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.

Metabolic long-term follow-up of functioning simultaneous pancreas-kidney transplantation versus pancreas transplantation alone: insights and limitations.

Lauria MW, Figueiró JM, Machado LJ, Sanches MD, Nascimento GF, Lana AM, Ribeiro-Oliveira A

Laboratory of Endocrinology, Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

BACKGROUND: Pancreas transplantation involves a set of procedures that, in some cases, lead to different complications and outcomes. The aim of this study was to analyze the long-term effects of pancreas transplantation regarding carbohydrate and lipid metabolism parameters to determine differences between simultaneous pancreas-kidney (SPK) transplantation and pancreas transplantation alone (PTA). METHODS: Sixty-four patients (46 SPK and 18 PTA), with an immunosuppression protocol based on tacrolimus plus mycophenolate mofetil and prednisone, were evaluated for at least 1 year after transplantation. No patient made use of any hypoglycemic or hypolipidemic drugs. Comparisons were performed between SPK and PTA patients using the chi-square test, Fischer's exact test, and unpaired Student's t test, as appropriate. RESULTS: Patients were 39.8+/-9.3 years old, predominantly male (60.9%), with a mean follow-up of 25.4+/-10.4 months after transplantation. The PTA group exhibited worse renal function and higher tacrolimus levels than the SPK group. Fasting glucose, 2 hr plasma glucose after overload, C-peptide, and HbA1C were within the normal range, with no statistically significant differences between the PTA and SPK groups. Insulin (INS) and the homeostasis model assessment of INS resistance index were above the normal range in both the groups. Lipids were also similar between groups. CONCLUSIONS: The majority of patients with long-term functioning pancreas transplant achieved good glucose control without use of exogenous INS or oral antidiabetic drugs, although they were hyperinsulinemic. There were no significant differences concerning glucose and lipid parameters between the SPK and PTA groups, even though the PTA patients exhibited higher tacrolimus levels and worse renal function.

Published 11 January 2010 in Transplantation, 89(1): 83-7.
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Articles on Pancreas Transplant published 10 November 2009:

Increased risk of squamous-cell carcinoma in simultaneous pancreas kidney transplant recipients compared with kidney transplant recipients.   J Invest Dermatol, 129(12): 2886-94.

The purpose of this study was to ascertain the risk of non-melanocytic skin cancer (NMSC) in simultaneous pancreas kidney transplant recipients (SPKTRs) compared with kidney transplant recipients (KTRs) in relation to other potential risk factors of skin cancer. In a cohort study, 208 SPKTRs were compared with 1,111 KTRs who were transplanted during the same time period. The effects of age, sex, country of origin, time period after transplantation, HLA matching, immunosuppressive regimen, and ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 22 September 2009:

Remission of type 1 diabetes after anti-CD3 antibody treatment and transplantation of embryonic pancreatic precursors.   Endocrinology, 150(10): 4512-20.

Type 1 diabetes (T1D) mellitus is characterized by progressive autoimmune destruction of insulin producing beta-cells of the pancreatic islets of Langerhans. Cure of the disease will require control of autoimmunity to halt the destruction of beta-cells in the pancreas and restoration of beta-cell mass. We have built on the success of preclinical and clinical trials of anti-CD3 antibody treatment in modulating the immune response of T1D by the induction of tolerance and combined this treatment, ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 10 September 2009:

No difference in transplant outcomes for local and import pancreas allografts.   Transplantation, 88(5): 723-8.

BACKGROUND: In the United States, pancreas allograft allocation is strictly regulated. Local centers have the first option to accept an organ, followed by regional and national allocation for those not accepted locally. For a pancreas to be imported, many centers must have previously rejected the organ for transplantation. This study reviews the outcomes of all pancreas allografts transplanted at a single center between January 2003 and November 2007. Early graft function and graft survival ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 17 August 2009:

Pancreas after living donor kidney transplants in diabetic patients: impact on long-term kidney graft function.   Clin Transplant, 23(4): 437-46.

In this single-institution study, we compared outcomes in diabetic recipients of living donor (LD) kidney transplants that did vs. did not undergo a subsequent pancreas transplant. Of 307 diabetic recipients who underwent LD kidney transplants from January 1, 1995, through December 31, 2003, a total of 175 underwent a subsequent pancreas after kidney (PAK) transplant; 75 were deemed eligible (E) for, but did not receive (for personal or financial reasons), a PAK, and thus had a kidney ... [Abstract] [Full-text]

The case for pancreas after kidney transplantation.   Clin Transplant, 23(4): 447-53.

Pancreas after kidney (PAK) transplantation has historically demonstrated inferior pancreas allograft survival compared to simultaneous pancreas and kidney (SPK) transplantation. Under our current immunosuppression protocol, we have noted excellent outcomes and rare immunological graft loss. The goal of this study was to compare pancreas allograft survival in PAK and SPK recipients using this regimen. This was a single center retrospective review of all SPK and PAK transplants performed between ... [Abstract] [Full-text]

Acute pancreatic graft fistula and peripancreatic fluid collection: demonstration by secretin-stimulated MRI.   Magn Reson Imaging, 27(7): 1005-8.

Peripancreatic fluid collections are among the common post pancreas transplant complications, which are mainly due to leakage from the anastomosis site to bowel and graft pancreatitis. Differentiation between these two entities is important because they are treated differently. In this case, secretin stimulated magnetic resonance cholangiopancreatography revealed gradual intraperitoneal fluid collection and accumulation of fluid in small bowel excluded leakage from the anastomosis of the ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 14 August 2009:

Healthcare-associated hepatitis C virus transmission among patients in an abdominal organ transplant center.   Transpl Infect Dis, 11(4): 324-9.

BACKGROUND: De novo hepatitis C virus (HCV) infection among transplant patients is rarely recognized but can have severe consequences. We investigated the scope, source, and mode of HCV transmission within a transplant center after incident HCV infection was identified in 2 patients who had liver transplantation in late 2006. METHODS: Patients were interviewed, and transplant logs, medical records, and staff practices were reviewed to identify opportunities for HCV transmission. Infection via ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 30 July 2009:

Microsurgical technique of simultaneous pancreas/kidney transplantation in the rat: clinical experience and review of the literature.   Eur Surg Res, 43(2): 245-51.

BACKGROUND: For experimental basic research, standardized transplantation models reflecting technical and immunologic aspects are necessary. This article describes an experimental model of combined pancreas/kidney transplantation (PKTx) in detail. MATERIALS AND METHODS: Donor rats underwent en bloc pancreatectomy and nephrectomy. Revascularization was performed using the aorta with the superior mesenteric artery and the inferior vena cava with the portal vein. Exocrine drainage of the pancreas ... [Abstract] [Full-text]

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