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Simultaneous pancreas kidney transplantation

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https://www.readbyqxmd.com/read/29428804/links-between-a-biomarker-profile-cold-ischaemic-time-and-clinical-outcome-following-simultaneous-pancreas-and-kidney-transplantation
#1
Hussein A Khambalia, M Yvonne Alexander, Mahesan Nirmalan, Ria Weston, Phillip Pemberton, Zia Moinuddin, Angela Summers, David van Dellen, Titus Augustine
In sepsis, trauma and major surgery, where an explicit physiological insult leads to a significant systemic inflammatory response, the acute evolution of biomarkers have been delineated. In these settings, Interleukin (IL) -6 and TNF-α are often the first pro-inflammatory markers to rise, stimulating production of acute phase proteins followed by peaks in anti-inflammatory markers. Patients undergoing SPKT as a result of diabetic complications already have an inflammatory phenotype as a result of uraemia and glycaemia...
February 8, 2018: Cytokine
https://www.readbyqxmd.com/read/29359836/factors-and-outcomes-in-association-with-sepsis-differ-between-simultaneous-pancreas-kidney-and-single-kidney-transplant-recipients
#2
Thomas Schachtner, Marina Zaks, Natalie M Otto, Andreas Kahl, Petra Reinke
As immunosuppressive therapy has improved in simultaneous pancreas/kidney transplant recipients (SPKTRs), infection has become the major limitation of disease-free survival. We studied all SPKTRs and deceased-donor kidney transplant recipients (KTRs) between 2003 and 2015. 36/134 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 (11.3%) with sepsis were used for comparison. Among SPKTRs, female sex, low BMI, CMV-seronegativity, CMV-disease, and acute cellular rejection increased the risk for sepsis (p<0...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29300330/alpha-lipoic-acid-a-therapeutic-strategy-that-tend-to-limit-the-action-of-free-radicals-in-transplantation
#3
REVIEW
Nella Ambrosi, Diego Guerrieri, Fiorella Caro, Francisco Sanchez, Geraldine Haeublein, Domingo Casadei, Claudio Incardona, Eduardo Chuluyan
Organ replacement is an option to mitigate irreversible organ damage. This procedure has achieved a considerable degree of acceptance. However, several factors significantly limit its effectiveness. Among them, the initial inflammatory graft reaction due to ischemia-reperfusion injury (IRI) has a fundamental influence on the short and long term organ function. The reactive oxygen species (ROS) produced during the IRI actively participates in these adverse events. Therapeutic strategies that tend to limit the action of free radicals could result in beneficial effects in transplantation outcome...
January 4, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29259387/simultaneous-liver-pancreas-duodenum-and-kidney-transplantation-in-a-patient-with-hepatitis-b-cirrhosis-uremia-and-insulin-dependent-diabetes-mellitus
#4
Jiang Li, Qing-Jun Guo, Jin-Zhen Cai, Cheng Pan, Zhong-Yang Shen, Wen-Tao Jiang
Simultaneous liver, pancreas-duodenum, and kidney transplantation has been rarely reported in the literature. Here we present a new and more efficient en bloc technique that combines classic orthotopic liver and pancreas-duodenum transplantation and heterotopic kidney transplantation for a male patient aged 44 years who had hepatitis B related cirrhosis, renal failure, and insulin dependent diabetes mellitus (IDDM). A quadruple immunosuppressive regimen including induction with basiliximab and maintenance therapy with tacrolimus, mycophenolate mofetil, and steroids was used in the early stage post-transplant...
December 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29233098/intractable-ascites-associated-with-mycophenolate-in-a-simultaneous-kidney-pancreas-transplant-patient-a-case-report
#5
Nina T Weber, Ali Sigaroudi, Alexander Ritter, Andreas Boss, Kuno Lehmann, David Goodman, Stefan Farese, Stefan Weiler, Thomas F Mueller
BACKGROUND: Mycophenolic acid (MPA), either given as an ester pro-drug or as an enteric-coated sodium salt, is the most commonly prescribed anti-proliferative immunosuppressive agent used following organ transplantation and widely applied in immune-mediated diseases. Clinicians are well aware of common adverse reactions related to MPA treatment, in particular diarrhea, leukopenia and infections. Here we report a case of severe, persistent ascites associated with MPA treatment. The otherwise unexplained and intractable ascites, requiring repeated paracenteses for more than 8 months, rapidly ceased with stopping the MPA treatment...
