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Total pancreatectomy islet transplantation

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https://www.readbyqxmd.com/read/29159905/autologous-mesenchymal-stem-cell-and-islet-cotransplantation-safety-and-efficacy
#1
Hongjun Wang, Charlie Strange, Paul J Nietert, Jingjing Wang, Taylor L Turnbull, Colleen Cloud, Stefanie Owczarski, Betsy Shuford, Tara Duke, Gary Gilkeson, Louis Luttrell, Kathie Hermayer, Jyotika Fernandes, David B Adams, Katherine A Morgan
Islet engraftment after transplantation is impaired by high rates of islet/β cell death caused by cellular stressors and poor graft vascularization. We studied whether cotransplantation of ex vivo expanded autologous bone marrow-derived mesenchymal stem cells (MSCs) with islets is safe and beneficial in chronic pancreatitis patients undergoing total pancreatectomy with islet autotransplantation. MSCs were harvested from the bone marrow of three islet autotransplantation patients and expanded at our current Good Manufacturing Practices (cGMP) facility...
November 21, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28993044/risk-factors-for-early-readmission-after-total-pancreatectomy-and-islet-auto-transplantation
#2
Rauf Shahbazov, Bashoo Naziruddin, Kunal Yadav, Giovanna Saracino, Gumpei Yoshimatsu, Mazhar A Kanak, Ernest Beecherl, Peter T Kim, Marlon F Levy
BACKGROUND: Little published data exist examining causes of hospital readmission following total pancreatectomy with islet autotransplantation (TPIAT). METHODS: A retrospective analysis was performed of a prospectively collected institutional TPIAT database. Primary outcome was unplanned readmission to the hospital within 30 days from discharge. Reasons and risk factors for readmission as well as islet function were evaluated and compared by univariate and multivariate analysis...
October 6, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28964481/pediatric-pancreas-transplantation-including-total-pancreatectomy-with-islet-autotransplantation
#3
Alexander J Bondoc, Maisam Abu-El-Haija, Jaimie D Nathan
Unlike other solid-organ transplants, whole pancreas transplantation in children is relatively rare, and it occurs more frequently in the context of multivisceral or composite organ transplantation. Because children only infrequently suffer severe sequelae of type 1 diabetes mellitus, pancreas transplantation is rarely indicated in the pediatric population. More commonly, pediatric pancreas transplant occurs in the setting of incapacitating acute recurrent or chronic pancreatitis, specifically islet autotransplantation after total pancreatectomy...
August 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28854965/adipose-stem-cells-from-chronic-pancreatitis-patients-improve-mouse-and-human-islet-survival-and-function
#4
Lili Song, Zhen Sun, Do-Sung Kim, Wenyu Gou, Charlie Strange, Huansheng Dong, Wanxing Cui, Gary Gilkeson, Katherine A Morgan, David B Adams, Hongjun Wang
BACKGROUND: Chronic pancreatitis has surgical options including total pancreatectomy to control pain. To avoid surgical diabetes, the explanted pancreas can have islets harvested and transplanted. Immediately following total pancreatectomy with islet autotransplantation (TP-IAT), many islet cells die due to isolation and transplantation stresses. The percentage of patients remaining insulin free after TP-IAT is therefore low. We determined whether cotransplantation of adipose-derived mesenchymal stem cells (ASCs) from chronic pancreatitis patients (CP-ASCs) would protect islets after transplantation...
August 30, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28821411/diagnosis-and-treatment-in-chronic-pancreatitis-an-international-survey-and-case-vignette-study
#5
Yama Issa, Hjalmar C van Santvoort, Paul Fockens, Marc G Besselink, Thomas L Bollen, Marco J Bruno, Marja A Boermeester
BACKGROUND: The aim of the study was to evaluate the current opinion and clinical decision-making process of international pancreatologists, and to systematically identify key study questions regarding the diagnosis and treatment of chronic pancreatitis (CP) for future research. METHODS: An online survey, including questions regarding the diagnosis and treatment of CP and several controversial clinical case vignettes, was send by e-mail to members of various international pancreatic associations: IHPBA, APA, EPC, ESGE and DPSG...
