas), and cause of native kidney failure, as well as for renal parameters including serum creatinine and urine protein excretion 1 year before delivery...
June 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29878910/defining-kidney-allograft-benefit-from-successful-pancreas-transplant-separating-fact-from-fiction
#8
Alexander C Wiseman, Erik Stites, Peter Kennealey
PURPOSE OF REVIEW: To define the natural history of kidney allograft loss related to recurrent diabetes following transplant, and to understand the potential benefit of pancreas transplantation upon kidney allograft survival. RECENT FINDINGS: A postulated benefit of simultaneous pancreas kidney transplant is that, unlike kidney transplant alone, euglycemia from the added pancreas allograft may confer a nephroprotective benefit and prevent recurrent diabetic nephropathy in the renal allograft...
June 6, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29873170/solving-the-mystery-hyalinized-cyst-wall-containing-organism-like-structures-in-a-lung-transplant-donor
#9
Julia Bini Viotti, Matthias Loebe, Nicolas Brozzi, Andre Pinto, Jacques Simkins, Christina M Cloke, Jose F Camargo, Sam Salama, Lilian M Abbo
A 59-year-old man with non-ischemic cardiomyopathy underwent orthotopic heart transplantation. The donor, a 31-year-old male declared brain dead after a gunshot wound to the head, was considered high risk due to history of incarceration, illicit drug use and sex with a HIV positive partner. At organ procurement, the heart, kidneys, pancreas and liver looked grossly normal. A small right lower lobe nodule was noticed, and lung biopsy was performed. Bronchoscopy showed purulent secretions in the right lower lobe...
June 5, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29872765/expansion-of-transplanted-islets-in-mice-by-co-transplantation-with-adipose-tissue-derived-mesenchymal-stem-cells
#10
Tomoko Tanaka, Daibo Kojima, Toshiyuki Mera, Masahito Matsumoto, Yohichi Yasunami, Toshihiko Yanase
The shortage of donor islets is a significant obstacle for widespread clinical application of pancreatic islet transplantation. To investigate whether adipose tissue-derived mesenchymal stem cells (ADSCs) induce expansion of transplanted islets, we performed co-transplantation experiments in a mouse model. Streptozotosin (STZ)-induced diabetic mice transplanted with 50 syngeneic islets remained hyperglycemic. However, hyperglycemia was ameliorated gradually when 50 islets were co-transplanted with ADSCs but not separately grafted into the contralateral kidney...
May 2018: Heliyon
https://www.readbyqxmd.com/read/29809315/clinical-characteristics-and-outcomes-of-late-onset-bk-virus-nephropathy-in-kidney-and-kidney-pancreas-transplant-recipients
#11
Hannah Imlay, Kathryn Whitaker, Cynthia E Fisher, Ajit P Limaye
BACKGROUND: BK virus nephropathy (BKPyVAN) is a major complication in kidney transplant recipients (KTR) and typically occurs within 1 year of transplant. Guidelines vary in recommendations for BKPyV screening beyond 1 year. A systematic characterization of risk factors and outcomes of late-onset (>1 year) BKPyVAN has not previously been reported. METHODS: We retrospectively compared characteristics and outcomes of early- (<1 year) and late-onset BKPyVAN (definitive [biopsy-confirmed] or presumptive [plasma BKPyV >10,000 copies/mL]) in a cohort of 671 KTR and simultaneous kidney-pancreas transplant (SPK) recipients between 2008 and 2013 at a single US transplant center...
May 29, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29798972/usefulness-of-pancreas-donor-risk-index-and-pre-procurement-pancreas-allocation-suitability-score-results-of-the-polish-national-study
#12
Kaja Śmigielska, Paweł Skrzypek, Jarosław Czerwiński, Grzegorz Michalak, Marek Durlik, Tadeusz Grochowiecki, Sławomir Nazarewski, Jacek Szmidt, Jacek Ziaja, Robert Król, Lech Cierpka, Wojciech Lisik, Maciej Kosieradzki
BACKGROUND Pre-procurement pancreas suitability score (P-PASS) and pancreas donor risk (PDRI) index are scoring systems believed to predict suitability of pancreatic grafts. Most European countries and the United States apply PDRI, while Poltransplant keeps using P-PASS: more than 16 points raises a red flag for graft use. Recent data discourage use of PDRI to predict pancreas graft survival. The aim of the present study was to assess PDRI and P-PASS as predictors of transplanted pancreas survival in a Polish population...
May 25, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29791046/impact-of-intensive-dosing-of-mycophenolate-on-pancreas-allograft-survival
#13
Jillian L Descourouez, Margaret Jorgenson, Nathan Menninga, Glen Leverson, Jon Odorico, Robert Redfield
PURPOSE: Evaluate the effect of mycophenolate (mycophenolic acid, MPA) dose on pancreas allograft survival following simultaneous pancreas kidney (SPK) transplant. METHODS: This was an observational study of adult SPK recipients transplanted between 1/1/2002-6/30/2015. Recipients were divided into cohorts based on MPA dose at discharge; high dose (HD) 1000mg three times daily mycophenolate mofetil (MMF) and standard dose (SD) 1000mg twice daily MMF. Primary outcome was pancreas allograft survival...
