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Simultaneous pancreas kidney transplantation

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https://www.readbyqxmd.com/read/28509373/bk-viremia-surveillance-and-outcomes-in-simultaneous-pancreas-kidney-transplant-recipients
#1
Scott G Westphal, Elizabeth R Lyden, Eric D Langewisch, Clifford D Miles
BACKGROUND: While screening for asymptomatic BK viremia (BKV) has been well studied in isolated kidney transplant recipients, there is a paucity of published outcomes in simultaneous pancreas-kidney (SPK) transplant recipients who underwent BKV screening followed by pre-emptive reduction of immunosuppression. METHODS: This is a single-center, retrospective review of 31 consecutive SPK recipients who were transplanted over a five year period following the initiation of a serum BKV screening protocol...
May 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28500781/pregnancy-outcomes-in-simultaneous-pancreas-and-kidney-transplant-recipients-a-national-french-survey-study
#2
G Normand, F Brunner, L Badet, F Buron, M Catton, J Massardier, L Esposito, P Grimbert, G Mourad, J E Serre, S Caillard, G Karam, D Cantarovich, E Morelon, O Thaunat
Simultaneous pancreas and kidney transplantation (SPK) is currently the best therapeutic option for patients with type-1 diabetes and terminal renal failure. Renal transplantation restores fertility enabling women to pursue pregnancies. However, scarcity of available data on pregnancy outcomes in SPK impedes fair medical counseling. Medical files of all pregnancies that lasted ≥3 months among recipients of functional SPK performed between 1990 and 2015 in France were retrospectively analyzed. Twenty-six pregnancies in 22 SPK recipients were identified...
May 13, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28480091/duodenal-graft-perforation-after-simultaneous-pancreas-kidney-transplantation
#3
Akihito Sannomiya, Ichiro Nakajima, Yuichi Ogawa, Kotaro Kai, Ichiro Koyama, Shohei Fuchinoue
A 45-year-old woman with type 1 diabetes and chronic renal failure on dialysis underwent simultaneous pancreas-kidney transplantation from a brain dead donor. On postoperative day 15, acute generalized peritonitis was diagnosed and emergency laparotomy was performed. Perforation of the donor duodenum was found, which had apparently resulted from duodenal compression by the tip of the intestinal fistula tube placed for decompression. The perforation was sutured and the intestinal fistula tube was exchanged. Following this, perforation repeatedly recurred at the same site and open repair at laparotomy was required a total of four times...
2017: Case Reports in Transplantation
https://www.readbyqxmd.com/read/28466634/update-on-pancreatic-transplantation-on-the-management-of-diabetes
#4
Carlo Lombardo, Vittorio G Perrone, Gabriella Amorese, Fabio Vistoli, Walter Baronti, Piero Marchetti, Ugo Boggi
Pancreas transplantation is the only therapy that can restore insulin independence in beta-cell penic diabetic recipients. Because of the need for life-long immunosuppression and the intial surgical risk associated with the transplant procedure, Pancreas transplantation is a therapeutic option only in selected diabetic patients. Based on renal function, three main populations of diabetic recipients of a pancreas transplant can be identified: uremic patients, post-uremic patients (following successful kidney transplantation), and non-uremic patients...
May 2, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28444815/endoscopic-findings-following-retroperitoneal-pancreas-transplantation
#5
Alexey Valer'evich Pinchuk, Ilya Victorovich Dmitriev, Nonna Valer'evna Shmarina, Yury Sergeevich Teterin, Aslan Galievich Balkarov, Roman Vasil'evich Storozhev, Yuri Andreevich Anisimov, Ali Magomedovich Gasanov
AIM: An evaluation of the efficacy of endoscopic methods for the diagnosis and correction of surgical and immunological complications after retroperitoneal pancreas transplantation. MATERIALS AND METHODS: From October 2011 to March 2015, 27 patients underwent simultaneous retroperitoneal pancreas-kidney transplantation (SPKT). Diagnostic oesophagogastroduodenoscopy (EGD) with protocol biopsy of the donor and recipient duodenal mucosa and endoscopic retrograde pancreatography (ERP) were performed to detect possible complications...