November 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28731996/-pancreatitis-genes-and-islet-cells-auto-transplant-updates-and-new-horizons
#6
Edgardo D Rivera Rivera
Pancreatitis is an inflammation of the pancreas that can progress from an acute presentation to an acute recurring presentation and eventually to chronic pancreatitis, which is characterized by irreversible morphological changes and scarring of the pancreas. The entity known as hereditary pancreatitis has been recognized in the literature for years and certainly the discovery of the PRSS1 gene in 1996 marked the beginning of a new era of genetic discoveries associated with the disease. Since then, multiple genes have been described as the causing agents of pancreatitis or disease modifiers, some of the most important ones being the PRSS1, SPINK1, CFTR, CASR, CTRC, CLDN2, and CPA1...
April 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28719390/total-pancreatectomy-with-islet-autotransplantation-recent-updates-and-outcomes
#7
Yoshitaro Shindo, Mazhar A Kanak
PURPOSE OF REVIEW: Total pancreatectomy with islet autotransplantation (TPIAT) is a reliable therapy to retain endocrine function, to alleviate pain and improve quality of life in adult and pediatric patients suffering from refractory chronic pancreatitis and recurrent acute pancreatitis. Recently, an expansion of indications to include benign and malignant pancreatic disease has been suggested. Improved methods for evaluating the functional quality of islets and predicting transplant outcome have been discussed...
October 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28583545/simultaneous-subtotal-pancreatectomy-and-streptozotocin-injection-for-diabetes-modeling-in-cynomolgus-monkeys
#8
H Park, J B Park, J H Kim, K W Lee, H S Lee, G-S Kim, D-Y Shin, S-H Oh, S-M Jin, S J Kim
BACKGROUND: In an experimental animal model of islet transplantation, stable induction of insulin-dependent diabetes mellitus (IDDM) and islet isolation from donor pancreas are essential. Total pancreatectomy for IDDM induction and islet procurement in nonhuman primates leads to unwanted loss of exocrine function and may lead to morbidities associated with IDDM. METHODS: IDDM induction with streptozotocin (STZ) is associated with drug toxicity of STZ and necessitates the killing of another animal for islet procurement...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28562418/autologous-islet-transplantation-challenges-and-lessons
#9
Ty B Dunn, Joshua J Wilhelm, Melena D Bellin, Timothy L Pruett
PURPOSE OF REVIEW: Human islet isolation and autotransplantation [autologous islet transplant (AUTX)] is performed to prevent or ameliorate brittle diabetes after total pancreatectomy performed for benign disease. The success or failure of the transplant can be associated with a profound impact on the individual's quality of life and even survival. AUTX offers unique insights into the effects of pancreas quality, islet number, isolation technique and alternate site engraftment on transplant efficacy...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28385584/a-study-of-the-clinical-utility-of-a-20-minute-secretin-stimulated-endoscopic-pancreas-function-test-and-performance-according-to-clinical-variables
#10
Luis F Lara, Morihito Takita, James S Burdick, Daniel C DeMarco, Ronnie R Pimentel, Tolga Erim, Marlon F Levy
BACKGROUND AND AIMS: Direct pancreas juice testing of bicarbonate, lipase, or trypsin after stimulation by secretin or cholecystokinin is used to determine exocrine function, a surrogate for diagnosing chronic pancreatitis (CP). Endoscopic pancreas function tests (ePFTs), where a peak bicarbonate concentration (PBC) ≥80 mEq/L in pancreas juice is considered normal, are now used more frequently. In this ePFT, aspirates start 35 minutes after secretin administration because pancreas output peaks 30 minutes after secretagogue administration...
