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pancreas transplant

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https://www.readbyqxmd.com/read/28332959/de-novo-donor-specific-antibody-formation-in-tacrolimus-based-mycophenolate-versus-mammalian-target-of-rapamycin-immunosuppressive-regimens
#1
Zain Mithani, Jane Gralla, Oluwafisayo Adebiyi, Patrick Klem, James E Cooper, Alexander C Wiseman
OBJECTIVES: De novo donor-specific antibody formation posttransplant is associated with decreased graft survival. It is not known whether mammalian target of rapamycin inhibitors may be advantageous or detrimental compared with mycophenolate in the prevention of de novo donor-specific antibody formation. MATERIALS AND METHODS: We compared 66 kidney and kidney-pancreas transplant recipients who received tacrolimus, mammalian target of rapamycin inhibitor, and prednisone (group 1; 36 of whom received everolimus and 30 of whom received sirolimus) versus 132 patients who received tacrolimus, mycophenolate, and prednisone (group 2) matched for age, sex, race, and type/timing of transplant from 2007 to 2012...
March 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28330678/acute-macular-edema-and-peripapillary-soft-exudate-after-pancreas-transplantation-with-accelerated-progression-of-diabetic-retinopathy
#2
Fang-Yi Tsai, Ling-Ing Lau, An-Fei Li, Shih-Jen Chen, Shin-E Wang, Fenq-Lih Lee, Catherine Jiu-Lin Liu, Yi-Ming Shyr
BACKGROUND: The effect of pancreas transplantation on diabetic retinopathy remains inconclusive. Herein, we report six patients with type 1 diabetes mellitus (DM) who underwent pancreas transplantation and developed acute macular edema and peripapillary soft exudate with rapid progression to proliferative diabetic retinopathy. METHODS: In this retrospective observational study, diabetic patients who underwent pancreas transplantation in a single medical center and developed symptomatic acute macular edema and peripapillary soft exudate within 3 months after the operation were enrolled...
March 18, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28325064/diabetic-foot-complications-despite-successful-pancreas-transplantation
#3
Dong-Kyo Seo, Ho Seong Lee, Jungu Park, Chang Hyun Ryu, Duck Jong Han, Sang Gyo Seo
BACKGROUND: It is known that successful pancreas transplantation enables patients with diabetes to maintain a normal glucose level without insulin and reduces diabetes-related complications. However, we have little information about the foot-specific morbidity in patients who have undergone successful pancreas transplantation. The purpose of this study was to investigate the prevalence and predisposing factors for foot complications after successful pancreas transplantation. METHODS: This retrospective study included 218 patients (91 males, 127 females) who had undergone pancreas transplantation for diabetes...
March 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28324008/vessel-network-architecture-of-adult-human-islets-promotes-distinct-cell-cell-interactions-in-situ-and-is-altered-after-transplantation
#4
Christian M Cohrs, Chunguang Chen, Stephan R Jahn, Julia Stertmann, Helena Chmelova, Jürgen Weitz, Andrea Bähr, Nikolai Klymiuk, Anja Steffen, Barbara Ludwig, Virginia Kamvissi, Eckhard Wolf, Stefan R Bornstein, Michele Solimena, Stephan Speier
Islet cell hormone release is modulated by signals from endothelial and endocrine cells within the islet. However, models of intra-islet vascularization and paracrine cell signaling are mostly based on rodent pancreas. We here assessed for the first time the architecture and endocrine cell interaction of the vascular network in unperturbed human islets in situ and their potential to re-establish their endogenous vascular network after transplantation in vivo. We prepared pancreas tissue slices of fresh tissue obtained from non-diabetic patients undergoing partial pancreatectomy...
January 27, 2017: Endocrinology
https://www.readbyqxmd.com/read/28322704/transmission-of-hepatitis-a-virus-through-combined-liver-small-intestine-pancreas-transplantation
#5
Monique A Foster, Lauren M Weil, Sherry Jin, Thomas Johnson, Tonya R Hayden-Mixson, Yury Khudyakov, Pallavi D Annambhotla, Sridhar V Basavaraju, Saleem Kamili, Jana M Ritter, Noele Nelson, George Mazariegos, Michael Green, Ryan W Himes, David T Kuhar, Matthew J Kuehnert, Jeffrey A Miller, Rachel Wiseman, Anne C Moorman
Although transmission of hepatitis A virus (HAV) through blood transfusion has been documented, transmission through organ transplantation has not been reported. In August 2015, state health officials in Texas, USA, were notified of 2 home health nurses with HAV infection whose only common exposure was a child who had undergone multi-visceral organ transplantation 9 months earlier. Specimens from the nurses, organ donor, and all organ recipients were tested and medical records reviewed to determine a possible infection source...
