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Pancreas transplant rejection

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https://www.readbyqxmd.com/read/29774602/pancreas-transplantation-using-compatible-but-non-identical-abo-blood-group-donors
#1
Santosh Nagaraju, Richard S Mangus, John A Powelson, Jonathan A Fridell
METHODS: A review of all pancreas transplants from a single institution from 01/2003 to 07/2016 (n=606) revealed 41 recipients of a NIC donor pancreas which were matched for age, race, gender, year and type of transplant with 41 ABO identical cases. Groups were compared for allograft survival, incidence of acute cellular rejection (ACR), length of hospital stay, 3-month readmissions and transfusion requirements. Serum haptoglobin and Lactate dehydrogenase were used to identify hemolysis in patients requiring repeated transfusions without overt blood loss...
May 17, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29757902/differential-impact-of-t-bet-and-ifn%C3%AE-on-pancreatic-islet-allograft-rejection
#2
Alix Besançon, Zeynep Demir, Tania Goncalves, Fabrice Valette, Emilie Panafieu, Lucienne Chatenoud, Sylvaine You
BACKGROUND: T-cell-mediated graft rejection is mostly correlated with potent Th1 responses. However, since IFNγ mice reject their graft as efficiently as wild-type (WT) mice, the exact contribution of IFNγ and its transcription factor T-bet remains a matter of debate. Here, we address this question in the context of pancreatic islet allograft to better inform the molecular pathways that hampers islet survival in vivo. METHODS: Pancreatic islets from BALB/c mice were transplanted in WT, IFNγ or T-bet C57BL/6 mice...
May 2, 2018: Transplantation
https://www.readbyqxmd.com/read/29741276/pancreatic-panniculitis-a-case-series-from-a-tertiary-university-hospital-in-spain
#3
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/29738100/steroid-free-three-drug-maintenance-regimen-for-pancreas-transplant-alone-comparison-of-induction-with-rabbit-antithymocyte-globulin-rituximab
#4
Jonathan Fridell, Richard Mangus, Jeanne Chen, Tim Taber, Arianna E Cabrales, Asif Sharfuddin, Muhammad Yaqub, John Powelson
Graft survival following pancreas transplant alone (PTA) is inferior to other pancreas transplants. Steroid elimination is appealing, but a two drug maintenance strategy may be inadequate. Additionally, recipients tend to have diabetic nephropathy and do not tolerate nephrotoxic medications. A three-drug maintenance strategy permits immunosuppression through different mechanisms as well as an opportunity to use lower doses of the individual medications. Induction consisted of five doses of rabbit antithymocyte globulin (1 mg/kg/dose)...
May 8, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29717931/-re-generating-human-beta-cells-status-pitfalls-and-perspectives
#5
Luc Baeyens, Marie Lemper, Willem Staels, Sofie De Groef, Nico De Leu, Yves Heremans, Michael S German, Harry Heimberg
Diabetes mellitus results from disturbed glucose homeostasis due to an absolute (type 1) or relative (type 2) deficiency of insulin, a peptide hormone almost exclusively produced by the beta cells of the endocrine pancreas in a tightly regulated manner. Current therapy only delays disease progression through insulin injection and/or oral medications that increase insulin secretion or sensitivity, decrease hepatic glucose production, or promote glucosuria. These drugs have turned diabetes into a chronic disease as they do not solve the underlying beta cell defects or entirely prevent the long-term complications of hyperglycemia...
July 1, 2018: Physiological Reviews
https://www.readbyqxmd.com/read/29683218/-outcome-of-patients-with-hemodialysis-or-peritoneal-dialysis-undergoing-simultaneous-pancreas-kidney-transplantation-comparative-study
#6
Alberto Marcacuzco, Carlos Jiménez-Romero, Alejandro Manrique, Jorge Calvo, Félix Cambra, Óscar Caso, Álvaro García-Sesma, Anisa Nutu, Iago Justo
BACKGROUND: Controversy remains with regard to the higher risk of intraabdominal infections and lower patient and graft survival when peritoneal dialysis (PD) rather than hemodialysis (HD) is used in simultaneous pancreas-kidney transplantation (SPKT). METHODS: From March 1995 to December 2015 we performed 165 SPKTs. Prior to transplant, patients received hemodialysis (Group HD; n=98) or peritoneal dialysis (Group PD; n=67). A comparison was performed to analyze posttransplant complications and patient, pancreas and kidney graft survivals...
