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https://www.readbyqxmd.com/read/29233098/intractable-ascites-associated-with-mycophenolate-in-a-simultaneous-kidney-pancreas-transplant-patient-a-case-report
#1
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
#2
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
#3
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
#4
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/29208633/in-vivo-visualization-of-beta-cells-by-targeting-of-gpr44
#5
Olof Eriksson, Peter Johnström, Zsolt Cselenyi, Mahabuba Jahan, Ram K Selvaraju, Marianne Jensen-Waern, Akihiro Takano, Maria Sörhede Winzell, Christer Halldin, Stanko Skrtic, Olle Korsgren
GPR44 expression has recently been described as highly beta cell selective in the human pancreas and constitutes a tentative surrogate imaging biomarker in diabetes.A radiolabeled small molecule GPR44 antagonist, [11C]AZ12204657, was evaluated for visualization of beta cells in pigs and non-human primates by Positron Emission Tomography (PET) as well as in immunodeficient mice transplanted with human islets under the kidney capsule. In vitro autoradiography of human and animal pancreatic sections from non-diabetic and diabetic subjects, in combination with insulin staining, was performed to assess beta cell selectivity of the radiotracer...
December 5, 2017: Diabetes
https://www.readbyqxmd.com/read/29205793/duodenal-graft-complications-requiring-duodenectomy-after-pancreas-and-pancreas-kidney-transplantation
#6
Erica Pieroni, Niccolò Napoli, Carlo Lombardo, Piero Marchetti, Margherita Occhipinti, Carla Cappelli, Davide Caramella, Giovanni Consani, Gabriella Amorese, Maurizio De Maria, Fabio Vistoli, Ugo Boggi
Duodenal graft complications are poorly reported complications of pancreas transplantation that can result in graft loss. Excluding patients with early graft failure, after a median follow-up period of 126 months (range 23-198) duodenectomy was required in 14 of 312 pancreas transplants (4.5%). All patients were insulin-independent at the time of diagnosis. Reasons for duodenectomy included delayed duodenal graft perforation (n=10, 71.5%) and refractory duodenal graft bleeding (n=4, 28.5%). In patients with duodenal graft bleeding, a total duodenectomy was performed...
December 4, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29198676/case-report-primary-de-novo-sarcoma-in-transplant-pancreas-allograft
#7
S Nagaraju, S J Grethlein, S Vaishnav, A A Sharfuddin, J A Powelson, J A Fridell
BACKGROUND: The majority of malignancies after transplantation appear to be virally mediated and of recipient origin. Donor-derived neoplasms occur early, whereas recipient-origin tumors typically occur many years after transplantation. Sarcomas are a relatively rare form of cancer. The etiology of sarcomas remains largely unknown, although some are linked to viruses, familial cancer syndromes, or therapeutic radiation exposure. Primary sarcomas are extremely rare, accounting for <0...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29198675/retroperitoneal-pancreas-transplantation-with-the-use-of-duodenal-drainage-via-button-technique-first-clinical-practice-case-report
#8
A Pinchuk, I Dmitriev, K Lazareva, R Storozhev, A Balkarov, Y Anisimov, A Kondrashkin
The persistent relative high incidence of duodenum-associated surgical complications significantly reduces pancreas grafts' (PG) and recipients' survival rates. A 31-year-old female patient underwent retroperitoneal pancreas transplantation with the use of PG exocrine drainage into the recipient's duodenum via the "button technique" approach. An uncomplicated postoperative period with satisfactory function of both transplants (pancreas and kidney) was noted. This was the 1st time ever that the transplantation was performed with the use of retroperitoneal placement of the pancreas transplant and duodenal drainage via the "button technique" approach...
December 2017: Transplantation Proceedings
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/29194971/the-causes-significance-and-consequences-of-inflammatory-fibrosis-in-kidney-transplantation-the-banff-i-ifta-lesion
#13
Brian J Nankivell, Meena Shingde, Karen L Keung, Caroline L-S Fung, Richard J Borrows, Philip J O'Connell, Jeremy R Chapman
Inflammation within areas of interstitial fibrosis and tubular atrophy (i-IFTA) is associated with adverse outcomes in kidney transplantation. We evaluated i-IFTA in 429 indication- and 2052 protocol-biopsies from a longitudinal cohort of 362 kidney-pancreas recipients to determine its prevalence, time-course, and relationships with T cell mediated rejection (TCMR), immunosuppression, and outcome. Sequential histology demonstrated that i-IFTA was preceded by cellular interstitial inflammation, and followed by IF/TA...