April 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28325587/the-impact-of-allogenic-blood-transfusion-on-the-outcomes-of-total-pancreatectomy-with-islet-autotransplantation
#11
Gumpei Yoshimatsu, Rauf Shahbazov, Giovanna Saracino, Michael C Lawrence, Peter T Kim, Nicholas Onaca, Ernest E Beecherl, Bashoo Naziruddin, Marlon F Levy
BACKGROUND: Allogenic blood transfusion (ABT) may be needed for severe bleeding during total pancreatectomy with autotransplantation (TPIAT), but may induce inflammation. This study investigated the impact of ABT. METHODS: With a population of 83 patients who underwent TPIAT from 2006 to 2014, this study compared cytokine levels, patient characteristics, islet characteristics, metabolic outcomes, insulin requirements, and hemoglobin A1c for those who received a blood transfusion (BT) versus no blood transfusion (NBT)...
November 2017: American Journal of Surgery
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
#12
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 intraislet vascularization and paracrine cell signaling are mostly based on the rodent pancreas. We assessed 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 slices of fresh pancreas tissue obtained from nondiabetic patients undergoing partial pancreatectomy...
May 1, 2017: Endocrinology
https://www.readbyqxmd.com/read/28317340/production-of-pancreatic-progenitor-cells-from-human-induced-pluripotent-stem-cells-using-a-three-dimensional-suspension-bioreactor-system
#13
Yuichiro Mihara, Katsuhisa Matsuura, Yoshihiro Sakamoto, Teruo Okano, Norihiro Kokudo, Tatsuya Shimizu
Islet replacement is a promising strategy for the treatment of patients with type 1 diabetes and patients who have undergone total pancreatectomy. Recent progress in cellular reprogramming technology may allow the transplantation of a patient's own pancreatic cells. Although many studies have reported the differentiation of pancreatic progenitor cells from mouse and human pluripotent stem cells (PSCs), obtaining sufficient cell numbers for clinical applications remains problematic. Here, we describe the mass production of human pancreatic progenitor cells from human induced (i)PSCs using a three-dimensional suspension bioreactor system...
March 20, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/28169284/long-term-glycemic-control-in-adult-patients-undergoing-remote-vs-local-total-pancreatectomy-with-islet-autotransplantation
#14
COMPARATIVE STUDY
Samuel J Kesseli, Matthew Wagar, Min K Jung, Kerrington D Smith, Yu Kuei Lin, R Matthew Walsh, Betul Hatipoglu, Martin L Freeman, Timothy L Pruett, Gregory J Beilman, David E R Sutherland, Ty B Dunn, David A Axelrod, Sushela S Chaidarun, Tyler K Stevens, Melena Bellin, Timothy B Gardner
OBJECTIVES: Total pancreatectomy with islet autotransplantation (TPIAT) is increasingly performed with remote islet cell processing and preparation, i.e., with islet cell isolation performed remotely from the primary surgical site at an appropriately equipped islet isolation facility. We aimed to determine whether TPIAT using remote islet isolation results in comparable long-term glycemic outcomes compared with TPIAT performed with standard local isolation. METHODS: We performed a retrospective cohort study of adult patients who underwent TPIAT at three tertiary care centers from 2010 to 2013...
April 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27870552/glycemic-predictors-of-insulin-independence-after-total-pancreatectomy-with-islet-autotransplantation
#15
Michael Quartuccio, Erica Hall, Vikesh Singh, Martin A Makary, Kenzo Hirose, Niraj Desai, Christi Walsh, Daniel Warren, Zhaoli Sun, Ellen Stein, Rita R Kalyani
Context: Total pancreatectomy with islet auto transplantation (TPIAT) is a treatment for medically refractory chronic pancreatitis that can prevent postsurgical diabetes in some patients. Predictors of insulin independence are needed for appropriate patient selection and counseling. Objective: To explore glycemic predictors of insulin independence after TPIAT. Design: A prospective cohort of patients. Methods: We investigated 34 patients undergoing TPIAT from 2011-2016 at Johns Hopkins Hospital, all had a 75-g oral glucose tolerance test (OGTT) administered prior to their TPIAT...
