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https://www.readbyqxmd.com/read/28215709/superior-mesenteric-artery-pseudoaneurysm-fistulised-to-the-small-intestine-in-a-pancreas-kidney-transplant-recipient-can-it-be-detected-by-capsule-endoscopy
#1
Hugo I Uchima, Isis K Araujo, Joana Ferrer, Marta Burrell, Alejandro Sotomayor, Ángeles García-Criado, Faust Feu, M J Ricart, Josep Llach, Begoña González-Suárez
No abstract text is available yet for this article.
February 16, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28201960/hypoglycemia-and-glucocorticoid-free-immunosuppression-are-related-with-low-dehydroepiandrosterone-sulfate-level
#2
Martina Zahradnicka, Frantisek Saudek, Kvetoslav Lipar, Jelena Skibova
BACKGROUND: Low dehydroepiandrosterone sulfate (DHEAS) levels and a high cortisol/DHEAS ratio are associated with higher mortality in elderly, dialyzed, and immunocompromised patients. The role of these hormones in patients with hypoglycemia unawareness (hypo) or in pancreas or islet recipients treated by glucocorticoid-free immunosuppressive regimen (IS) has not been studied. OBJECTIVE: The aim of this study was to determine the effects of IS and of recurrent hypoglycemia on DHEAS and adrenocorticotropic hormone (ACTH) levels in patients with type-1 diabetes (T1DM)...
February 13, 2017: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/28188676/hemoglobin-based-oxygen-carrier-rescues-double-transplant-patient-from-life-threatening-anemia
#3
M F Gomez, O Aljure, G Ciancio, M Lynn
This is a case of a 46-year-old male, Jehovah's Witness kidney-pancreas transplant recipient found to have early in the postoperative period, splenic vein thrombosis requiring heparin infusion. Two days later, he developed severe symptomatic anemia (Hb < 6 g/dL). Standard medical therapy for bloodless surgical patients with severe anemia was instituted. Nevertheless, the patient's hemoglobin concentration continued to decline to critical levels (2 g/dL). Transfusion of allogeneic blood products was not an option, prompting use of a hemoglobin-based oxygen carrier (HBOC)...
February 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28178127/robotic-pancreas-transplantation-in-a-type-1-diabetic-patient-with-morbid-obesity-a-case-report
#4
Chun Chieh Yeh, Mario Spaggiari, Ivo Tzvetanov, José Oberholzer
RATIONALE: Obesity is considered a relative contraindication to pancreas transplantation due to increased risks of wound-related complications. Robotic surgeries have never been applied for pancreas transplantation in obese recipients though robotic kidney transplantation did and already proved its value in reducing wound-related complications in obese recipients. PATIENT CONCERNS & DIAGNOSES: We performed the first robotic pancreas after kidney transplantation for a 34-year-old Hispanic type 1 diabetic male with class III obesity (BMI = 41 kg/m)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28176480/de-novo-thrombotic-microangiopathy-following-simultaneous-pancreas-and-kidney-transplantation-managed-with-eculizumab
#5
REVIEW
Lani Shochet, John Kanellis, Ian Simpson, Joseph Ta, William Mulley
Thrombotic microangiopathy (TMA) is a well-recognised complication following transplantation, often due to an underlying genetic predisposition, medications or rejection. The use of eculizumab in these settings has been previously described, but its role still remains to be clarified. A 45-year-old man, with a history of type 1 diabetes mellitus and subsequent end-stage kidney failure, presented for a simultaneous pancreas-kidney transplant. Immunologically, he was well matched with the donor, and he received standard induction immunosuppression including tacrolimus...
February 2017: Nephrology
https://www.readbyqxmd.com/read/28148909/en-bloc-transplant-of-the-liver-kidney-and-pancreas-experience-from-a-latin-american-transplant-center
#6
Luis A Caicedo, Jorge I Villegas, Oscar Serrano, Mauricio Millán, Mauricio Sepúlveda, Diego Jiménez, Jairo García, Juan G Posada, Liliana Mesa, Carlos Duran, Johanna Schweineberg, Diana Dávalos, Eliana Manzi, Angie Sabogal, Ana María Aristizabal, Gabriel J Echeverri
BACKGROUND En-bloc transplantation is a surgical procedure in which multiple organs are transplanted simultaneously. It has some similarities with multi-organ transplantation but offers certain advantages. This report highlights the experience of our interdisciplinary group regarding the treatment and follow-up of patients who received en-bloc transplantation, with the aim of encouraging the development of this surgical technique. CASE REPORT The first case is a 38-year-old patient with type 1 diabetes mellitus, liver cirrhosis, and chronic kidney failure who received an en-bloc transplant of the liver, pancreas, and kidney with no intraoperative complications...