December 12, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29233018/type-1-diabetic-patients-have-better-endothelial-function-after-simultaneous-pancreas-kidney-transplantation-than-after-kidney-transplantation-with-continued-insulin-therapy
#6
Jacek Ziaja, Adrian P Kowalik, Aureliusz Kolonko, Dorota Kamińska, Aleksander J Owczarek, Agata Kujawa-Szewieczek, Mariusz A Kusztal, Joanna Badura, Dominika Bożek-Pająk, Piotr Choręza, Agnieszka Zakrzewska, Robert Król, Stefan Chłopicki, Marian Klinger, Andrzej Więcek, Jerzy Chudek, Lech Cierpka
The purpose of this study was to analyse the influence of simultaneous pancreas-kidney or kidney transplantation on endothelial function and systemic inflammation in type 1 diabetic patients with end-stage renal disease. In 39 simultaneous pancreas-kidney, 39 type 1 diabetic kidney and 52 non-diabetic kidney recipients, flow-mediated dilatation was measured. Additionally, blood glycated haemoglobin, serum creatinine and lipids, plasma nitrites [Formula: see text] and nitrates, asymmetric dimethylarginine, soluble vascular cell adhesion molecule-1, intercellular adhesion molecule-1, and E-selectin, high-sensitivity C-reactive protein, tumour necrosis factor-α, interleukin 1β and interleukin 6 concentrations were assessed...
December 1, 2017: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/29225054/the-clinical-efficacy-of-seasonal-influenza-vaccination-characteristics-of-two-outbreaks-of-influenza-a-h1n1-in-immunocompromised-patients
#7
Ilkka Helanterä, Rita Janes, Veli-Jukka Anttila
BACKGROUND: Influenza A(H1N1) causes serious complications in immunocompromised patients. The efficacy of seasonal vaccination in these patients has been questioned. AIMS: We describe two outbreaks of influenza A(H1N1) in immunocompromised patients. METHODS: Two outbreaks of influenza A(H1N1) occurred in our institution: on the kidney transplant ward in 2014 including patients early after kidney or simultaneous pancreas-kidney transplantation, and on the oncology ward in 2016 including patients receiving chemotherapy for malignant tumors...
December 7, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29215537/simultaneous-pancreas-and-kidney-transplantation-is-associated-with-inferior-long-term-outcomes-in-african-americans
#8
Joseph T Brooks, Rong Liu, Madeleine Oliver, Anthony DeLeonibus, Jingning Mei, Donald White, Eric Siskind, Jorge Ortiz
OBJECTIVES: Simultaneous pancreas and kidney transplant (SPK) is the most effective treatment for patients with type 1 diabetes mellitus and renal failure. However, the effect of ethnicity on SPK outcomes is not well understood. METHODS: We studied the influence of recipient ethnicity on SPK using the United Network for Organ Sharing database. A retrospective review of 20,196 SPK patients from 1989 to 2014 was performed. The recipients were divided into 4 groups: 15,833 whites (78...
