Excellent Outcomes of Simultaneous Pancreas Kidney Transplantation in Patients From Rural and Urban Australia

Thwaites, Stephen; Gurung, Bina; Yao, Jinna; Kable, Kathy; Robertson, Paul; Ryan, Brendan; Lam, Vincent; Pleass, Henry; Chapman, Jeremy R.; Hawthorne, Wayne J.; Allen, Richard D.

doi:10.1097/tp.0b013e3182708e04

Cited by 17 publications

(8 citation statements)

References 29 publications

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“…The two-tailed Fisher’s exact test was used to compare proportions between non-variant (46) TT patients and LCS-variant (TG and GG) patients. PFS and OS were estimated by Kaplan-Meier method and their association with genotypes was tested with the log-rank test.…”

Section: Methodsmentioning

confidence: 99%

A let-7 microRNA-Binding Site Polymorphism in KRAS Predicts Improved Outcome in Patients with Metastatic Colorectal Cancer Treated with Salvage Cetuximab/Panitumumab Monotherapy

Saridaki

Weidhaas

Lenz

et al. 2014

Clinical Cancer Research

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Purpose An inherited mutation in KRAS (LCS6-variant, rs61764370) results in altered control of the KRAS oncogene. We studied this biomarker’s correlation to anti-EGFR monoclonal Antibody therapy (moAbs) response in metastatic colorectal cancer patients (mCRC) patients. Experimental Design LCS6-variant and KRAS/BRAF mutational status was determined in 512 mCRC patients treated with salvage anti-EGFR moAbs therapy, and findings correlated with outcome. Reporters were tested in colon cancer cell lines to evaluate the differential response of the LCS6-variant allele to therapy exposure. Results 21.2% (109/512) of mCRC patients had the LCS6-variant (TG/GG), which was found twice as frequently in the BRAF mutated versus the wt group (p = 0.03). LCS6-variant patients had significantly longer PFS with anti-EGFR moAbs monotherapy treatment in the whole cohort (16.85 vs 7.85 weeks, p = 0.019) and in the double wt (KRAS and BRAF) patient population (18 vs 10.4 weeks, p = 0.039). Combination therapy (moAbs plus chemotherapy) led to improved PFS and OS for non-variant patients, and brought their outcome to levels comparable to LCS6-variant patients receiving anti-EGFR moAbs monotherapy. Combination therapy did not lead to improved PFS or OS for LCS6-variant patients. Cell line studies confirmed a unique response of the LCS6-variant allele to both anti-EGFR moAbs monotherapy and chemotherapy. Conclusions LCS6-variant mCRC patients have an excellent response to anti-EGFR moAbs monotherapy, without any benefit of additional chemotherapy. These findings further confirm the importance of this mutation as a biomarker of anti-EGFR moAbs response in mCRC patients, and warrant further prospective confirmation.

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Section: Methodsmentioning

confidence: 99%

A let-7 microRNA-Binding Site Polymorphism in KRAS Predicts Improved Outcome in Patients with Metastatic Colorectal Cancer Treated with Salvage Cetuximab/Panitumumab Monotherapy

Saridaki

Weidhaas

Lenz

et al. 2014

Clinical Cancer Research

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“…Except for Newcastle (160 km north of Sydney, with a population of approximately 450 000), all transplant units are in Australian capital cities. The concentration of medical specialists and services in metropolitan regions 4,5 means that rural and regionally located transplant recipients are required to travel for specialist appointments and for surgery 5 . They often relocate to major cities during the intensive workup phase and immediately post‐surgery.…”

Section: Introductionmentioning

confidence: 99%

The psychosocial experiences and supportive care preferences of organ transplant recipients and their carers who live in regional Australia

Gunn

Ross

McLoughlin³

et al. 2021

Australian J Rural Health

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Background There is no evidence that being a rural or regional organ transplant recipient has adverse physical health outcomes post‐surgery compared with those experienced by people living in cities, but the impact of living remotely from transplant centres on psychosocial outcomes has not been explored. Objective To identify the social, emotional, psychological, spiritual, informational and practical issues associated with being a regionally based organ transplant recipient or carer and determine how support services could be improved for this group. Design/ Setting/ Participants Twenty‐two purposively sampled adult Australians who lived outside metropolitan centres and had received an organ transplant (n = 15) or were the primary carer of someone who had received one (n = 7), participated in semi‐structured, telephone interviews. Qualitative data were collected until data saturation was reached and were analysed using thematic analysis. Results Five key themes (plus subthemes) were identified: (a) travelling for specialist transplant care takes a toll, (b) unique transplant‐related psychological and emotional issues experienced before and after transplants, (c) caring for transplant recipients is a demanding role, (d) lay, peer and professional support, including rural general practitioners and accommodation facilities, help ease the burden, but (e) significant barriers to accessing transplant‐focused psychosocial support exist. Conclusion Novel methods of delivering targeted, transplant‐specific information and psychosocial care to rural transplant recipients and their carers, employers and rural health professionals require development and evaluation. Strategies might be delivered by peers or professionals via telehealth, telephone, social media or websites for example, depending on preferences and level of need.

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“…It is essential that the common iliac bifurcation is not damaged during this process [45]. Like a number of other major units our center preferentially retrieves the pancreas en bloc with the liver, with separation of both organs performed on the back-table (see below) [47].…”

Section: Dbd Retrievals-pancreas-specific Considerationsmentioning

confidence: 99%

Pancreas Retrieval for Whole Organ and Islet Cell Transplantation

Hawthorne¹,

Hameed²,

Pleass³

2018

Organ Donation and Transplantation - Current Status and Future Challenges

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For more than five decades, we have been refining advances in pancreas whole organ and islet cell transplantation as clinical therapies to treat the ever-increasing number of patients suffering from type-1-diabetes. Research and clinical practice have contributed to making both whole organ and cellular transplantation viable therapeutic options for a broader range of patients. Furthermore, both forms of clinical transplantation results have progressively improved, due to the ongoing refinement of organ donation and its various technical processes, combined with the evolution of immunosuppression and patient care now offering excellent long-term treatment for both type-1-diabetes and concomitant renal failure. This chapter provides an overview on how this has been undertaken and achieved over decades to ultimately provide outstanding outcomes on par with other organ transplantation results. Briefly, we cover the history of pancreas retrieval procedures, the importance of donor selection, the intricate processes of the organ donor operation, preservation of the pancreas, and the ideal ways to best improve outcomes for transplantation. Improving and providing the optimal donor and preservation conditions underpinning the success of subsequent whole pancreas or islet transplantation as a safe, effective, and feasible therapeutic option for an increasing number of patients suffering from type-1-diabetes.

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Excellent Outcomes of Simultaneous Pancreas Kidney Transplantation in Patients From Rural and Urban Australia

Abstract: SPK transplantation can be performed with excellent outcomes at a national center with a vast catchment area, irrespective of donor or recipient location.

Cited by 17 publications

References 29 publications

A let-7 microRNA-Binding Site Polymorphism in KRAS Predicts Improved Outcome in Patients with Metastatic Colorectal Cancer Treated with Salvage Cetuximab/Panitumumab Monotherapy

A let-7 microRNA-Binding Site Polymorphism in KRAS Predicts Improved Outcome in Patients with Metastatic Colorectal Cancer Treated with Salvage Cetuximab/Panitumumab Monotherapy

The psychosocial experiences and supportive care preferences of organ transplant recipients and their carers who live in regional Australia

Pancreas Retrieval for Whole Organ and Islet Cell Transplantation

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