April 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28319566/pancreas-transplantation-from-pediatric-donors-a-unos-registry-analysis
#6
Mario Spaggiari, Martha Bissing, Maya Campara, Chun-Chieh Yeh, Ivo Tzvetanov, Hoonbae Jeon, Enrico Benedetti
BACKGROUND: Pancreas grafts from pediatric donors are still considered "not ideal". Perceived concerns are related to low islet mass and potential for graft thrombosis. METHODS: The study evaluated all pancreas transplants from January 2000 to May 2015 using the Organ Procurement and Transplant Network (OPTN) database. Comparative analysis of recipient and graft survival was performed between pediatric (≤18 years) and adult donors. In the pediatric group, the outcomes were stratified based on donor age (≤ 6 years; 7-12 years; 13-18 years) and weight (<30 kg; 30-95 Kg; >95 kg)...
March 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28319322/an-analysis-of-the-survival-outcomes-of-simultaneous-pancreas-and-kidney-transplantation-compared-to-live-donor-kidney-transplantation-in-patients-with-type-1-diabetes-a-uk-transplant-registry-study
#7
Adam D Barlow, Kourosh Saeb-Parsy, Christopher J E Watson
BACKGROUND: Transplant options for patients with type 1 diabetes and end-stage renal disease (ESRD) include deceased donor kidney, live donor kidney (LDK) and simultaneous pancreas-kidney (SPK) transplantation. The aim of this study was to compare outcomes between LDK and SPK for patients with type 1 diabetes and ESRD in the UK. METHODS: Data on all SPK (n=1739) and LDK (n=385) transplants performed between January 2001 and December 2014 were obtained from the UK Transplant Registry...
March 20, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28297573/magnetic-resonance-imaging-guided-delivery-of-neural-stem-cells-into-the-basal-ganglia-of-nonhuman-primates-reveals-a-pulsatile-mode-of-cell-dispersion
#8
Kristen E Malloy, Jinqi Li, Gourav R Choudhury, April Torres, Shruti Gupta, Chris Kantorak, Tim Goble, Peter T Fox, Geoffrey D Clarke, Marcel M Daadi
Optimal stem cell delivery procedures are critical to the success of the cell therapy approach. Variables such as flow rate, suspension solution, needle diameter, cell density, and tissue mechanics affect tissue penetration, backflow along the needle, and the dispersion and survival of injected cells during delivery. Most cell transplantation centers engaged in human clinical trials use custom-designed cannula needles, syringes, or catheters, sometimes precluding the use of magnetic resonance imaging (MRI)-guided delivery to target tissue...
March 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28295646/the-epidemiology-of-clostridium-difficile-infection-in-a-national-kidney-transplant-centre
#9
C Kennedy, C Waldron, M Skally, L Gaughan, C Magee, K Burns, F Fitzpatrick
BACKGROUND: We aimed to describe the epidemiology and outcomes of CDI in a national kidney transplant centre from 2008-2015. METHODS: Adult kidney and kidney-pancreas transplant recipients were included for analysis if they met the surveillance CDI case definition. Rates of new healthcare-associated CDI (HA-CDI) were expressed per 10,000 KTR/KTPR bed days used (BDU) to facilitate comparisons. RESULTS: Fifty-two cases of CDI were identified in 42 KTRs and KPTRs...
March 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28290711/visualising-a-rare-and-complex-case-of-advanced-hilar-cholangiocarcinoma
#10
Jia Qu, Albert Fung, Paul Kelly, Gordon Tait, Paul D Greig, Anne Agur, Ian D McGilvray, Jodie Jenkinson
The Toronto Video Atlas of Liver, Pancreas, Biliary, and Transplant Surgery (TVASurg) is a free online library of three-dimensional (3D) animation-enhanced surgical videos, designed to instruct surgical fellows in hepato-pancreato-biliary (HPB) and transplant procedures. The video 'Klatskin tumours: Extended left hepatectomy with complex portal vein reconstruction and in situ cold perfusion of the liver', which is available to watch at http://TVASurg.ca , is a unique and valuable visual resource for surgeons in training to assist them in learning this rare procedure...
