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Pancreas alone transplantation

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https://www.readbyqxmd.com/read/28696022/outcomes-in-pancreas-transplantation-with-exocrine-drainage-through-a-duodenoduodenostomy-versus-duodenojejunostomy
#1
J P Lindahl, R Horneland, E Nordheim, A Hartmann, E M Aandahl, K Grzyb, H Haugaa, G Kjøsen, A Åsberg, T Jenssen
Until recently, pancreas transplantation has mostly been performed with exocrine drainage via duodenojejunostomy (DJ). Since 2012, DJ was substituted with duodenoduodenostomy (DD) in our hospital, allowing endoscopic access for biopsies. This study assessed safety profiles with DD versus DJ procedures, and clinical outcomes with the DD technique in pancreas transplantation. DD patients (n=117; 62 simultaneous pancreas and kidney [SPKDD ] and 55 pancreas transplantation alone [PTADD ] with median follow-up 2...
July 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28683901/in-hospital-cardiovascular-complications-after-pancreas-transplantation-in-the-united-states-from-2003-to-2012
#2
Jim Kim, Joshua Schulman-Marcus, Anthony C Watkins, Dmitriy N Feldman, Rajesh Swaminathan, Jun B Lee, Thangamani Muthukumar, David Serur, Luke Kim, Choli Hartono
Large database studies detailing the risk of perioperative cardiovascular complications after pancreas transplant has been limited, perhaps because these outcomes are not captured by transplant registries. Greater data on the incidence and risks of such outcomes could provide additional insight for referring physicians and inform potential recipients of their risk. We performed a serial, cross-sectional analysis of the National Inpatient Sample, the largest publicly available inpatient database in the United States, to assess for the risk of cardiovascular complications after pancreas transplants in the United States from 2003 to 2012 (n = 13,399)...
May 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28636074/optimizing-outcomes-in-pancreas-transplantation-impact-of-organ-preservation-time
#3
Ehren N Rudolph, Ty B Dunn, David E R Sutherland, Raja Kandaswamy, Erik B Finger
Recent changes to pancreas graft allocation policy have increased the number of organs available for regional and distant sharing, which results in a corresponding increase in preservation time. We sought to systematically assess the impact of cold ischemia time (CIT) on outcomes posttransplant. A retrospective review of 1,253 pancreas transplants performed at a single transplant center was performed to correlate CIT to transplant outcomes. The rate of technical failure (TF) increased with 20+ hours of CIT, with a 2...
June 21, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28538038/live-donor-kidney-pak-versus-spk-how-to-decide
#4
Erik Stites, Alexander C Wiseman
PURPOSE OF REVIEW: Patients with type 1 diabetes and end stage renal disease face a complex choice when considering the relative risks and benefits of kidney transplant alone with or without subsequent pancreas after kidney transplant (PAK) or simultaneous kidney pancreas transplant (SPK). RECENT FINDINGS: SPK is considered the optimal treatment regarding long-term patient survival, but when also faced with the option of living donor kidney transplant with the potential for PAK later, the ideal option is less clear...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28466634/update-on-pancreatic-transplantation-on-the-management-of-diabetes
#5
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, posturemic patients (following successful kidney transplantation), and non-uremic patients...
October 2017: Minerva Medica
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/28362046/co-microencapsulation-of-bmscs-and-mouse-pancreatic-%C3%AE-cells-for-improving-the-efficacy-of-type-i-diabetes-therapy
#7
Ruimin Long, Yuangang Liu, Shibin Wang, Li Ye, Peng He
INTRODUCTION: To overcome the shortcomings of pancreas transplantation and insulin injection treatment for type I diabetes, biocompatible materials were used to prepare alginate-chitosan-alginate microcapsules that co-encapsulated bone marrow mesenchymal stem cells and mouse pancreatic β cells to treat diabetic mice. METHODS: Blank alginate-chitosan-alginate (ACA) microcapsules and co-microencapsulated cells were prepared using a high-voltage electrostatic method and then characterized using an inverted microscope...
May 9, 2017: International Journal of Artificial Organs
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/28267898/laparoscopic-biopsies-in-pancreas-transplantation
#9
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...
August 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28266040/ex-vivo-porcine-organ-perfusion-models-as-a-suitable-platform-for-translational-transplant-research
#10
Rohan Kumar, Wen Yuan Chung, Ashley Robert Dennison, Giuseppe Garcea
In transplantation surgery, extending the criteria for organ donation to include organs that may have otherwise been previously discarded has provided the impetus to improve organ preservation. The traditional method of cold static storage (CS) has been tried and tested and is suitable for organs meeting standard criteria donation. Ex vivo machine perfusion is, however, associated with evidence suggesting that it may be better than CS alone and may allow for organ donation criteria to be extended. Much of our knowledge of organ preservation is derived from animal studies...
March 6, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28151808/techniques-for-abdominal-wall-reconstruction-in-intestinal-transplantation
#11
Gabriel E Gondolesi, Nicolás F Aguirre
PURPOSE OF REVIEW: One of the most important challenges in the intestinal (ITx) and multivisceral transplant (MVTx) is to achieve a successful abdominal wall closure. RECENT FINDINGS: A tension-free primary closure should be our aim. In most of the cases, we need to perform a component separation technique, alone or combined, to the use of a synthetic mesh. If those options are not feasible, the abdominal wall composite vascularized allograft transplant (AW-CVA) utilizing direct orthotopic vascularization can be considered...
