Donors With a Maximum Body Weight of 50 kg for Simultaneous Pancreas-Kidney Transplantation

Schulz, Tim J.; Schenker, Peter; Flecken, M.; Kapischke, Matthias

doi:10.1016/j.transproceed.2004.12.252

Cited by 18 publications

(10 citation statements)

References 3 publications

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“…[4], the thrombosis rate was lower in the pediatric group compared to the adult group donors. In one series of patients demonstrating negative outcomes of pediatric donors in the literature, there was heterogeneity in use of preservation solution, exocrine drainage, and venous drainage [7]; furthermore, there were no comparison group data presented. Plausible explanations for lower graft thromboses rates include meticulous effort to avoid capsular injury and a short portal vein during the recovery, selection bias toward organs with good‐sized splenic artery/superior mesenteric artery stumps for reconstruction, minimizing cold and warm time, and attempting to mitigate risk of ischemia–reperfusion injury (which may be the major cause of thrombosis rather than technical causes).…”

Section: Discussionmentioning

confidence: 99%

“…Pancreata from pediatric donors are significantly underutilized and remained steady at 3–5% of the total pancreas donors recovered over the last two decades [1,2]. National and single‐center reports demonstrate equivalent patient and graft outcomes in recipients of younger pancreas grafts to those from older donors [4–9]. However, owing to the assumption that young donors have reduced islet cell mass and that the surgical procedure demands greater technical skill and possible higher risks of vascular thrombosis, many centers are reluctant to utilize these grafts.…”

Section: Introductionmentioning

confidence: 99%

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Pancreas transplants from small donors: are the outcomes acceptable? A retrospective study

et al. 2020

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Despite good organ quality, pancreata from extremely small pediatric donors (<30 kg) are generally avoided by many centers because of concerns of reduced islet cell mass and early technical failure. Therefore, we sought to compare the outcomes of small pancreas grafts (<30 kg) to those from higher weight donors from transplants performed between 1994 and 2015 (n = 1183). A total of 33 pancreata were from donors' ≤30 kg (3%), with a mean weight of 23.8 kg and mean age of 7.8 years. Patient survival was similar at 1, 5, and 10 years between recipients of ≤30 and >30 kg donors (≤30 kg: 96.8%, 86.8%, and 78.1% vs. >30 kg: 96.8%, 89.5%, and 79.1%, P = 0.5). Pancreas graft survival at 1, 5, and 10 years was also similar, ≤30 kg: 93.9%, 73.2%, and 61.0% vs. >30 kg: 87%, 73.3%, and 58.3% (P = 0.7). This graft survival pattern was also seen when comparing pancreata from ≤20 kg donors to those from >20 to 30 kg. Cause of graft loss, and metabolic and physiologic outcomes did not differ between the groups. After assessing the impact of donor weight as a continuous variable and calculating recipient-to-donor weight ratio (RDWR), we observed no effect of donor weight on patient and graft outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pancreas transplants from small donors: are the outcomes acceptable? A retrospective study

et al. 2020

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“…Zhang et al 3.0 × 10 8 [27] 3 CO 3 2-+ H 2 O → HCO 3 − + OH − 3.06 × 10 5 [28] 4 HO + HCO 3 − → H 2 O + CO 3…”

Section: Highlightsmentioning

confidence: 99%

A Fast Photochemical Oxidation of Proteins (FPOP) platform for free-radical reactions: the carbonate radical anion with peptides and proteins

Zhang

Rempel

Gross

2019

Free Radical Biology and Medicine

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Fast Photochemical Oxidation of Protein (FPOP), based on a pulsed KrF laser (248 nm) for freeradical generation, is a biophysical method that utilizes hydroxyl radicals to footprint proteins in solution. FPOP has been recognized for structural proteomics investigations, including epitope mapping, protein-aggregation characterization, protein-folding monitoring, and binding-affinity determination. The distinct merits of the platform are: i) the use of a scavenger to control radical lifetime and allow fast ("snapshot") footprinting of solvent-accessible residues in a protein; ii) the employment of a flow system to enable single-shot irradiation of small plugs of the targeted sample; iii) the use of methionine and catalase after radical oxidation chemistry to prevent postoxidation with residual oxidizing species; and iv) the utilization of mature mass spectrometrybased proteomic methods to afford detailed analysis. In addition to • OH, other reactive reagents (e.g., carbenes, iodide, sulfate radical anion, and trifluoromethyl radical) can be implemented on this platform to increase the versatility and scope. In this study, we further elaborate the use of FPOP platform to generate secondary radicals and establish a workflow to answer fundamental questions regarding the intrinsic selectivity and reactivity of radicals that are important in biology. Carbonate radical anion is the example we chose owing to its oxidative character and important putative pathogenic roles in inflammation. This systematic study with model proteins/peptides gives consistent results with a previous study that evaluated reactivity with free amino acids and shows that methionine and tryptophan are the most reactive residues with CO 3 −•. Other aromatic amino acids (i.e., tyrosine, histidine and phenylalanine) exhibit moderate reactivity, whereas, aliphatic amino acids are inert, unlike with • OH. The outcome demonstrates this approach to be appropriate for studying the fast reactions of radicals with proteins.

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“…Etiologies for poor graft survival and higher technical failure rates have been implicated due to decreased islet mass and the small size of the splenic and superior mesenteric arteries in these pancreata. This perception is largely responsible for a general reluctance to utilize pancreata from young donors [51]. However, there are also reports of extremely effective outcomes with the use of pancreata from young donors.…”

Section: Non-standard Pancreas Donorsmentioning

confidence: 99%

Expanding the Pancreas Donor Pool

Fridell

Stratta

2014

Curr Transpl Rep

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Currently underutilized and in somewhat short supply, the pancreas allograft is a relatively scarce resource. Despite factors such as increased demand, positive changes in organ donation rates, and the liberalization of 'organ-acceptable' criteria, there has been a decline in the number of deceased donor pancreas transplants performed in the US. Concomitantly, there has been an increase in similar transplants performed in other countries. While it is understandable that there are a multiplicity of factors to be considered in the evaluation of the potential pancreas allograft donor in an attempt to minimize graft loss and morbidity, it is a simple truth that as a result there are unused transplantable organs. This paper will deal with the multifaceted problem of pancreas underutilization and will discuss strategies that could lead to the expansion of the pancreas donor pool.

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Donors With a Maximum Body Weight of 50 kg for Simultaneous Pancreas-Kidney Transplantation

Cited by 18 publications

References 3 publications

Pancreas transplants from small donors: are the outcomes acceptable? A retrospective study

Pancreas transplants from small donors: are the outcomes acceptable? A retrospective study

A Fast Photochemical Oxidation of Proteins (FPOP) platform for free-radical reactions: the carbonate radical anion with peptides and proteins

Expanding the Pancreas Donor Pool

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