March 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27760705/clinical-effectiveness-of-a-pylorus-preserving-procedure-on-total-pancreatectomy-with-islet-autotransplantation
#16
Rauf Shahbazov, Gumpei Yoshimatsu, Waqas Z Haque, Omar S Khan, Giovanna Saracino, Michael C Lawrence, Peter T Kim, Nicholas Onaca, Bashoo Naziruddin, Marlon F Levy
BACKGROUND: The impact of pylorus preserving procedures (PP) on total pancreatectomy with islet autotransplantation (TPIAT) has not been examined. This study aimed to investigate the clinical impact of the PP on TPIAT. METHODS: The Baylor Simmons Transplant Institute database was queried to identify seventy-three patients who underwent TPIAT from 2006 to 2014. All patients were investigated in postoperative complications, long-term nutritional status, and graft function...
June 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/27643615/unmethylated-insulin-dna-is-elevated-after-total-pancreatectomy-with-islet-autotransplantation-assessment-of-a-novel-beta-cell-marker
#17
M D Bellin, P Clark, S Usmani-Brown, T B Dunn, G J Beilman, S Chinnakotla, T L Pruett, P Ptacek, B J Hering, Z Wang, T Gilmore, J J Wilhelm, J S Hodges, A Moran, K C Herold
Beta cell death may occur both after islet isolation and during infusion back into recipients undergoing total pancreatectomy with islet autotransplantation (TPIAT) for chronic pancreatitis. We measured the novel beta cell death marker unmethylated insulin (INS) DNA in TPIAT recipients before and immediately after islet infusion (n = 21) and again 90 days after TPIAT, concurrent with metabolic functional assessments (n = 25). As expected, INS DNA decreased after pancreatectomy (p = 0.0002). All TPIAT recipients had an elevated unmethylated INS DNA ratio in the first hours following islet infusion...
April 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/27623240/the-impact-of-bacterial-colonization-on-graft-success-after-total-pancreatectomy-with-autologous-islet-transplantation-considerations-for-early-definitive-surgical-intervention
#18
Joshua S Jolissaint, Linda W Langman, Claire L DeBolt, Jacob A Tatum, Allison N Martin, Andrew Y Wang, Daniel S Strand, Victor M Zaydfudim, Reid B Adams, Kenneth L Brayman
OBJECTIVE: The purpose of this study was to determine whether bacterial contamination of islets affects graft success after total pancreatectomy with islet autotransplantation (TPIAT). BACKGROUND: Factors associated with insulin independence after TPIAT are inconclusive. Although bacterial contamination does not preclude transplantation, the impact of bacterial contamination on graft success is unknown. METHODS: Patients who received TPIAT at the University of Virginia between January 2007 and January 2016 were reviewed...
November 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27610653/spontaneous-hypoglycemia-after-islet-transplantation-the-case-for-using-non-hepatic-sites
#19
REVIEW
R Paul Robertson
This Perspective provides a brief history of intrahepatic alloislet and autoislet transplantation in humans and an update of the recent success rates. It also examines the important role that hypoglycemia plays in clinical outcomes. On the one hand, recurrent serious hypoglycemic episodes related to insulin therapy are a major criterion for alloislet transplantation. On the other hand, spontaneous clinical hypoglycemia, perhaps related to the accompanying Roux-en-Y procedure for total pancreatectomy, is a complication of autoislet transplantation...
October 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27465328/gastric-submucosa-is-inferior-to-the-liver-as-transplant-site-for-autologous-islet-transplantation-in-pancreatectomized-diabetic-beagles
#20
Zhu-Zeng Yin, Shu-Sen Wang, Qiang Li, Ying Huang, Li Chen, Gang Chen, Rong Liu, Xi-Mo Wang
Intraportal transplantation of islets is no longer considered to be an ideal procedure and finding the extrahepatic alternative site is becoming a subject of high priority. Herein, in this study, we would introduce our initial outcomes of using gastric submucosa (GS) and liver as sites of islet autotransplantation in pancreatectomized diabetic Beagles. Total pancreatectomy was performed in Beagles and then their own islets extracted from the excised pancreas were transplanted into GS (GS group, n=8) or intrahepatic via portal vein (PV group, n=5)...
August 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
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