December 1, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29190645/cd105-mesenchymal-stem-cells-migrate-into-osteoarthritis-joint-an-animal-model
#14
Pablo Fernandez-Pernas, Iván Rodríguez-Lesende, Alexandre de la Fuente, Jesús Mateos, Isaac Fuentes, Javier De Toro, Fco J Blanco, M C Arufe
Mesenchymal stem cells are being the focus of connective tissue technology and regenerative medicine, presenting a good choice cell source for improving old and well recognized techniques of cartilage defect repair. For instance, the autologous chondrocyte transplantation using new concepts of regenerative medicine. The present study investigated the risk of xenogenicity of human synovial membrane-derived MSCs, injected into the monkeys using intravenous and intra-articular administration. The animal models used were adult monkeys Rhesus which had been injured into the left knee to create an Osteoarthritis (OA) animal model...
2017: PloS One
https://www.readbyqxmd.com/read/29174777/cardiac-surgery-outcomes-in-abdominal-solid-organ-transplant-recipients
#15
Takushi Kohmoto, Satoru Osaki, Dixon B Kaufman, Glen Leverson, Nilto DeOliveira, Shahab A Akhter, Susan Ulschmid, Lucian Lozonschi, Entela B Lushaj
BACKGROUND: Cardiovascular disease is a cause of morbidity and mortality in organ transplant recipients. Cardiac surgery after organ transplantation is not uncommon in this population. We evaluated 30-day outcomes and long-term survival of abdominal transplant recipients undergoing cardiac surgery at our institution. METHODS: In all, 138 patients with previous kidney, kidney-pancreas, and liver transplants underwent cardiac surgery from 2000 to 2016. Propensity score (ratio 1:3) matched 115 abdominal transplant with 345 patients undergoing cardiac surgery without a history of abdominal transplant...
November 23, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29160954/islet-allo-autotransplantation-allogeneic-pancreas-transplantation-followed-by-transplant-pancreatectomy-and-islet-transplantation
#16
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
#17
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/29140547/islet-transplantation-as-safe-and-efficacious-method-to-restore-glycemic-control-and-to-avoid-severe-hypoglycemia-after-donor-organ-failure-in-pancreas-transplantation
#18
Philipp A Gerber, Michel Hochuli, Bara D Benediktsdottir, Richard A Zuellig, Oliver Tschopp, Michael Glenck, Olivier de Rougemont, Christian Oberkofler, Giatgen A Spinas, Roger Lehmann
The aim of this study was to assess safety and efficacy of islet transplantation after initial pancreas transplantation with subsequent organ failure. Patients undergoing islet transplantation at our institution after pancreas organ failure were compared to a control group of patients with pancreas graft failure, but without islet transplantation and to a group receiving pancreas re-transplantation. 10 patients underwent islet transplantation after initial pancreas transplantation failed and were followed for a median of 51 months...
November 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29139617/world-s-smallest-combined-en-bloc-liver-pancreas-transplantation
#19
Ahmed M Elsabbagh, Jason Hawksworth, Khalid M Khan, Nada Yazigi, Cal S Matsumoto, Thomas M Fishbein
We present a case of a 2-year-old child who underwent a combined en bloc liver and pancreas transplant following complications of WRS. WRS is characterized clinically through infantile insulin-dependent diabetes mellitus, neutropenia, recurrent infections, propensity for liver failure following viral infections, bone dysplasia, and developmental delay. Usually, death occurs from fulminant liver and concomitant kidney failure. Few cases with WRS are reported in the literature, mostly from consanguineous parents...
November 15, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29138633/influence-of-spk-with-enteric-drainage-on-the-pancreatic-exocrine-function-in-diabetic-patients-with-uremia
#20
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
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