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Simultaneous pancreas kidney transplantation

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https://www.readbyqxmd.com/read/29893956/pancreas-outcomes-between-living-and-deceased-kidney-donor-in-pancreas-after-kidney-transplantation-patients
#1
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
https://www.readbyqxmd.com/read/29885442/dual-antibody-induction-and-de-novo-use-of-everolimus-enable-low-dose-tacrolimus-with-early-corticosteroid-withdrawal-in-simultaneous-pancreas-kidney-transplantation
#2
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
https://www.readbyqxmd.com/read/29880375/preoperative-muscle-volume-predicts-graft-survival-after-pancreas-transplantation-a-retrospective-observational-cohort-study
#3
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
https://www.readbyqxmd.com/read/29880374/pancreas-transplantation-at-a-single-latin-american-center-overall-results-with-type-1-and-type-2-diabetes-mellitus
#4
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
https://www.readbyqxmd.com/read/29878910/defining-kidney-allograft-benefit-from-successful-pancreas-transplant-separating-fact-from-fiction
#5
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
https://www.readbyqxmd.com/read/29809315/clinical-characteristics-and-outcomes-of-late-onset-bk-virus-nephropathy-in-kidney-and-kidney-pancreas-transplant-recipients
#6
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
https://www.readbyqxmd.com/read/29798972/usefulness-of-pancreas-donor-risk-index-and-pre-procurement-pancreas-allocation-suitability-score-results-of-the-polish-national-study
#7
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
https://www.readbyqxmd.com/read/29791046/impact-of-intensive-dosing-of-mycophenolate-on-pancreas-allograft-survival
#8
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
https://www.readbyqxmd.com/read/29781845/redefining-the-influence-of-ethnicity-on-simultaneous-kidney-and-pancreas-transplantation-outcomes-a-15-year-single-center-experience
#9
Carlton J Young, Paul A MacLennan, Elinor C Mannon, Rhiannon D Reed, Brittany A Shelton, Michael J Hanaway, Gaurav Agarwal, Robert S Gaston, Bruce A Julian, Clifton E Kew, Vineeta Kumar, Roslyn B Mannon, Shikha Mehta, Song C Ong, Graham C Towns, Mark H Deierhoi, Jayme E Locke
OBJECTIVE: To examine the largest single-center experience of simultaneous kidney/pancreas transplantation (SPK) transplantation among African-Americans (AAs). BACKGROUND: Current dogma suggests that AAs have worse survival following SPK than white recipients. We hypothesize that this national trend may not be ubiquitous. METHODS: From August 30, 1999, through October 1, 2014, 188 SPK transplants were performed at the University of Alabama at Birmingham (UAB) and 5523 were performed at other US centers...
May 17, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29776756/sex-hormone-binding-globulin-is-a-biomarker-associated-with-nonvertebral-fracture-in-men-on-dialysis-therapy
#10
Jasna Aleksova, Phillip Wong, Robert McLachlan, Kay Weng Choy, Peter R Ebeling, Frances Milat, Grahame J Elder
Gonadal hormones impact bone health and higher values of sex hormone-binding globulin (SHBG) have been independently associated with fracture risk in men without chronic kidney disease. People with chronic kidney disease have a greatly increased fracture risk, and gonadal dysfunction is common in men receiving dialysis treatment. Nevertheless, in these men the effect of gonadal steroids and SHBG on bone mineral density (BMD) and fracture risk is unknown. Here we investigate relationships between gonadal steroids, SHBG, BMD and fracture in men on long-term dialysis therapy, awaiting kidney or simultaneous pancreas kidney transplantation...
May 15, 2018: Kidney International
https://www.readbyqxmd.com/read/29741276/pancreatic-panniculitis-a-case-series-from-a-tertiary-university-hospital-in-spain
#11
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/29720961/osteoporosis-therapy-with-denosumab-in-organ-transplant-recipients
#12
Jana Brunova, Simona Kratochvilova, Jitka Stepankova
Objective: Osteoporosis and fragility fractures represent serious complications for the solid organ transplant population. The recommended osteoporosis therapy for organ recipients involves supplementation with calcium and vitamin D and bisphosphonate administration. However, these options can prove limited for patients with impaired renal function. An alternative therapy option is offered by denosumab, a monoclonal antibody that targets receptor activator of nuclear factor kappa-B ligand...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29683218/outcome-of-patients-with-hemodialysis-or-peritoneal-dialysis-undergoing-simultaneous-pancreas-kidney-transplantation-comparative-study
#13
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 intra-abdominal 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 made to analyze post-transplant complications and patient, pancreas, and kidney graft survivals...