April 23, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29676018/conversion-from-tacrolimus-mycophenolate-mofetil-to-tacrolimus-mtor-immunosuppression-after-kidney-pancreas-transplantation-reduces-the-incidence-of-both-bk-and-cmv-viremia
#7
Richard J Knight, Edward A Graviss, Duc T Nguyen, Samantha A Kuten, Samir J Patel, Lillian Gaber, A Osama Gaber
BACKGROUND: We sought to determine if conversion from tacrolimus/mycophenolate mofetil (TAC-MMF) to tacrolimus/mTOR inhibitor (TAC-mTOR) immunosuppression would reduce the incidences of BK and CMV viremia after kidney/pancreas (KP) transplantation. METHODS: In this single center review, the TAC-mTOR cohort (n=39) was converted at one month post-transplant to an mTOR inhibitor and reduced dose tacrolimus. Outcomes were compared to a cohort of KP recipients (n=40) maintained on TAC-MMF...
April 19, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29661440/renopancreatic-transplantation-evaluation-of-15-years-in-131-patients
#8
C G Marmanillo, C Langaro, J E Nicoluzzi, R T Belila, M Macri, R Zamprogna, M Luvizotto, M Takahashi
BACKGROUND: The most common multiple-organ transplant is the simultaneous pancreas-kidney transplantation (SPK). It is usually offered to patients who have insulin-dependent diabetes mellitus and those with diabetic nephropathy and renal failure that has already been established. In this study we present the results of 15 years of SPK in a transplant hospital center in Paraná, Brazil, and evaluated survival, immunosuppression, and transplant-related problems. METHODS: This study was a retrospective analysis of 131 SPK transplants performed at the Angelina Caron Hospital between January 2001 and December 2015...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29620617/pancreas-transplantation-from-pediatric-donors-a-single-center-experience
#9
Mario Spaggiari, Caterina Di Bella, Pierpaolo Di Cocco, Maya Campara, Kelly Galen, Federico Gheza, Jose Oberholzer, Enrico Benedetti, Ivo Tzvetanov
BACKGROUND: Pancreas allografts from pediatric donors are considered less suitable due to the increased risk of surgical complications and reduced islet cell mass that may compromise function. METHODS: All pancreatic transplants, procured from donors <18 years old, between January 2007 and March 2017, were included in the analysis. The grafts were subdivided into 3 groups by donor's weight: <30kg, 30-60kg, >60kg. Analysis of patient and graft survival was done between the groups, and subsequently between the pediatric cohort and the adult-donor control group...
April 3, 2018: Transplantation
https://www.readbyqxmd.com/read/29597032/current-advanced-therapy-cell-based-medicinal-products-for-type-1-diabetes-treatment
#10
REVIEW
Alberto Cañibano-Hernández, Laura Sáenz Del Burgo, Albert Espona-Noguera, Jesús Ciriza, Jose Luis Pedraz
In the XXI century diabetes mellitus has become one of the main threats to human health with higher incidence in regions such as Europe and North America. Type 1 diabetes mellitus (T1DM) occurs as a consequence of the immune-mediated destruction of insulin producing β-cells located in the endocrine part of the pancreas, the islets of Langerhans. The administration of exogenous insulin through daily injections is the most prominent treatment for T1DM but its administration is frequently associated to failure in glucose metabolism control, finally leading to hyperglycemia episodes...
March 27, 2018: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29593968/engineering-a-tumor-microenvironment-mimetic-niche-for-tissue-regeneration-with-xenogeneic-cancer-cells
#11
Zhenzhen Wang, Chunming Wang, Ayipaxia Abudukeremu, Xiaying Rui, Shang Liu, Xiaoyi Zhang, Min Zhang, Junfeng Zhang, Lei Dong
The insufficient number of cells suitable for transplantation is a long-standing problem to cell-based therapies aimed at tissue regeneration. Xenogeneic cancer cells (XCC) may be an alternative source of therapeutic cells, but their transplantation risks both immune rejection and unwanted spreading. In this study, a strategy to facilitate XCC transplantation is reported and their spreading in vivo is confined by constructing an engineering matrix that mimics the characteristics of tumor microenvironment. The data show that this matrix, a tumor homogenate-containing hydrogel (THAG), successfully creates an immunosuppressive enclave after transplantation into immunocompetent mice...