January 2018: Pancreas
https://www.readbyqxmd.com/read/29198669/broadened-allocation-of-pancreas-transplants-across-compatible-abo-blood-types
#9
J A Fridell, S K Gustafson, B W Thompson, A C Fox, M A Prentice, M A Curry, J S Odorico
BACKGROUND: Current Organ Procurement and Transplantation Network (OPTN) policy restricts certain blood type-compatible simultaneous pancreas and kidney (SPK) transplants. Using the Kidney Pancreas Simulated Allocation Model, we examined the effects of 5 alternative allocation sequences that allowed all clinically compatible ABO transplants. METHODS: The study cohort included kidney (KI), SPK, and pancreas alone (PA) candidates waiting for transplant for at least 1 day between January 1, 2010, and December 31, 2010 (full cohort), and kidneys and pancreata recovered for transplant during the same period...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29198668/a-case-of-successful-simultaneous-pancreas-kidney-transplantation-using-the-injured-pancreas-graft
#10
S Miyagi, K Shimizu, K Miyazawa, W Nakanishi, Y Hara, K Tokodai, C Nakanishi, S Satomi, M Goto, M Unno, T Kamei
OBJECTIVE: Graft injuries sometimes occur and may cause complications such as the leakage of pancreatic secretions, which is often lethal. We report our experience of a case of successful simultaneous pancreas-kidney transplantation using injured pancreas graft. PATIENTS AND METHODS: The recipient was a 57-year-old woman with type 1 diabetes mellitus, and the donor was a 30-year-old man with a brain injury. In the donation, the pancreas parenchyma, splenic artery, and gastroduodenal artery were injured iatrogenically...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29198667/donation-after-circulatory-arrest-in-pancreas-transplantation-a-report-of-10-cases
#11
J A Fridell, R S Mangus, C M Thomas, C A Kubal, J A Powelson
INTRODUCTION: Transplantation of pancreas allografts procured from donation after circulatory death (DCD) remains uncommon. This study reviews a series of pancreas transplants at a single center to assess the donor and recipient characteristics for DCD pancreas transplant and to compare clinical outcomes. METHODS: DCD procurement was performed with a 5-minute wait time from pronouncement of death to first incision. In 2 patients, tissue plasminogen activator was infused as a thrombolytic during the donor flush...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29198666/the-pancreas-can-take-the-cold-lower-waitlist-times-through-importation
#12
K Choinski, J P Rocca, J Torabi, K Lorenzen, C Yongue, M E Herbert, T Block, A Chokechanachaisakul, L Kamal, M Kinkhabwala, J A Graham
BACKGROUND: Our center has used a strategy of pancreas importation owing to long regional waitlist times. Here we assess the clinical outcomes and financial considerations of this strategy. METHODS: This was a retrospective observational cohort study of patients who received a pancreas transplant at Montefiore Medical Center (MMC) from 2014 to 2017 (n = 28). Clinical parameters, including hemoglobin A1c and complications, were analyzed. The cohort was compared with United Network for Organ Sharing (UNOS) Region 9 with the use of the UNOS/Organ Procurement and Transplantation Network database...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29160954/islet-allo-autotransplantation-allogeneic-pancreas-transplantation-followed-by-transplant-pancreatectomy-and-islet-transplantation
#13
M F Nijhoff, J Dubbeld, A R van Erkel, P J M van der Boog, T J Rabelink, M A Engelse, E J P de Koning
Simultaneous pancreas/kidney (SPK) transplantation is an important treatment option for patients with type 1 diabetes (T1D) and end stage renal disease (ESRD). Due to complications, in up to 10% of cases allograft pancreatectomy is necessary shortly after transplantation. Usually the donor pancreas is discarded. Here we report on a novel procedure to rescue endocrine tissue after allograft pancreatectomy. A 39-year-old woman with T1D and ESRD who had received an SPK transplantation required emergency allograft pancreatectomy due to bleeding at the vascular anastomosis...
November 21, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29140549/improving-pancreas-graft-utilization-through-importation
#14
Julia Torabi, Juan P Rocca, Krystina Choinski, Katherine Lorenzen, Camille Yongue, Michelle L Lubetzsky, Melvon E Herbert, Attasit Chokechanachaisakul, Maria Ajaimy, Layla Kamal, Enver Akalin, Milan Kinkhabwala, Jay A Graham
BACKGROUND: We analyze our outcomes utilizing imported allografts as a strategy to shorten wait list time for pancreas transplantation. METHODS: This is an observational retrospective cohort of 26 recipients who received either a locally procured (n=16) or an imported pancreas graft (n=10) at our center between January 2014 and May 2017. Wait list times of this cohort were compared to UNOS Region 9 (New York State and Western Vermont). Hospital financial data was also reviewed to analyze the cost effectiveness of this strategy...
November 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29138633/influence-of-spk-with-enteric-drainage-on-the-pancreatic-exocrine-function-in-diabetic-patients-with-uremia
#15
Guanghui Pei, Wu Lv, Xiaohang Li, Guoqing Zhang, Jialin Zhang
Objective: This study aimed to determine the use of fecal elastase in evaluating the effect of simultaneous pancreas-kidney transplantation with enteric drainage on the pancreatic exocrine function of diabetic patients with uremia. Methods: A total of 19 patients with simultaneous pancreas-kidney transplantation (SPK) with enteric drainage, 31 diabetic patients with uremia (chronic renal failure (CRF)), 22 diabetic patients with uremia who underwent renal transplantation (RT), and 20 normal individuals (CON) were included in the study...