February 2, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28141909/improving-the-outcomes-of-organs-obtained-from-controlled-donation-after-circulatory-death-donors-using-abdominal-normothermic-regional-perfusion
#7
Eduardo Miñambres, Borja Suberviola, Beatriz Dominguez-Gil, Emilio Rodrigo, Juan Carlos Ruiz-San Millan, Juan Carlos Rodríguez-San Juan, Maria Angeles Ballesteros
Donation after circulatory death (DCD) has experienced a significant expansion over the last decade. However, warm ischemia results in a greater risk for transplantation. Indeed, controlled DCD (cDCD) was associated with inferior outcomes compared to donation after brain death. The use of abdominal normothermic regional perfusion (nRP) to restore blood flow prior to organ recovery in cDCD has been proposed as a better alternative than rapid recovery to reverse the effect of ischemia and improve recipients' outcome...
January 31, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28135283/the-spleen-is-an-ideal-site-for-inducing-transplanted-islet-graft-expansion-in-mice
#8
Takeshi Itoh, Hitomi Nishinakamura, Kenjiro Kumano, Hiroyuki Takahashi, Shohta Kodama
Alternative islet transplantation sites have the potential to reduce the marginal number of islets required to ameliorate hyperglycemia in recipients with diabetes. Previously, we reported that T cell leukemia homeobox 1 (Tlx1)+ stem cells in the spleen effectively regenerated into insulin-producing cells in the pancreas of non-obese diabetic mice with end-stage disease. Thus, we investigated the spleen as a potential alternative islet transplantation site. Streptozotocin-induced diabetic C57BL/6 mice received syngeneic islets into the portal vein (PV), beneath the kidney capsule (KC), or into the spleen (SP)...
2017: PloS One
https://www.readbyqxmd.com/read/28120462/research-priority-setting-in-organ-transplantation-a-systematic-review
#9
Allison Tong, Benedicte Sautenet, Jeremy R Chapman, Claudia Harper, Peter MacDonald, Nicholas Shackel, Sally Crowe, Camilla Hanson, Sophie Hill, Anneliese Synnot, Jonathan C Craig
BACKGROUND: Barriers to access and long-term complications remain a challenge in transplantation. Further advancements may be achieved through research priority setting with patient engagement to strengthen its relevance. We evaluated research priority setting in solid organ transplantation and described stakeholder priorities. METHODS: Databases were searched to October 2016. We synthesized the findings descriptively. RESULTS: The 28 studies (n=2071 participants) addressed kidney (9 [32%]), heart (7 [25%]), liver (3 [11%]), lung (1 [4%]), pancreas (1 [4%]), and non-specified organ transplantation (7 [25%]) using consensus conferences, expert panel meetings, workshops, surveys, focus groups, interviews, and the Delphi technique...
January 25, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28110269/genetic-predictors-of-long-term-graft-function-in-kidney-and-pancreas-transplant-patients
#10
Claire E Duff, Matthew J Simmonds
Kidney and pancreas transplantation have helped transform the lives of people with end-stage renal failure and individuals with type 1 diabetes who have poor glycaemic control/severe secondary complications, respectively. Despite an improvement in immunosuppressive regimes, operative techniques and decreased initial rejection rates, there has been little improvement in long-term graft survival rates over the past decade. Whilst limited progress has been made in establishing clinical markers of graft function, several genetic markers of long-term graft function have been identified...
