Experience With Protocol Biopsies After Solitary Pancreas Transplantation1

Stratta, Robert J.; Taylor, Rodney J.; Grune, Martin T.; Sindhi, Rakesh; Sudan, Debra L.; Castaldo, P.; Cushing, Kathleen; Radio, Stanley J.; Wisecarver, James L.; Matamoros, Aurelio; Nelson, Nick; Hapke, Marc R.; Pillen, Todd; Markin, Rodney S.

doi:10.1097/00007890-199560120-00011

Cited by 31 publications

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“…A total of 15 patients (12 PTA, 3 PAK) were con- (14-85) 13 (65) 6(30) 12 (60) 10 (50) Data are means ± SD (range) or n verted from cyclosporine to Prograf-based therapy for either ongoing rejection (n = 13) or drug toxicity (n = 2). The diagnosis of rejection was based on clinical criteria, such as hematuria, hyperamylasemia, a reduction in urine amylase levels, positive urine cytology, or a rise in serum anodal trypsinogen levels, and confirmed by pancreaticoduodenal histopathology (19,20).…”

Section: Preoperative Management and Immunosuppressionmentioning

confidence: 99%

“…In patients with bladder drainage, cystoscopic transduodenal needle biopsy with ultrasound guidance affords an innovative approach to the histopathologic examination of the pancreaticoduodenal allograft. We have previously reported our experience with so-called protocol or surveillance biopsies after solitary PTx (20). To date, we have performed prospective monitoring with protocol biopsies in 36 solitary PTx recipients.…”

Section: Conclusion-vascularizedmentioning

confidence: 99%

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Solitary Pancreas Transplantation: Experience with 62 consecutive cases

et al. 1997

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Section: Preoperative Management and Immunosuppressionmentioning

confidence: 99%

Section: Conclusion-vascularizedmentioning

confidence: 99%

Solitary Pancreas Transplantation: Experience with 62 consecutive cases

et al. 1997

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“…Another method for the early detection of pancreas rejection may be the use of protocol biopsies. However, Stratta et al could not demonstrate a difference in 1 -year actuarial graft survival for patients with or without protocol cytoscopic transduodenal pancreas biopsies [26].…”

Section: Introductionmentioning

confidence: 92%

Interstitial and vascular pancreas rejection in relation to graft survival

Boonstra¹,

Pijl²,

Es³

et al. 1997

Transplant Int

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Interstitial and vascular pancreas rejection in relation to graft survivalAbstract To examine the incidence Key words Pancreas of interstitial and vascular rejection in pancreas allografts and its impact on graft survival, we studied 36 percutaneous pancreas biopsies and 10 pancreas transplantectomy specimens from 32 patients who had undergone simultaneous pancreas-kidney transplantation. Interstitial rejection (IR) was predominantly found in the biopsies, while vascular rejection (VR) was most prominent in the transplantectomies. Pancreas graft survival was significantly decreased for pancreas grafts that had suffered from vascular rejection when compared to those with only interstitial rejection. Potential rejection markers, i. e., serum amylase, glucose, creatinine, and urinary amylase, did not correlate with histological signs of rejection, although increased levels of serum amylase were, in all but one case, associated with rejection.We conclude that a percutaneous pancreas biopsy remains the most reliable method to determine pancreas rejection, and that by distinguishing between IR and VR, a pancreas biopsy may provide important diagnostic as well as prognostic information.

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“…Additionally, serum amylase and lipase levels are not always reliable indicators of pancreas allograft rejection, and do not correlate with rejection grade. Due to the challenges of diagnosing rejection in SPT, we routinely perform surveillance pancreas biopsies in SPT recipients [13].…”

Section: Solitary Pancreas Transplantation: Outcomes and Utility Of Smentioning

confidence: 99%

Pancreas Transplantation: Lessons Learned From a Decade of Experience at Wake Forest Baptist Medical Center

et al. 2011

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■ AbstractThis article reviews the outcome of pancreas transplantations in diabetic recipients according to risk factors, surgical techniques, and immunosuppression management that evolved over the course of a decade at Wake Forest Baptist Medical Center. A randomized trial of alemtuzumab versus rabbit anti-thymocyte globulin (rATG) induction in simultaneous kidney-pancreas transplantation (SKPT) at our institution demonstrated lower rates of acute rejection and infection in the alemtuzumab group. Consequently, alemtuzumab induction has been used exclusively in all pancreas transplantations since February 2009. Early steroid elimination has been feasible in the majority of patients. Extensive experience with surveillance pancreas biopsies in solitary pancreas transplantation (SPT) is described. Surveillance pancreas biopsy-directed immunosuppression has contributed to equivalent long-term pancreas graft survival rates in SKPT and SPT recipients at our center, in contrast to recent registry reports of persistently higher rates of immunologic pancreas graft loss in SPT. Furthermore, the impact of donor and recipient selection on outcomes is explored. Excellent results have been achieved with older (extended) donors and recipients, in recipients of organs from donation after cardiac death donors managed with extracorporeal support, and in African-American patients. Type 2 diabetics with detectable C-peptide levels have been transplanted successfully with outcomes comparable to those of insulinopenic diabetics. Our experiences are discussed in the light of findings reported in the literature.

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Experience With Protocol Biopsies After Solitary Pancreas Transplantation1

Cited by 31 publications

References 0 publications

Solitary Pancreas Transplantation: Experience with 62 consecutive cases

Solitary Pancreas Transplantation: Experience with 62 consecutive cases

Interstitial and vascular pancreas rejection in relation to graft survival

Pancreas Transplantation: Lessons Learned From a Decade of Experience at Wake Forest Baptist Medical Center

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