April 23, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29681134/an-audit-of-pregnancy-outcomes-in-solid-organ-transplant-recipients-at-a-metropolitan-hospital
#14
Yunjing E Fang, Roshini Nayyar, Hayley Diplock
BACKGROUND: Pregnancies in patients with solid organ transplants have higher rates of complications and caesarean sections (CS). AIM: To perform an audit of the pregnancy outcomes in transplant recipients, to determine the rate of CS in our cohort, the appropriate skin incision for CS in these patients and to formulate recommendations for preoperative planning. MATERIALS AND METHODS: This is a retrospective cohort study. All patients who had a solid organ transplant were identified from the obstetrics database...
April 22, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29661440/renopancreatic-transplantation-evaluation-of-15-years-in-131-patients
#15
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/29625745/evaluation-of-a-single-pass-with-biphasic-intravenous-contrast-medium-injection-ct-protocol-for-the-assessment-of-complications-post-simultaneous-pancreas-kidney-transplant
#16
D Y-F Chung, E M Anderson
AIM: To evaluate the use of a single-pass with biphasic intravenous contrast medium injection computed tomography (CT) protocol to provide diagnostic quality CT studies for the assessment of complications post-simultaneous pancreas-kidney transplant (SPK). MATERIALS AND METHODS: This was an audit of practice and the need for informed consent was waived. The protocol was used in consecutive patients undergoing CT to exclude intra-abdominal sepsis post-SPK between June and December 2015...
July 2018: Clinical Radiology
https://www.readbyqxmd.com/read/29622761/simultaneous-pancreas-kidney-transplantation-in-a-patient-with-heparin-induced-thrombocytopenia-on-dabigatran-therapy
#17
Agnieszka Jóźwik, Wojciech Lisik, Jarosław Czerwiński, Maciej Kosieradzki
BACKGROUND New oral anticoagulants like direct thrombin inhibitors are an attractive alternative to vitamin K antagonists as anticoagulation therapy and can be used in heparin-induced thrombocytopenia. They are convenient in low-risk surgery, as there is no need for bridging with heparins. Patients who need urgent major surgery are at similar risk as on warfarin therapy, which, however, is much higher than in elective procedures. Due to their elimination profiles, these drugs are generally contraindicated in patients with severe renal insufficiency...
April 6, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29604531/the-successful-salvage-of-a-thrombosed-pancreatic-graft-at-the-early-postoperative-period-of-a-simultaneous-pancreas-and-kidney-transplantation
#18
Rauf Shahbazov, Feredun Azari, Park Auh Whan, Liu Wei, Avinash Agarwal, Kenneth L Brayman
INTRODUCTION: Simultaneous kidney and pancreas transplant is the preferred treatment option for end-stage renal disease due to type 1 diabetic nephropathy. Vascular complications are detrimental to graft survival and can lead to graft loss in the early postoperative phase of transplantation. Generally, duplex Doppler ultrasound is used for vascular patency monitoring and pancreatectomy followed by re-transplantation is required in the majority of cases. Recently, pancreatic graft salvage with non-operative management, including medical anticoagulation and endovascular thrombectomy, in the early postoperative period has been described with success...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29579886/pancreas-donor-hypernatremia-is-it-really-a-risk-factor-for-simultaneous-pancreas-kidney-transplantation
#19
J M Sánchez-Hidalgo, L Rodríguez-Ortiz, A Arjona-Sánchez, J Ruiz-Rabelo, J J Salamanca-Bustos, A Rodríguez-Benot, F J Márquez-López, J Briceño-Delgado
INTRODUCTION: Solid organ donor hypernatremia has been classically reported to be a risk factor for cell lysis and graft damage. National criteria for pancreatic donation consider severe hypernatremia (sodium level more than 160 mEq/L) to be relative exclusion criteria. The aim of our study is to review the postoperative outcomes of our simultaneous pancreas-kidney transplantation (SPKT) sample in terms of pancreatic fistula, intra-abdominal abscesses, pancreatitis, pancreas graft thrombosis, early pancreatectomy, and reoperation rates regarding different ranges of donor sodium levels...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29579885/intraoperative-heparinization-during-simultaneous-pancreas-kidney-transplantation-is-it-really-necessary
#20
A Arjona-Sánchez, L Rodríguez-Ortiz, J M Sánchez-Hidalgo, J Ruiz Rabelo, J J Salamanca-Bustos, A Rodríguez-Benot, P Campos-Hernández, J Briceño-Delgado
INTRODUCTION: The use of intraoperative sodium heparin during simultaneous pancreas-kidney transplantation (SPKT) remains as a routine practice in some referral centers to minimize pancreatic graft thrombosis rate. One of its disadvantages is the theoretical increased risk of postoperative bleeding. In our center, we have abandoned its use since 2011. MATERIALS AND METHODS: We performed a retrospective analysis among 198 SPKTs performed in our center between the years 1989 and 2017...
March 2018: Transplantation Proceedings
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