Pancreas Transplant Research Today is a free monthly online journal that collates and summarizes the latest research about Pancreas Transplant, including details on risks, prognosis, procedure, surgery, organ donation.

Kidney and pancreas transplantation in the United States, 1997-2006: the HRSA Breakthrough Collaboratives and the 58 DSA Challenge.

Leichtman AB, Cohen D, Keith D, O'Connor K, Goldstein M, McBride V, Gould CJ, Christensen LL, Ashby VB

Scientific Registry of Transplant Recipients, University of Michigan, Ann Arbor, MI, USA. aleicht@umich.edu

Growth in the number of active patients on the kidney transplant waiting list has slowed. Projections based on the most recent 5-year data suggest the total waiting list will grow at a rate of 4138 registrations per year, whereas the active waiting list will increase at less than one-sixth that rate, or 663 registrations per year. The last 5 years have seen a small trend toward improved unadjusted allograft survival for living and deceased donor kidneys. Since 2004 the overall number of pancreas transplants has declined. Among pancreas recipients, those with simultaneous kidney-pancreas transplants experienced the highest pancreas graft survival rates. In response to the ongoing shortage of deceased donor organs, the US Health Resources and Services Administration launched the Organ Donation Breakthrough Collaborative in September 2003 and the Organ Transplantation Breakthrough Collaborative (OTBC) in October 2005. The 58 DSA Challenge is prominent among the goals adopted by the OTBC. Its premise: were each of the 58 existing donation service areas to increase the number of kidney transplants performed within their boundaries by 10 per month, an additional 7000 transplants over current annual levels would result.Such an increase could potentially eliminate the national kidney transplantation waiting list by 2030.

Published 13 March 2008 in Am J Transplant, 8(4): 946-57.
Full-text of this article is available online (may require subscription).

Articles on Pancreas Transplant published 10 March 2008:

Review of various techniques of pancreas transplantation in rat model.   J Surg Res, 145(2): 205-13.

Pancreas transplantation (PTx) is being applied with increasing frequency in the treatment of diabetes mellitus Type 1 and selected cases of Type 2. It is known that PTx can consistently establish normoglycemic insulin-independent state. Due to the increased use of different PTx models in rats for studying the metabolic function of the transplanted pancreas, reviewing the various techniques in PTx seemed to be necessary. A review of the literature of PTx in rat models showed that different ... [Abstract] [Full-text]

Development of beta-cells in the native pancreas after pancreas allo-transplantation in the Spontaneously Diabetic Torii rat.   J Surg Res, 145(2): 229-37.

BACKGROUND: We previously demonstrated the development of beta-cells in the native pancreas after syngeneic pancreas transplantation (PTx) in a model of type 2 diabetes, namely the Spontaneously Diabetic Torii (SDT; RT1 a) rat. In this study, we evaluated the effect of fully allogeneic PTx (allo-PTx) under immunosuppression on the native pancreases in the recipients. MATERIALS AND METHODS: Diabetic 25-week-old SDT rats were divided into two groups: untreated controls and PTx-treated recipients. ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 7 March 2008:

Fatal graft-versus-host disease presenting as fever of unknown origin in a pancreas-after-kidney transplant recipient.   Am J Transplant, 8(4): 881-3.

Acute graft-versus-host disease (GVHD) is a rare complication of pancreas transplantation. We describe a 54-year-old male with type 1 diabetes who received a zero-antigen mismatched pancreas-after-kidney transplant from a pancreas donor who was homozygous at the HLA-B, -Cw, -DR, and -DQ alleles. Starting on postoperative day (POD) #22, the patient developed persistent fevers. Workup was notable only for low-grade cytomegalovirus viremia, which was treated. The fevers eventually disappeared. On ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 29 February 2008:

Pancreas allotransplants in patients with a previous total pancreatectomy for chronic pancreatitis.   J Am Coll Surg, 206(3): 458-65.

BACKGROUND: A total pancreatectomy is the last resort in the treatment of chronic pancreatitis because it results in complete endocrine and exocrine pancreatic insufficiency. More than 50% of total pancreatectomy patients experience severe glucose control problems, which cause up to 50% of late deaths. STUDY DESIGN: Between June 1, 1986, and May 15, 2007, we performed 26 pancreas allotransplants (18 primary, 8 retransplants) in 18 patients who had previously undergone a total pancreatectomy for ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 28 February 2008:

Reduced immunogenicity of first-trimester human fetal pancreas.   Diabetes, 57(3): 627-34.

OBJECTIVE: The use of human fetal pancreatic tissue may provide a potential source of transplantable beta-cells as a therapy for type 1 diabetes. Human fetal pancreas has a remarkable capacity to grow and differentiate in vivo and has been shown to reverse diabetes in rodents. However, it is known that human fetal pancreas obtained from the second trimester of gestation is immunogenic and is rejected after transplantation. Tissue obtained from earlier stages might prove to be immune privileged, ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 25 September 2007:

Pancreas graft drainage in recipient duodenum: preliminary experience.   Transplantation, 84(6): 795-7.

Pancreas graft survival has continuously improved over the years to become a main treatment option of uncontrolled complicated diabetes. Rejection remains the major challenge as it often goes unnoticed until severe damage of the graft manifests itself by elevated blood sugar. Pancreas enzymes monitoring in the blood and in the urine is a sensitive marker of rejection but lack of specificity. Biopsy remains the gold standard. Cystoscopy-guided biopsy of bladder-drained pancreas has a good ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 18 September 2007:

Impact of portal versus systemic venous drainage on acute rejection of simultaneous pancreas-kidney transplantation in pig.   Transplantation, 84(5): 629-33.

BACKGROUND: The immunological benefits of portal venous drainage (PVD) in pancreas transplantation remain debated clinically. We established simultaneous pancreas-kidney transplantation (SPK) models with portal venous drainage and systemic venous drainage to compare the impact of venous drainage site on acute rejection in pig. METHODS: Forty-eight nonrelated, first hybrid landrace pigs were divided into PE (portal-enteric drainage) and SE (systemic-enteric drainage) groups. Type I diabetes ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 11 September 2007:

Pancreas graft salvage using pancreatico-duodenectomy with enteric drainage.   Am J Transplant, 7(10): 2422-4.

As demand for donor pancreases increases, attempts are being made to utilize even marginal grafts for transplantation. Injury during pancreas recovery can predispose to posttransplant complications and graft loss. Early recognition and correction can salvage these grafts. The authors report an instance of poor segmental perfusion of the pancreas graft that was salvaged by pancreas head resection and enteric drainage through a Roux-en-Y pancreatico-jejunostomy. [Abstract] [Full-text]

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