May 23, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29787417/human-leukocyte-antigen-mismatch-and-precision-medicine-in-transplantation
#14
Chris Wiebe, Peter Nickerson
PURPOSE OF REVIEW: Pretransplant and posttransplant alloimmune risk assessment needs to evolve towards a precision medicine model already used in other areas of medicine. Although this has not been possible with traditional risk factors available at the time of transplant, new methods of human leukocyte antigen (HLA) molecular mismatch have generated hope that alloimmune risk assessment may be precise enough for personalized treatment strategies. RECENT FINDINGS: This review describes the various HLA molecular mismatch methods and some of the recent publications for each method...
May 18, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29782007/intraportal-transplantation-of-pancreatic-islets-in-mouse-model
#15
Rahul Khatri, Birte Hussmann, Divya Rawat, Ali Osman Gürol, Thomas Linn
Pancreatic islet transplantation to reduce hyperglycemia is highly successful in rodents with chemically-induced diabetes. The most common transplantation site in experimental islet transplantation is the kidney capsule. However, as less is known about the interaction of pancreatic islets with blood constituents, it also makes sense to utilize the portal vein approach in experimental islet transplantation. This protocol demonstrates an intraportal islet transplantation technique in NMRI nude mice. Streptozotocin (180 mg/kg) is injected intraperitoneally to induce hyperglycemia in recipient mice...
May 5, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29781952/optimizing-temperature-and-oxygen-supports-long-term-culture-of-human-islets
#16
Hirotake Komatsu, Jeffrey Rawson, Leonard Medrano, Colin A Cook, Alyssa Barriga, Nelson Gonzalez, Mayra Salgado, Keiko Omori, Fouad Kandeel, Yu-Chong Tai, Yoko Mullen
BACKGROUND: Islet transplantation is a promising treatment for type-1 diabetes; however, donor shortage is a concern. Even when a pancreas is available, low islet yield limits the success of transplantation. Islet culture enables pooling of multiple low-yield isolations into an effective islet mass, but isolated islets rapidly deteriorate under conventional culture conditions. Oxygen depletion in the islet core, which leads to central necrosis and volume loss, is one of the major reasons for this deterioration...
May 16, 2018: Transplantation
https://www.readbyqxmd.com/read/29781845/redefining-the-influence-of-ethnicity-on-simultaneous-kidney-and-pancreas-transplantation-outcomes-a-15-year-single-center-experience
#17
Carlton J Young, Paul A MacLennan, Elinor C Mannon, Rhiannon D Reed, Brittany A Shelton, Michael J Hanaway, Gaurav Agarwal, Robert S Gaston, Bruce A Julian, Clifton E Kew, Vineeta Kumar, Roslyn B Mannon, Shikha Mehta, Song C Ong, Graham C Towns, Mark H Deierhoi, Jayme E Locke
OBJECTIVE: To examine the largest single-center experience of simultaneous kidney/pancreas transplantation (SPK) transplantation among African-Americans (AAs). BACKGROUND: Current dogma suggests that AAs have worse survival following SPK than white recipients. We hypothesize that this national trend may not be ubiquitous. METHODS: From August 30, 1999, through October 1, 2014, 188 SPK transplants were performed at the University of Alabama at Birmingham (UAB) and 5523 were performed at other US centers...
May 17, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29776756/sex-hormone-binding-globulin-is-a-biomarker-associated-with-nonvertebral-fracture-in-men-on-dialysis-therapy
#18
Jasna Aleksova, Phillip Wong, Robert McLachlan, Kay Weng Choy, Peter R Ebeling, Frances Milat, Grahame J Elder
Gonadal hormones impact bone health and higher values of sex hormone-binding globulin (SHBG) have been independently associated with fracture risk in men without chronic kidney disease. People with chronic kidney disease have a greatly increased fracture risk, and gonadal dysfunction is common in men receiving dialysis treatment. Nevertheless, in these men the effect of gonadal steroids and SHBG on bone mineral density (BMD) and fracture risk is unknown. Here we investigate relationships between gonadal steroids, SHBG, BMD and fracture in men on long-term dialysis therapy, awaiting kidney or simultaneous pancreas kidney transplantation...
May 15, 2018: Kidney International
https://www.readbyqxmd.com/read/29741276/pancreatic-panniculitis-a-case-series-from-a-tertiary-university-hospital-in-spain
#19
Clara Fernández-Sartorio, Andrea Combalia, Joan Ferrando, Mercè Alsina, Pilar Iranzo, Teresa Estrach, Eugenia Hernández-Ruiz, José M Mascaró
Pancreatic panniculitis is a rare type that only occurs in 2-3% of all patients with pancreatic diseases. It is usually described in association with benign pancreatic disease and less commonly in association with pancreatic carcinoma. We describe a case of pancreatic panniculitis as the first manifestation of underlying ampullary adenocarcinoma and a new case of pancreatitis, panniculitis and polyarthritis (PPP-Syndrome). Pancreatic panniculitis may be the cutaneous manifestation of pancreatic allograft rejection after simultaneous pancreas-kidney transplantation...
May 9, 2018: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/29735033/pancreas-transplantation-for-patients-with-type-1-and-type-2-diabetes-mellitus-in-the-united-states-a-registry-report
#20
REVIEW
Angelika C Gruessner, Rainer W G Gruessner
Successful pancreas transplantation is still the only method to restore short-term and long-term insulin independence and good metabolic control for patients with diabetes. Since the first transplant in 1966, tremendous progress in outcome was made; however, transplant numbers have declined since 2004. This article describes the development and risk factors of pancreas transplantation with or without a kidney graft between 2001 and 2016. Patient survival and graft function improved significantly owing to careful recipient and donor selection, which reduced technical failure and immunologic graft loss rates...
June 2018: Gastroenterology Clinics of North America
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