April 26, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28437790/utility-in-treating-kidney-failure-in-end-stage-liver-disease-with-simultaneous-liver-kidney-transplantation
#6
Xingxing S Cheng, Margaret R Stedman, Glenn M Chertow, W Ray Kim, Jane C Tan
BACKGROUND: Simultaneous liver-kidney (SLK) transplantation plays an important role in treating kidney failure in patients with end-stage liver disease. It used 5% of deceased donor kidney transplanted in 2015. We evaluated the utility, defined as posttransplant kidney allograft lifespan, of this practice. METHODS: Using data from the Scientific Registry of Transplant Recipients, we compared outcomes for all SLK transplants between January 1, 1995, and December 3, 2014, to their donor-matched kidney used in kidney-alone (Ki) or simultaneous pancreas kidney (SPK) transplants...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28349124/alemtuzumab-induction-and-delayed-acute-rejection-in-steroid-free-simultaneous-pancreas-kidney-transplant-recipients
#7
Jonna R Bank, Sebastiaan Heidt, Dirk Jan A R Moes, Dave L Roelen, Marko J K Mallat, Paul J M van der Boog, Manon Vergunst, Cornelia M Jol-van der Zijde, Robbert G M Bredius, Andries E Braat, Jan Ringers, Maarten J D van Tol, Frans H J Claas, Marlies E J Reinders, Johannes W de Fijter
BACKGROUND: The optimal immunosuppressive regimen in simultaneous pancreas-kidney transplant (SPKT) recipients that prevents acute rejection episodes (AREs) and allows optimal outcome remains elusive. METHODS: This cohort study assessed incidence and time to AREs in 73 consecutive SPKT recipients receiving alemtuzumab induction and steroid-free maintenance with tacrolimus and mycophenolate mofetil. A cohort with single high-dose antithymocyte globulin (ATG; n = 85) and triple therapy served as controls...
January 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28342278/simultaneous-pancreas-and-kidney-transplantation-incidence-and-risk-factors-for-amputation-after-10-year-follow-up
#8
Eoin MacCraith, Niall F Davis, Cliodhna Browne, Ponnusamy Mohan, David Hickey
INTRODUCTION: The incidence of amputation after simultaneous pancreas and kidney (SPK) transplantation ranges from 9.5% to 23% after 5 years of follow-up. The objective of this study was to investigate the incidence and risk factors for amputation in SPK transplant patients compared to kidney transplantation alone (KTA) after a minimum follow-up of 10 years. METHODS: An analysis was performed on a prospectively maintained database of 81 SPK transplants and 43 KTA consecutively performed in one center for insulin-dependent diabetes mellitus between December 1992 and January 2006...
March 25, 2017: Clinical 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
#9
Adam D Barlow, Kourosh Saeb-Parsy, Christopher J E Watson
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. 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. Unadjusted patient and kidney graft survival were calculated using the Kaplan-Meier method...
