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.

Pancreas transplantation.

White SA, Shaw JA, Sutherland DE

Department of Hepatopancreatobiliary and Transplantation Surgery, Freeman Hospital, Newcastle upon Tyne, Tyne and Wear, UK. steve.white@nuth.nhs.uk

Since the introduction of pancreas transplantation more than 40 years ago, efforts to develop more minimally invasive techniques for endocrine replacement therapy have been in progress, yet this surgical procedure still remains the treatment of choice for diabetic patients with end-stage renal failure. Many improvements have been made in the surgical techniques and immunosuppressive regimens, both of which have contributed to an increasing number of indications for pancreas transplantation. This operation can be justified on the basis that patients replace daily injections of insulin with an improved quality of life but at the expense of a major surgical procedure and lifelong immunosuppression. The various indications, categories, and outcomes of patients having a pancreas transplant are discussed, particularly with reference to the effect on long-term diabetic complications.

Published 25 May 2009 in Lancet, 373(9677): 1808-17.
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Articles on Pancreas Transplant published 9 February 2009:

Functional beta-cell mass and insulin sensitivity is decreased in insulin-independent pancreas-kidney recipients.   Transplantation, 87(3): 402-7.

BACKGROUND: To compare functional beta-cell mass and insulin sensitivity in insulin-independent pancreas-kidney recipients with that in age- and body mass index-matched nondiabetic kidney recipients and normal controls. METHODS: All transplant recipients were on maintenance immunosuppression with mycophenolate mofetil and tacrolimus since more than 2.7 years (2.2-3.8 years). Their C-peptide release was measured during a 170-min hyperglycemic clamp, first in absence and then in presence of ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 27 January 2009:

Subcutaneous transplantation of embryonic pancreas for correction of type 1 diabetes.   Am J Physiol Endocrinol Metab, 296(2): E323-32.

Islet transplantation is a promising therapeutic approach for type 1 diabetes. However, current success rates are low due to progressive graft failure in the long term and inability to monitor graft development in vivo. Other limitations include the necessity of initial invasive surgery and continued immunosuppressive therapy. We report an alternative transplantation strategy with the potential to overcome these problems. This technique involves transplantation of embryonic pancreatic tissue ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 22 January 2009:

Deficiency of cytomegalovirus (CMV)-specific CD8+ T cells in patients presenting with late-onset CMV disease several years after transplantation.   Transpl Infect Dis, 11(1): 20-7.

Cytomegalovirus (CMV) is a major cause of morbidity and mortality among transplant recipients. The routine use of anti-CMV prophylaxis has modified the epidemiology of post-transplant CMV infection by delaying the onset of clinical disease. While the majority of delayed-onset CMV disease still occurs during the first year after transplant, reports of late-onset CMV disease presenting many years after transplantation are increasing. Here, we describe 2 CMV-seropositive transplant recipients who ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 21 January 2009:

A pilot study of gene expression-based categorization of pancreas transplant biopsies.   Transplantation, 87(2): 222-6.

Gene expression profiling has emerged as a powerful strategy to define transcriptional mechanism activated in organ transplantation. We performed a pilot feasibility study of mRNA-based pancreas transplant biopsy stratification. The mRNAs expression of 32 genes, observed in renal transplant dysfunction, and 10 pancreas-specific genes were evaluated in 26 pancreas transplant biopsy specimens by quantitative real-time polymerase chain reaction using TaqMan Low Density Array technology. ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 12 January 2009:

Alemtuzumab induction and antibody-mediated kidney rejection after simultaneous pancreas-kidney transplantation.   Transplantation, 87(1): 125-32.

BACKGROUND: The best induction agent for simultaneous pancreas-kidney transplantation (SPKT) remains the subject of debate. Alemtuzumab is effective in preventing acute cellular rejection (ACR) in SPK recipients and has been used to prevent antibody-mediated rejection (AMR) in sensitized kidney transplant candidates. METHODS: A retrospective cohort study was performed including 136 SPK recipients receiving maintenance immunosuppression with tacrolimus, mycophenolic acid prodrugs, and ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 23 December 2008:

C4d-positive interacinar capillaries correlates with donor-specific antibody-mediated rejection in pancreas allografts.   Transplantation, 86(12): 1849-56.

BACKGROUND: The deposition of the complement split fragment C4d and its association with acute antibody-mediated rejection (AMR) in pancreas transplant (PTx) is not well defined. To characterize the deposition of C4d in PTx, we analyzed 27 PTx biopsies from 18 patients transplanted between 2004 and 2007 at the University of Wisconsin. METHODS: The presence of C4d was graded in interacinar capillaries (IAC), islets, interstitium, and small- and medium-size vessels. Sera obtained at the time or ... [Abstract] [Full-text]

Pancreas transplant alone as an independent risk factor for the development of renal failure: a retrospective study.   Transplantation, 86(12): 1789-94.

BACKGROUND: Pancreas transplant alone (PTA) is a controversial procedure. Without clearly demonstrated patient survival, recipients report improved quality of life. Nephrotoxic immunosuppression (IS) may exacerbate diabetic renal injury post-PTA. METHODS: A single institution retrospective review of patients receiving PTA over a 14-year period was completed. Patient and donor demographics, surgical outcomes, rejection, and patient or graft survival were analyzed. Pre- and Postoperative ... [Abstract] [Full-text]

Articles on Pancreas Transplant published 16 December 2008:

Outcome of pancreas transplantation in recipients older than 50 years: a single-centre experience.   Transplantation, 86(11): 1511-4.

BACKGROUND: Pancreas transplantation (PT) remains the only treatment that can restore insulin independence among insulin-dependent diabetics. An ageing population in developed countries has led to an increasing number of older patients who may be suitable for PT. Some investigators argue that PT in recipients older than 50 years has an inferior outcome compared with the younger group. METHODS: The object of this study was to compare the outcomes of 31 PT in patients aged 50 and above 105 PT in ... [Abstract] [Full-text]

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