2017: International Journal of Endocrinology
https://www.readbyqxmd.com/read/29095903/association-between-the-pancreas-transplantation-and-survival-of-patients-with-diabetes-a-single-center-experience
#16
Ji Yoon Choi, Joo Hee Jung, Sung Shin, Young Hoon Kim, Duck Jong Han
Pancreas transplantation is considered a therapeutic option for patients with complicated diabetes mellitus. In this study, we compared survival rate between patients on the waiting list for pancreas transplant alone(PTA), simultaneous pancreas-kidney(SPK) transplant, and pancreas after kidney(PAK) transplant and transplant recipients. A total of 503 patients (PTA:n = 116; SPK:n = 303; PAK:n = 84) and 280 PT recipients (PTA:n = 89; SPK:n = 155; PAK:n = 36) were retrospectively analyzed at our center between February 2000 and December 2015; 11...
2017: PloS One
https://www.readbyqxmd.com/read/29089105/simultaneous-pancreas-kidney-transplantation-experience-of-the-doce-de-octubre-hospital
#17
Carlos Jiménez-Romero, Alberto Marcacuzco Quinto, Alejandro Manrique Municio, Iago Justo Alonso, Jorge Calvo Pulido, Félix Cambra Molero, Óscar Caso Maestro, Álvaro García-Sesma, Enrique Moreno González
INTRODUCTION: Simultaneous pancreas-kidney transplantation (SPKT) constitutes the therapy of choice for diabetes type1 or type2 associated with end-stage renal disease, because is the only proven method to restore normo-glicemic control in the diabetic patient. METHODS: Retrospective and descriptive study of a series of 175 patients who underwent SPKT from March 1995 to April 2016. We analyze donor and recipient characteristics, perioperative variables and immunosuppression, post-transplant morbi-mortality, patient and graft survival, and risk factors related with patient and graft survival...
October 28, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29026874/australia-and-new-zealand-islets-and-pancreas-transplant-registry-annual-report-2017-pancreas-waiting-list-recipients-and-donors
#18
Angela C Webster, James Hedley, Abhijit Patekar, Paul Robertson, Patrick J Kelly
This is a registry report from the Australia and New Zealand Islet and Pancreas Transplant Registry. We report data for all solid organ pancreas transplant activity from inception in 1984 to end of 2016. Data analysis was performed using Stata Software version 14 (StataCorp, College Station, Tex). From 1984 to 2016 a total of 756 solid organ pancreas transplants have been performed in Australia and New Zealand, in 738 individuals. In 2016, 55 people received a pancreas transplant. These transplants were performed in Auckland (4), Monash (22), and Westmead (29)...
October 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29024476/prevalence-and-outcomes-of-cystic-lesions-of-the-transplant-pancreas-the-university-of-wisconsin-experience
#19
Talal M Al-Qaoud, Eric J Martinez, Hans W Sollinger, Dixon B Kaufman, Robert R Redfield, Bridget Welch, Glen Leverson, Jon S Odorico
Literature on the behavior of cystic lesions in pancreas transplants is scarce, and hence a better understanding is warranted. Data on recipients and their respective donors that underwent simultaneous kidney and pancreas, pancreas transplant alone, and pancreas after kidney between 1994-2015 were reviewed (n=1185). Cystic lesions of the transplant pancreas developed in 22 patients (1.8%): 12 pseudocysts, 2 cysts/remnants, 4 intraductal papillary mucinous neoplasms (IPMN), 2 adenocarcinomas, 1 low grade intraepithelial pancreatic neoplasia, and 1 case of polycystic kidney disease...
October 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28975104/proliferative-glomerulonephritis-with-monoclonal-igg-deposits-an-unusual-cause-of-de-novo-disease-in-kidney-allograft
#20
Sabiha M Hussain, Kalathil K Sureshkumar
BACKGROUND: Proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) is a newly described and rare entity that can develop in native and very rarely in transplanted kidneys. We present a patient who developed de novo PGNMID in the kidney allograft along with a review of the literature. CASE PRESENTATION: A 38-year old female with type 1 diabetes who underwent successful simultaneous pancreas-kidney (SPK) transplantation 6 years earlier presented with rising serum creatinine, nephrotic range proteinuria and microhematuria...
July 2017: Journal of Nephropathology
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