March 20, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28273393/a-retrospective-study-to-describe-the-epidemiology-and-outcomes-of-opportunistic-infections-after-abdominal-organ-transplantation
#10
Mia Helfrich, Peter Dorschner, Kathryn Thomas, Valentina Stosor, Michael G Ison
BACKGROUND: Most epidemiologic studies of opportunistic infections (OI) following abdominal organ transplantation 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 abdominal organ transplant 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/28267898/laparoscopic-biopsies-in-pancreas-transplantation
#11
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/28260427/annual-data-for-kidney-transplant-services-in-kuwait-2015
#12
Yahya M Makkeyah, Turki Al-Otaibi, Narayanan Nampoory, Prasad Nair, Mostafa Al-Mousawi, Mahmoud Samhan, Alaa Gawish, Tarek Said, Medhat A Halim, Osama Gheith
OBJECTIVES: Renal transplant services have been provided by the Hamed Al-Essa Organ Transplant Center in Ibn Sina Hospital since 1979 for Kuwaitis and non-Kuwaiti citizens residing in Kuwait. We aimed to monitor the activity and outcome of annual renal transplants in 2015. MATERIALS AND METHODS: Data on transplant patients were collected from hospital records from January 1, 2015, through December 31, 2015, at Ibn Sina Hospital. RESULTS: Eighty-one patients underwent a renal transplant in Kuwait in 2015; 46 patients (56...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28176480/de-novo-thrombotic-microangiopathy-following-simultaneous-pancreas-and-kidney-transplantation-managed-with-eculizumab
#13
REVIEW
Lani Shochet, John Kanellis, Ian Simpson, Joseph Ta, William Mulley
Thrombotic microangiopathy (TMA) is a well-recognised complication following transplantation, often due to an underlying genetic predisposition, medications or rejection. The use of eculizumab in these settings has been previously described, but its role still remains to be clarified. A 45-year-old man, with a history of type 1 diabetes mellitus and subsequent end-stage kidney failure, presented for a simultaneous pancreas-kidney transplant. Immunologically, he was well matched with the donor, and he received standard induction immunosuppression including tacrolimus...
February 2017: Nephrology
https://www.readbyqxmd.com/read/28148909/en-bloc-transplant-of-the-liver-kidney-and-pancreas-experience-from-a-latin-american-transplant-center
#14
Luis A Caicedo, Jorge I Villegas, Oscar Serrano, Mauricio Millán, Mauricio Sepúlveda, Diego Jiménez, Jairo García, Juan G Posada, Liliana Mesa, Carlos Duran, Johanna Schweineberg, Diana Dávalos, Eliana Manzi, Angie Sabogal, Ana María Aristizabal, Gabriel J Echeverri
BACKGROUND En-bloc transplantation is a surgical procedure in which multiple organs are transplanted simultaneously. It has some similarities with multi-organ transplantation but offers certain advantages. This report highlights the experience of our interdisciplinary group regarding the treatment and follow-up of patients who received en-bloc transplantation, with the aim of encouraging the development of this surgical technique. CASE REPORT The first case is a 38-year-old patient with type 1 diabetes mellitus, liver cirrhosis, and chronic kidney failure who received an en-bloc transplant of the liver, pancreas, and kidney with no intraoperative complications...
February 2, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28109015/a-single-centre-experience-of-roux-en-y-enteric-drainage-for-pancreas-transplantation
#15
Irum Amin, Andrew J Butler, Gail Defries, Neil K Russell, Simon J F Harper, Asif Jah, Kourosh Saeb-Parsy, Gavin J Pettigrew, Christopher J E Watson
Exocrine drainage following pancreas transplantation can be achieved by drainage into the bladder or bowel, the latter typically by direct duodeno-jejunostomy; the use of Roux-en-Y enteric drainage is uncommon. We report a retrospective analysis of a single-centre experience of Roux-en-Y enteric drainage following pancreas transplantation. Over a 14-year period (2001-2015), 204 consecutive adult pancreas transplants were performed (96.6% simultaneous pancreas and kidney transplants), of which 26.0% were from donors after circulatory death (DCD)...
January 21, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28099402/transplant-center-volume-and-the-risk-of-pancreas-allograft-failure
#16
Tarek Alhamad, Andrew F Malone, Daniel C Brennan, Robert J Stratta, Su-Hsin Chang, Jason R Wellen, Timothy A Horwedel, Krista L Lentine
BACKGROUND: Successful pancreas transplantation requires surgical expertise and multidisciplinary medical management. The impact of transplant center volume on pancreas allograft survival remains unclear. METHODS: We examined Organ Procurement and Transplantation Network (OPTN) data on 11,568 simultaneous pancreas-kidney (SPK) and 4308 solitary pancreas (pancreas transplant alone and pancreas after kidney) transplants between 2000 and 2013. RESULTS: Average annual transplant center volume was categorized by tertiles into low, medium and high volume, respectively, as follows: 1-6 (n=3,861), 7-13 (n=3,891), and 14-34 (n=3,888) for SPK, and 1-3 (n=1,417), 4-10 (n=1,518), and 11-33 (n=1,377) for solitary pancreas transplants...