March 2018: Advanced Science (Weinheim, Baden-Wurttemberg, Germany)
https://www.readbyqxmd.com/read/29579858/visceral-leishmaniasis-in-renal-transplant-recipients-report-of-2-cases
#12
F Clavijo Sánchez, T Vázquez Sánchez, M Cabello Díaz, V E Sola Moyano, C Jironada Gallego, D Hernández Marrero
Visceral leishmaniasis is a disease caused by the protozoan Leishmania and is transmitted by Lutzomyia longipalpis (sand fly). It is an endemic parasitic infection in numerous areas around the Mediterranean basin. Though immunocompetent patients may not develop the disease, in transplant recipients the use of corticoids and intensified immunosuppressants to prevent graft rejection may accelerate the disease, causing severe damage to the liver, spleen, and hematopoietic system. We report 2 cases of visceral leishmaniasis with an atypical presentation in transplant recipients...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29521877/a-novel-subcutaneous-site-of-islet-transplantation-superior-to-the-liver
#13
Yohichi Yasunami, Yuki Nakafusa, Naoyoshi Nitta, Masafumi Nakamura, Masafumi Goto, Junko Ono, Masaru Taniguchi
BACKGROUND: Islet transplantation is an attractive treatment for patients with insulin-dependent diabetes mellitus, and currently the liver is the favored transplantation site. However, an alternative site is desirable because of the low efficiency of hepatic transplantation, requiring 2-3 donors for a single recipient, and because the transplanted islets cannot be accessed or retrieved. METHODS: We developed a novel procedure of islet transplantation to the inguinal subcutaneous white adipose tissue (ISWAT) of mice and described functional and morphological characteristics of transplanted syngeneic islets...
March 8, 2018: Transplantation
https://www.readbyqxmd.com/read/29501238/development-and-results-of-a-novel-pancreas-transplant-program-in-spain-the-surgeon-s-point-of-view
#14
Luis Muñoz-Bellvis, María Del Carmen Esteban, Manuel Iglesias, Luis González, Juan Ignacio González-Muñoz, Cristina Muñoz-González, José E Quiñones, Guadalupe Tabernero, Rosa Ana Iglesias, José María Sayagués, Pilar Fraile
INTRODUCTION: Simultaneous kidney-pancreas transplantation for patients with type 1 diabetes and end-stage chronic renal disease is widely performed. However, the rate of surgical morbidity from pancreatic complications remains high. The aim of this study was to describe the development and results of a new program, from the point of view of the pancreatic surgeon. METHODS: We analyzed 53 simultaneous kidney-pancreas transplantations performed over a period of seven years (2009-2016), with a median follow up of 39 months (range: 1-86 months)...
April 2018: Cirugía Española
https://www.readbyqxmd.com/read/29485032/long-term-results-of-protocol-kidney-biopsy-directing-steroid-withdrawal-in-simultaneous-pancreas-kidney-transplant-patients
#15
Nemin Zhu, Neal E Rowe, Paul R Martin, Sean S Luke, Thomas B Mcgregor, Frank Myslik, Vivian C Mcalister, Alp Sener, Patrick P Luke
INTRODUCTION: We sought to determine whether protocol biopsies could be used to guide treatment and improve outcomes in simultaneous pancreas-kidney (SPK) patients. METHODS: Between 2004 and 2013, protocol biopsies were performed on SPK patients at 3-6 months and one year post-transplant. Maintenance immunosuppression consisted of a calcineurin inhibitor, anti-proliferative agent, and corticosteroid. Corticosteroid was withdrawn in negative early biopsies, maintained in subclinical/borderline biopsies, and increased if Banff IB or greater rejection was identified...