March 14, 2017: Journal of Visual Communication in Medicine
https://www.readbyqxmd.com/read/28286566/gastrointestinal-manifestations-of-mitochondrial-disorders-a-systematic-review
#11
REVIEW
Josef Finsterer, Marlies Frank
Mitochondrial disorders (MIDs) due to respiratory-chain defects or nonrespiratory chain defects are usually multisystem conditions [mitochondrial multiorgan disorder syndrome (MIMODS)] affecting the central nervous system (CNS), peripheral nervous system, eyes, ears, endocrine organs, heart, kidneys, bone marrow, lungs, arteries, and also the intestinal tract. Frequent gastrointestinal (GI) manifestations of MIDs include poor appetite, gastroesophageal sphincter dysfunction, constipation, dysphagia, vomiting, gastroparesis, GI pseudo-obstruction, diarrhea, or pancreatitis and hepatopathy...
January 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28281726/anastomotic-loop-between-common-hepatic-artery-and-gastroduodenal-artery-in-coexistence-with-an-aberrant-right-hepatic-artery
#12
Konstantinos Natsis, Maria Piagkou, Theodosis Stamatopoulos, Ioannis Spyridakis, Stylianos Apostolidis
Anatomical variations of the hepatic arteries are not uncommon. The anomalous hepatic arterial supply is of paramount importance in hepatobiliary, pancreatic or liver transplantation and in laparoscopic surgery. We describe an unusual case of a 66-year-old Greek male cadaver, where a rare anastomosis (in the form of an enlarged arterial loop, 4.84 mm in diameter) between the common hepatic artery (6.42 mm) and the gastroduodenal artery (GDA) (4.82 mm) coexisted with an aberrant right hepatic artery (ARHA) (6...
March 10, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28280376/single-donor-islet-transplantation-in-type-1-diabetes-patient-selection-and-special-considerations
#13
REVIEW
Jacob A Tatum, Max O Meneveau, Kenneth L Brayman
Type 1 diabetes mellitus is an autoimmune disorder of the endocrine pancreas that currently affects millions of people in the United States. Although the disease can be managed with exogenous insulin administration, the ultimate cure for the condition lies in restoring a patient's ability to produce their own insulin. Islet cell allotransplantation provides a means of endogenous insulin production. Though far from perfected, islet transplants are now a proven treatment for type 1 diabetics. However, proper patient selection is critical for achieving optimal outcomes...
2017: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/28279194/crispr-targeted-genome-editing-of-mesenchymal-stem-cell-derived-therapies-for-type-1-diabetes-a-path-to-clinical-success
#14
REVIEW
Dario Gerace, Rosetta Martiniello-Wilks, Najah Therese Nassif, Sara Lal, Raymond Steptoe, Ann Margaret Simpson
Due to their ease of isolation, differentiation capabilities, and immunomodulatory properties, the therapeutic potential of mesenchymal stem cells (MSCs) has been assessed in numerous pre-clinical and clinical settings. Currently, whole pancreas or islet transplantation is the only cure for people with type 1 diabetes (T1D) and, due to the autoimmune nature of the disease, MSCs have been utilised either natively or transdifferentiated into insulin-producing cells (IPCs) as an alternative treatment. However, the initial success in pre-clinical animal models has not translated into successful clinical outcomes...
March 9, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28273393/a-retrospective-study-to-describe-the-epidemiology-and-outcomes-of-opportunistic-infections-after-abdominal-organ-transplantation
#15
Mia Helfrich, Peter Dorschner, Kathryn Thomas, Valentina Stosor, Michael G Ison
BACKGROUND: Most epidemiologic studies of opportunistic infections (OI) following abdominal organ transplant (AOT) are derived prior to the era of contemporary immunosuppression and prophylaxis. These studies suggest that most OI occur within the first 6 months post transplant. METHOD: In this single-center, retrospective cohort study, we describe the epidemiology of OI in 359 consecutive AOT recipients, in the era of contemporary prophylaxis practices and alemtuzumab induction in kidney and simultaneous pancreas-kidney transplant recipients...