January 20, 2017: Briefings in Functional Genomics
https://www.readbyqxmd.com/read/28109015/a-single-centre-experience-of-roux-en-y-enteric-drainage-for-pancreas-transplantation
#11
Irum Amin, Andrew J Butler, Gail Defries, Neil K Russell, Simon J F Harper, Asif Jah, Kourosh Saeb-Parsy, Gavin J Pettigrew, Christopher J E Watson
Exocrine drainage following pancreas transplantation can be achieved by drainage into the bladder or bowel, the latter typically by direct duodeno-jejunostomy; the use of Roux-en-Y enteric drainage is uncommon. We report a retrospective analysis of a single centre experience of Roux-en-Y enteric drainage following pancreas transplantation. Over a 14-year period (2001- 2015), 204 consecutive adult pancreas transplants were performed (96.6% simultaneous pancreas and kidney transplants), of which 26.0% were from donors after circulatory death (DCD)...
January 21, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28099402/transplant-center-volume-and-the-risk-of-pancreas-allograft-failure
#12
Tarek Alhamad, Andrew F Malone, Daniel C Brennan, Robert J Stratta, Su-Hsin Chang, Jason R Wellen, Timothy A Horwedel, Krista L Lentine
BACKGROUND: Successful pancreas transplantation requires surgical expertise and multidisciplinary medical management. The impact of transplant center volume on pancreas allograft survival remains unclear. METHODS: We examined Organ Procurement and Transplantation Network (OPTN) data on 11,568 simultaneous pancreas-kidney (SPK) and 4308 solitary pancreas (pancreas transplant alone and pancreas after kidney) transplants between 2000 and 2013. RESULTS: Average annual transplant center volume was categorized by tertiles into low, medium and high volume, respectively, as follows: 1-6 (n=3,861), 7-13 (n=3,891), and 14-34 (n=3,888) for SPK, and 1-3 (n=1,417), 4-10 (n=1,518), and 11-33 (n=1,377) for solitary pancreas transplants...
January 17, 2017: Transplantation
https://www.readbyqxmd.com/read/28052606/optn-srtr-2015-annual-data-report-pancreas
#13
R Kandaswamy, P G Stock, S K Gustafson, M A Skeans, M A Curry, M A Prentice, A K Israni, J J Snyder, B L Kasiske
The number of pancreas transplants performed in the United States stabilized over the last 3 years after nearly a decade of steady decline. Numbers of new additions to the list also stabilized during the same period. Notably, the persistent decline in pancreas after kidney transplants also seems to have abated, at least for now. The first full year of data after implementation of the new pancreas allocation system revealed no change in the distribution of organs between simultaneous pancreas-kidney (SPK) transplant and pancreas transplant alone...
January 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/27994337/management-of-graft-duodenal-leak-in-simultaneous-pancreas-kidney-transplant-a-case-report-from-india-and-review-of-literature
#14
REVIEW
Sunil Kumar, Sarbpreet Singh, Deepesh Benjamin Kenwar, Manish Rathi, Sanjay Bhadada, Ashish Sharma, Vikas Gupta, Anil Bhansali, Anupam Lal, Mukut Minz
Pancreatic transplantation is currently the only effective cure for Type 1 diabetes mellitus. It allows long-term glycemic control without exogenous insulin and amelioration of secondary diabetic complications. In India, pancreas transplant has not yet established with only a single successful transplant reported so far in the literature. We report a 24-year-old Type 1 diabetic patient with renal failure who underwent a simultaneous pancreas kidney transplant. On postoperative day 15, he had leak from the graft duodenal stump for which a tube duodenostomy and proximal diversion enterostomy was done...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27984519/the-importance-and-utility-of-hemoglobin-a1c-levels-in-the-assessment-of-donor-pancreas-allografts
#15
Emre Arpali, Joseph R Scalea, Robert R Redfield, Lynn Berg, Dixon Kaufman, Hans W Sollinger, Bridget Welch, Glen Leverson, Jon S Odorico
BACKGROUND: Hemoglobin A1C (HbA1c) levels are often obtained in potential pancreas graft donors to assess the overall long-term functional glycemic control or the possibility of unrecognized diabetes. Although routinely measured, the impact of donor HbA1c levels on pancreas graft outcomes has not been reported. Here, we researched the relationship between donor HbA1c levels and postoperative pancreas graft survival. METHODS: Data from 266 pancreas transplant patients including 182 simultaneous kidney-pancreas and 84 pancreas alone transplants were reviewed for the study...