January 17, 2017: Transplantation
https://www.readbyqxmd.com/read/28052606/optn-srtr-2015-annual-data-report-pancreas
#17
R Kandaswamy, P G Stock, S K Gustafson, M A Skeans, M A Curry, M A Prentice, A K Israni, J J Snyder, B L Kasiske
The number of pancreas transplants performed in the United States stabilized over the last 3 years after nearly a decade of steady decline. Numbers of new additions to the list also stabilized during the same period. Notably, the persistent decline in pancreas after kidney transplants also seems to have abated, at least for now. The first full year of data after implementation of the new pancreas allocation system revealed no change in the distribution of organs between simultaneous pancreas-kidney (SPK) transplant and pancreas transplant alone...
January 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/27994337/management-of-graft-duodenal-leak-in-simultaneous-pancreas-kidney-transplant-a-case-report-from-india-and-review-of-literature
#18
REVIEW
Sunil Kumar, Sarbpreet Singh, Deepesh Benjamin Kenwar, Manish Rathi, Sanjay Bhadada, Ashish Sharma, Vikas Gupta, Anil Bhansali, Anupam Lal, Mukut Minz
Pancreatic transplantation is currently the only effective cure for Type 1 diabetes mellitus. It allows long-term glycemic control without exogenous insulin and amelioration of secondary diabetic complications. In India, pancreas transplant has not yet established with only a single successful transplant reported so far in the literature. We report a 24-year-old Type 1 diabetic patient with renal failure who underwent a simultaneous pancreas kidney transplant. On postoperative day 15, he had leak from the graft duodenal stump for which a tube duodenostomy and proximal diversion enterostomy was done...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27984519/the-importance-and-utility-of-hemoglobin-a1c-levels-in-the-assessment-of-donor-pancreas-allografts
#19
Emre Arpali, Joseph R Scalea, Robert R Redfield, Lynn Berg, Dixon Kaufman, Hans W Sollinger, Bridget Welch, Glen Leverson, Jon S Odorico
BACKGROUND: Hemoglobin A1C (HbA1c) levels are often obtained in potential pancreas graft donors to assess the overall long-term functional glycemic control or the possibility of unrecognized diabetes. Although routinely measured, the impact of donor HbA1c levels on pancreas graft outcomes has not been reported. Here, we researched the relationship between donor HbA1c levels and postoperative pancreas graft survival. METHODS: Data from 266 pancreas transplant patients including 182 simultaneous kidney-pancreas and 84 pancreas alone transplants were reviewed for the study...
December 14, 2016: Transplantation
https://www.readbyqxmd.com/read/27932141/validation-of-the-pancreatic-donor-risk-index-in-simultaneous-pancreas-kidney-transplantation-performed-in-c%C3%A3-rdoba-hospital-from-2000-to-2015
#20
J J Salamanca-Bustos, J P Campos-Hernandez, J M Sánchez-Hidalgo, A Arjona-Sánchez, A Sánchez-González, A J Arenas-Bonilla, J Ruiz-Rabelo, J Carrasco-Valiente, J Ruiz-García, J C Regueiro-López, J Briceño-Delgado, M J Requena-Tapia
BACKGROUND: The Pancreatic Donor Risk Index (PDRI) was developed in 2010 in the United States to predict graft survival after pancreas transplantation, based on donor characteristics and logistical and technical conditions. The aim of the study was to validate the utility of PDRI as a pancreas allograft survival predictor in simultaneous pancreas-kidney transplantation (SPK) transplants performed in our hospital between 2000 and 2015. METHODS: This retrospective analysis of 126 SPK transplants was performed by the same surgical team from the years 2000 to 2015...
November 2016: Transplantation Proceedings
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