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pancreas transplant

Beata Greb-Markiewicz, Mirosław Zarębski, Andrzej Ożyhar
Neuronal Per-Arnt-Sim (PAS) domain-containing protein 4 (NPAS4) is a basic helix-loop-helix (bHLH)-PAS transcription factor that was first discovered in neurons in the neuronal layer of the mammalian hippocampus and was later discovered in pancreatic β-cells. NPAS4 has been proposed as a therapeutic target not only for depression and neurodegenerative diseases associated with synaptic dysfunction but also for type 2 diabetes and pancreas transplantation. The ability of bHLH-PAS proteins to fulfil their function depends on their intracellular trafficking, which is regulated by specific sequences, i...
June 13, 2018: Journal of Biological Chemistry
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
Jun Li, Martina Koch, Kathrin Kramer, Katja Kloth, Abd El Rahman Abu Ganim, Silke Scheidat, Franz Rinninger, Friedrich Thaiss, Amit Gulati, Uta Herden, Eike Achilles, Lutz Fischer, Bjoern Nashan
BACKGROUND: To be an optimal immunosuppressive regimen after simultaneous pancreas kidney transplantation (SPK), low dose calcineurin inhibitor and early withdrawal of corticosteroids are desired. METHODS: Immunosuppressive regimen as such has been conducted consecutively in SPK recipients since 2009 in authors' institute. In addition to tacrolimus in low trough level and early corticosteroid withdraw, dual induction with basiliximab and low-dose thymoglobulin in combination with everolimus are the important components of the protocol...
June 6, 2018: Transplant Immunology
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
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
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
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
Sahana Shankar, Rishi Bolia, Alexandra Hodgson, Jonathan R Bishop, Helen M Evans, Mark R Oliver
We report the first two pediatric patients with CF who underwent successful combined liver-pancreas transplantation in Australia and New Zealand for CF liver disease and CF-related diabetes mellitus.
June 6, 2018: Pediatric Transplantation
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
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
Federico Bertuzzi, Luciano De Carlis, Mario Marazzi, Antonio Gaetano Rampoldi, Matteo Bonomo, Barbara Antonioli, Marta Cecilia Tosca, Marta Galuzzi, Andrea Lauterio, Danila Fava, Patrizia Dorighet, Andrea De Gasperi, Giacomo Colussi
Islet transplantation has been reported to restore normoglycemia and the overall metabolic control in type 1 diabetes mellitus (DM). In the most experienced centers, islet transplantation clinical outcome is similar to that of the whole pancreas transplantation. Long-term islet transplantation function remains a very interesting matter worth discussing. A progressive islet function decrease was reported, probably due to islet exhaustion. In 5 islet-transplanted patients with at least 3-yr follow-up and still insulin independent, their glycemic control was characterized by a blinded retrospective continuous glucose monitoring system (CGMS)...
January 1, 2018: Cell Transplantation
Andrej Babic, Laurent Vinet, Vineetha Chellakudam, Karolina Janikowska, Eric Allemann, Norbert Lange
Novel drug delivery systems targeting native, transplanted or cancerous beta-cells are of utmost importance. Herein, we present new exendin-4 derivatives with modified unnatural amino acids at strategic positions within the polypeptide sequence. The modified peptides allowed modular orthogonal chemical modifications to attach imaging agents and amphiphilic squalene-PEG groups. The resulting conjugates, SQ-PEG-ExC1-Cy5 and SQ-PEG-ExC40-Cy5 fluorescence probes display low nM affinity to GLP-1R in fluorescence-based binding assays with EC50 at 1...
June 5, 2018: Bioconjugate Chemistry
Elizabeth M Thompson, Jennifer L Sollinger, Emmanuel C Opara, Christopher A Adin
Currently, islet isolation is performed using harsh collagenases that cause nonspecific injury to both islets and exocrine tissue, negatively affecting the outcome of cell transplantation. We evaluated a novel islet isolation protocol utilizing high concentrations of glucose to cause selective osmotic shock (SOS). Islets have a membrane glucose transporter that allows adaptation to changes in glucose concentrations while exocrine tissue can be selectively destroyed by these osmolar shifts. Canine pancreata were obtained within 15 min after euthanasia from animals ( n = 6) euthanized for reasons unrelated to this study...
March 2018: Cell Transplantation
Piyaporn Rattananinsruang, Chavaboon Dechsukhum, Wilairat Leeanansaksiri
Diabetes mellitus (DM) is a group of diseases characterized by abnormally high levels of glucose in the blood stream. In developing a potential therapy for diabetic patients, pancreatic cells transplantation has drawn great attention. However, the hinder of cell transplantation for diabetes treatment is insufficient sources of insulin-producing cells. Therefore, new cell based therapy need to be developed. In this regard, human embryonic stem cells (hESCs) may serve as good candidates for this based on their capability of differentiation into various cell types...
2018: Frontiers in Cell and Developmental Biology
Andrew R Pepper, Antonio Bruni, A M James Shapiro
PURPOSE OF REVIEW: Clinical pancreatic islet transplantation has evolved into a routine means to restore glycemic control in patients with type 1 diabetes mellitus (T1DM) suffering from life-threatening hypoglycemia and severe glucose liability. This chapter examines the current progress in islet transplantation while outlining the remaining limitations preventing this life-altering therapy's application to the broader T1DM population. RECENT FINDINGS: Islet transplantation has recently been demonstrated to provide superior glycemic control with reduced glucose lability and hypoglycemic events compared with standard insulin therapy...
May 29, 2018: Current Opinion in Organ Transplantation
Lucas S Nacif, Vinicius Rocha-Santos, Laura C L Claro, Agustin Vintimilla, Leandro A Ferreira, Rubens M Arantes, Rafael S Pinheiro, Wellington Andraus, Venancio A F Alves, Luiz Carneiro D'Albuquerque
OBJECTIVES: The number of pancreatic transplants has decreased in recent years. Pancreatic grafts have been underutilized compared to other solid grafts. One cause of discard is the macroscopic appearance of the pancreas, especially the presence of fatty infiltration. The current research is aimed at understanding any graft-related association between fatty tissue infiltration of the pancreas and liver steatosis. METHODS: From August 2013 to August 2014, a prospective cross-sectional clinical study using data from 54 multiple deceased donor organs was performed...
2018: Clinics
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
Paula Gallego Ferrero, Juan Crespo Del Pozo
Pancreatic transplantation is a therapeutic option for both poorly controlled cases of diabetes mellitus and patients with advanced diabetic nephropathy. It is important for radiologists to know the different surgical techniques as well as the typical radiological appearance after pancreatic transplantation, in order to accurately identify the complications. These complications can be classified according to the period of time after the transplantation in which they typically occur: immediate (first 24 hours), early (24-72 hours), intermediate (72 hours to weeks) and late (months)...
May 28, 2018: Journal of Medical Imaging and Radiation Oncology
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
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
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