March 8, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28272465/reconstituting-development-of-pancreatic-intraepithelial-neoplasia-from-primary-human-pancreas-duct-cells
#16
Jonghyeob Lee, Emily R Snyder, Yinghua Liu, Xueying Gu, Jing Wang, Brittany M Flowers, Yoo Jung Kim, Sangbin Park, Gregory L Szot, Ralph H Hruban, Teri A Longacre, Seung K Kim
Development of systems that reconstitute hallmark features of human pancreatic intraepithelial neoplasia (PanINs), the precursor to pancreatic ductal adenocarcinoma, could generate new strategies for early diagnosis and intervention. However, human cell-based PanIN models with defined mutations are unavailable. Here, we report that genetic modification of primary human pancreatic cells leads to development of lesions resembling native human PanINs. Primary human pancreas duct cells harbouring oncogenic KRAS and induced mutations in CDKN2A, SMAD4 and TP53 expand in vitro as epithelial spheres...
March 8, 2017: Nature Communications
https://www.readbyqxmd.com/read/28272287/risk-factors-and-outcomes-of-de-novo-cancers-excluding-nonmelanoma-skin-cancer-after-liver-transplantation-for-primary-sclerosing-cholangitis
#17
Mohamad A Mouchli, Siddharth Singh, Edward V Loftus, Lisa Boardman, Jayant Talwalkar, Charles B Rosen, Julie K Heimbach, Russell H Wiesner, Bashar Hasan, John J Poterucha, Kymberly D Watt
BACKGROUND: Patients with primary sclerosing cholangitis (PSC) may be at higher of risk of malignancy after liver transplantation (LT) compared to other LT recipients. We aimed to determine the cumulative incidence of/risk factors for and long-term cancer-related mortality in patients with PSC after LT. METHODS: All adult patients who underwent LT for PSC without cholangiocarcinoma from 1984-2012, with follow-up through June 2015. We estimated cumulative incidence, risk factors and mortality from de novo malignancies after LT RESULTS: 293 patients were identified (mean age, 47±12 years; 63...
March 8, 2017: Transplantation
https://www.readbyqxmd.com/read/28267898/laparoscopic-biopsies-in-pancreas-transplantation
#18
P D Uva, J S Odorico, A Giunippero, I C Cabrera, A Gallo, L R Leon, E Minue, F Toniolo, I Gonzalez, E Chuluyan, D H Casadei
As there is no precise laboratory test or imaging study for detection of pancreas allograft rejection, there is increasing interest in obtaining pancreas tissue for diagnosis. Pancreas allograft biopsies are most commonly performed percutaneously, transcystoscopically, or endoscopically, yet pancreas transplant surgeons often lack the skills to perform these types of biopsies. We have performed 160 laparoscopic pancreas biopsies in 95 patients. There were 146 simultaneous kidney-pancreas biopsies and 14 pancreas only biopsies due to pancreas alone, kidney loss or extraperitoneal kidney...
March 7, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28266040/ex-vivo-porcine-organ-perfusion-models-as-a-suitable-platform-for-translational-transplant-research
#19
Rohan Kumar, Wen Yuan Chung, Ashley Robert Dennison, Giuseppe Garcea
In transplantation surgery, extending the criteria for organ donation to include organs that may have otherwise been previously discarded has provided the impetus to improve organ preservation. The traditional method of cold static storage (CS) has been tried and tested and is suitable for organs meeting standard criteria donation. Ex vivo machine perfusion is, however, associated with evidence suggesting that it may be better than CS alone and may allow for organ donation criteria to be extended. Much of our knowledge of organ preservation is derived from animal studies...
March 6, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28265591/tubulovillous-adenoma-in-the-bladder-in-a-dual-pancreas-kidney-transplant-patient
#20
Taylor Remondini, Stephan Van Zyl, Tarek A Bismar, Serdar Yilmaz, M Eric Hyndman
Background: A rare report of a tubulovillous adenoma arising in the setting of a dual pancreas-kidney transplant patient. Case Presentation: This adenoma was discovered in a 60-year-old male with a dual pancreas-kidney transplant that presented with urinary retention and gross hematuria. Management of this patient required both transurethral resection of the tumor as well as a laparotomy after recurrence. Follow-up with cystoscopy has shown no further recurrence of the tumor. Conclusion: This case adds to the few cases documented of adenomas arising in bladders augmented with gastrointestinal tract tissue...
2017: Journal of Endourology Case Reports
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