December 14, 2016: Transplantation
https://www.readbyqxmd.com/read/27983753/effectiveness-and-safety-of-tigecycline-compared-with-other-broad-spectrum-antimicrobials-in-abdominal-solid-organ-transplant-recipients-with-polymicrobial-intraabdominal-infections
#16
Tyler Liebenstein, Lucas T Schulz, Chris Viesselmann, Emma Bingen, Jackson Musuuza, Nasia Safdar, Warren E Rose
STUDY OBJECTIVE: Because patients with abdominal solid organ transplants (SOTs) are at increased risk of polymicrobial intraabdominal infections (IAIs) following transplantation, the objective of this study was to compare the effectiveness and adverse event profile of tigecycline with those of other broad-spectrum therapies for polymicrobial IAIs in this population. DESIGN: Retrospective cohort study. SETTING: Large academic medical center with multiple outpatient clinics...
December 16, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27932184/intrapancreatic-splenule-in-a-pancreas-allograft-case-report
#17
K Yadav, O K Serrano, R Kandaswamy
A 16-year-old white man was involved in a motor vehicle collision and suffered head, chest, and abdominal trauma. Despite initial resuscitative efforts, he progressed to brain death and was designated to be an organ donor by his family. He had no earlier medical or surgical history and no high-risk behaviors. Blood work revealed normal creatinine, liver function tests, lipase, and amylase. Viral serologies were negative except for cytomegalovirus IgG and Epstein-Barr virus nucleic acid. Imaging revealed a right kidney contusion, a manubrial fracture, and fractures of right first rib and bilateral scapulae...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932141/validation-of-the-pancreatic-donor-risk-index-in-simultaneous-pancreas-kidney-transplantation-performed-in-c%C3%A3-rdoba-hospital-from-2000-to-2015
#18
J J Salamanca-Bustos, J P Campos-Hernandez, J M Sánchez-Hidalgo, A Arjona-Sánchez, A Sánchez-González, A J Arenas-Bonilla, J Ruiz-Rabelo, J Carrasco-Valiente, J Ruiz-García, J C Regueiro-López, J Briceño-Delgado, M J Requena-Tapia
BACKGROUND: The Pancreatic Donor Risk Index (PDRI) was developed in 2010 in the United States to predict graft survival after pancreas transplantation, based on donor characteristics and logistical and technical conditions. The aim of the study was to validate the utility of PDRI as a pancreas allograft survival predictor in simultaneous pancreas-kidney transplantation (SPK) transplants performed in our hospital between 2000 and 2015. METHODS: This retrospective analysis of 126 SPK transplants was performed by the same surgical team from the years 2000 to 2015...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932140/influence-of-donor-and-recipient-ages-in-survival-of-simultaneous-pancreas-kidney-transplantation
#19
A J Arenas-Bonilla, J P Campos-Hernández, J Carrasco-Valiente, F J Márquez-López, J M Ruiz-García, A Sánchez-Gónzalez, J J Salamanca-Bustos, J C Regueiro-López, M D Navarro-Cabello, M J Requena-Tapia
INTRODUCTION: Simultaneous pancreas-kidney transplantation (SPKT) is a well treatment for patients with insulin-dependent diabetes and end-stage renal disease. Donor age is a barrier to the acceptance of organs. Age matching has been extensively studied in kidney transplantation; however, there are no studies in graft survival after SPKT. We aimed to study the combined influence of the ages of the donors and recipients in graft survival after SPKT. MATERIAL AND METHODS: Donors and recipients are classified as younger (age <40 years) or older (age ≥40 years)...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932102/kidney-transplantation-results-in-very-highly-sensitized-patients-included-in-a-virtual-crossmatch-program-analysis-of-kidney-pairs
#20
A Mazuecos, A Alvarez, A Nieto, M A Gentil, M Cabello, A Rodriguez-Benot, C Gracia, F Gonzalez, P Castro, M Alonso
BACKGROUND: Kidney transplantation in highly-sensitized (HS) patients can improve with organ-exchange strategies based on virtual crossmatch (V-XM). Experience in very-HS patients is limited. METHODS: In June 2012, Andalusia started a V-XM protocol for very-HS patients (calculated panel reactive antibodies ≥95%). After organ allocation a cytotoxic-XM performed immediately before transplantation had to be negative for surgery to proceed. We analyzed results up until December 2015...
November 2016: Transplantation Proceedings
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