February 23, 2018: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29455936/engineering-a-clinically-translatable-bioartificial-pancreas-to-treat-type-i-diabetes
#16
REVIEW
Gorka Orive, Dwaine Emerich, Ali Khademhosseini, Shinichi Matsumoto, R M Hernández, J L Pedraz, Tejal Desai, Riccardo Calafiore, Paul de Vos
Encapsulating, or immunoisolating, insulin-secreting cells within implantable, semipermeable membranes is an emerging treatment for type 1 diabetes. This approach can eliminate the need for immunosuppressive drug treatments to prevent transplant rejection and overcome the shortage of donor tissues by utilizing cells derived from allogeneic or xenogeneic sources. Encapsulation device designs are being optimized alongside the development of clinically viable, replenishable, insulin-producing stem cells, for the first time creating the possibility of widespread therapeutic use of this technology...
April 2018: Trends in Biotechnology
https://www.readbyqxmd.com/read/29406443/extended-pancreas-donor-program-the-expand-study-a-prospective-multicenter-trial-testing-the-use-of-pancreas-donors-over-age-50
#17
Andrea Proneth, Andreas A Schnitzbauer, Peter Schenker, Andreas Wunsch, Falk Rauchfuss, Helmut Arbogast, Steffen Manekeller, Silvio Nadalin, Michael Heise, Michael A Ströhlein, Bernhard Banas, Peter Schemmer, Thomas Becker, Wolf O Bechstein, Andreas Pascher, Richard Viebahn, Edward K Geissler, Hans J Schlitt, Stefan A Farkas
BACKGROUND: Pancreas transplantation is the only curative treatment option for patients with juvenile diabetes. Organ shortage and restrictive allocation criteria are the main reasons for increasing waitlists leading to severe morbidity and mortality. We designed a study to increase the donor pool with extended donor criteria (EDC) organs (donor age 50-60 years or BMI 30-34kg/m). METHODS: Utilization of EDC organs required the implementation of a new allocation system within Eurotransplant...
February 5, 2018: Transplantation
https://www.readbyqxmd.com/read/29391389/does-enteric-conversion-affect-graft-survival-after-pancreas-transplantation-with-bladder-drainage
#18
Ji Yoon Choi, Joo Hee Jung, Hyun Wook Kwon, Sung Shin, Young Hoon Kim, Duck Jong Han
BACKGROUND Although bladder drainage is effective for monitoring urine amylase levels to detect graft rejection, enteric drainage is performed more frequently. The optimal method for monitoring pancreatic enzyme secretions remains unclear. We investigated graft survival in recipients of bladder drainage and assessed the risk of graft rejection and failure after enteric conversion. MATERIAL AND METHODS From January 1999 to October 2015, we performed 318 pancreas transplantations at our institution. We enrolled 180 recipients who underwent pancreas transplantation with bladder drainage (82 underwent enteric conversion and the rest did not)...
February 2, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29359836/factors-and-outcomes-in-association-with-sepsis-differ-between-simultaneous-pancreas-kidney-and-single-kidney-transplant-recipients
#19
Thomas Schachtner, Marina Zaks, Natalie M Otto, Andreas Kahl, Petra Reinke
BACKGROUND: As immunosuppressive therapy has improved in simultaneous pancreas/kidney transplant recipients (SPKTRs), infection has become the major limitation of disease-free survival. METHODS: We studied all SPKTRs and deceased-donor kidney transplant recipients (KTRs) between 2003 and 2015. Thirty-six of 134 SPKTRs (26.9%) were diagnosed with sepsis among which 13/36 SPKTRs (36.1%) developed severe sepsis/septic shock. A control group of 98 SPKTRs without sepsis and 61/538 KTRs (11...
April 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29317301/antibody-mediated-rejection-due-to-de-novo-dsa-causing-venous-thrombosis-of-pancreas-allograft-a-case-report
#20
Kunal Yadav, Adrian Cotterell, Pamela Kimball, Laura Warmke, Melissa Contos, Gaurav Gupta, Anne King, Dhiren Kumar, Marlon Levy
This case describes a 34year old female who underwent an HLA identical living donor kidney transplant with a positive flow cytometric crossmatch (FCXM), but without any donor specific antibody (DSA). Tests to detect non-HLA antibody and autoantibody were negative. Allograft functioned well without rejection. She later received a pancreas allograft, again with a weakly positive FCXM, without DSA. After good initial graft function, she developed hyperglycemia six weeks posttransplant. Cross-sectional imaging demonstrated non-enhancing pancreas allograft with new vein thrombosis...
April 2018: Transplant Immunology
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