February 1, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28099402/transplant-center-volume-and-the-risk-of-pancreas-allograft-failure
#12
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
#13
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/27984519/the-importance-and-utility-of-hemoglobin-a1c-levels-in-the-assessment-of-donor-pancreas-allografts
#14
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/27932185/inferior-vena-cava-duodenal-drainage-in-pancreas-alone-transplantation-for-chronic-pancreatitis-a-case-report
#15
B H Choi, Y M Park, K H Yang, C W Chu, J H Ryu
Enteric drainage has been the main trend in solitary pancreas transplantation. Compared with bladder drainage, it does not cause metabolic or urologic complications, but there is no way to perform immunologic monitoring, except by graft pancreas biopsy. Additionally, although portal drainage of the graft vein is considered physiological drainage, it has more of a risk for surgical complications. To overcome these disadvantages, we successfully performed inferior vena cava (IVC)-duodenal drainage in pancreas alone transplantation...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27849440/use-of-cidofovir-for-cytomegalovirus-disease-refractory-to-ganciclovir-in-solid-organ-recipients
#16
Hugo Bonatti, Costi D Sifri, Clara Larcher, Stefan Schneeberger, Camille Kotton, Christian Geltner
BACKGROUND: Solid organ transplantation (SOT) frequently is complicated by cytomegalovirus (CMV) infections. Cidofovir (CDV) is active against CMV, including many ganciclovir (GCV)-resistant mutants, but often is considered to be too nephrotoxic for use after organ transplantation. PATIENTS AND METHODS: Seven males and two females (median age 50.1 years), including two kidney/pancreas, four lung, one small bowel, and two hand recipients, received CDV for refractory CMV disease...
February 2017: Surgical Infections
https://www.readbyqxmd.com/read/27467687/cardiac-assessment-of-patients-with-type-1-diabetes-median-10-years-after-successful-simultaneous-pancreas-and-kidney-transplantation-compared-with-living-donor-kidney-transplantation
#17
Jørn Petter Lindahl, Richard John Massey, Anders Hartmann, Svend Aakhus, Knut Endresen, Anne Günther, Karsten Midtvedt, Hallvard Holdaas, Torbjørn Leivestad, Rune Horneland, Ole Øyen, Trond Jenssen
BACKGROUND: In recipients with type 1 diabetes, we aimed to determine whether long-term normoglycemia achieved by successful simultaneous pancreas and kidney (SPK) transplantation could beneficially affect progression of coronary artery disease (CAD) when compared with transplantation of a kidney-alone from a living donor (LDK). METHODS: In 42 kidney transplant recipients with functioning grafts who had received either SPK (n = 25) or LDK (n = 17), we studied angiographic progression of CAD between baseline (pretransplant) and follow-up at 7 years or older...
June 2017: Transplantation
https://www.readbyqxmd.com/read/27283012/challenges-in-pancreas-transplantation
#18
REVIEW
E J Sharples, S M Mittal, P J Friend
Whole-organ pancreas transplantation, either alone or combined with a kidney transplant, is the only definitive treatment for many patients with type 1 diabetes that restores normal glucose homoeostasis and insulin independence. Pancreas transplantation delays, or potentially prevents, secondary diabetes complications and is associated with improvement in patient survival when compared with either patients remaining on the waiting list or those receiving kidney transplant alone. Pancreas transplantation is safe and effective, with 1-year patient survival >97 % and graft survival rates of 85 % at 1 year and 76 % at 5 years in recent UK data...
December 2016: Acta Diabetologica
https://www.readbyqxmd.com/read/27258580/long-term-outcome-after-pancreas-transplantation-a-registry-analysis
#19
Angelika C Gruessner, Rainer W G Gruessner
PURPOSE OF REVIEW: Pancreas transplantation provides the only proven method to restore long-term normoglycemia in patients with insulin-dependent diabetes mellitus. Although many studies describe the most important risk factors for short-term survival of a pancreas transplant, more information about factors that distinguish short-term from long-term graft function is needed. RECENT FINDINGS: Analysis of 21 328 pancreas transplants from the International Pancreas Transplant Registry, performed from 1984 to 2009 (minimum 5-year follow-up), shows a significant improvement in long-term patient survival and pancreas graft function...
August 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27232750/pancreas-transplantation-an-alarming-crisis-in-confidence
#20
R J Stratta, A C Gruessner, J S Odorico, J A Fridell, R W G Gruessner
In the past decade, the annual number of pancreas transplantations performed in the United States has steadily declined. From 2004 to 2011, the overall number of simultaneous pancreas-kidney (SPK) transplantations in the United States declined by 10%, whereas the decreases in pancreas after kidney (PAK) and pancreas transplant alone (PTA) procedures were 55% and 34%, respectively. Paradoxically, this has occurred in the setting of improvements in graft and patient survival outcomes and transplanting higher-risk patients...
September 2016: American Journal of Transplantation
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