International Pancreas Transplantation Registry report

Sutherland, David E.R.; Gillingham, K.; Moudry-Munns, K.

doi:10.1007/978-94-011-3386-9_45

Cited by 9 publications

(14 citation statements)

References 5 publications

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“…Furthermore, if the indications for pancreas transplantation remain strong after successful LD kidney transplantation, a cadaveric pancreas may then be transplanted. Pancreatic graft survival is lower in that case [14]. However, three patients in our LD group later underwent pancreas transplantation.…”

Section: Discussionmentioning

confidence: 66%

“…The only case in the LD group was one below-knee amputation; the other 9 were equally distributed between the Comb and the CD groups ( Table 4). 14 Time spent in the hospital during the first 6 months posttransplantation vaned widely within each group (Fig.2). The mean value was significantly higher for the Comb group than for the LD group (P < 0.05; Table 4).…”

Section: Major Vascular Complicationsmentioning

confidence: 97%

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Transplantation in patients with diabetic nephropathy: Outcome of combined pancreas and kidney transplantation compared with kidney transplantation only

et al. 1990

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Detailed results of 12 combined pancreas and kidney transplantations (Comb) were compared with those of two matched diabetic controls per patientone living donor kidney recipient (LD) and one cadaveric donor kidney recipient (CD)who, though eligible for pancreas transplantation also, preferred kidney transplantation only. Mean follow-up was 22,23, and 21 months in the three groups. There was no mortality in the LD group, but two CD and one Comb patient died from cardiovascular disease. Two kidneys were lost in both the Comb and the LD group, compared to five in the CD group. Ten major vascular events occurred and three of them were lethal. The only LD case was one below-knee amputation; the other nine were equally distributed in the Comb and CD groups. The time spent in the hospital was shorter for the LD group. Thus, in the short run, LDs confer the best results, whereas in the long term the bettermetabolic control in the Combs may prove favorable.

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Section: Discussionmentioning

confidence: 66%

Section: Major Vascular Complicationsmentioning

confidence: 97%

Transplantation in patients with diabetic nephropathy: Outcome of combined pancreas and kidney transplantation compared with kidney transplantation only

et al. 1990

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“…In experienced centers in 1984, 86% of the recipients survived surgery2'; in 1989, this success level was true worldwide. 22 The surgical failure rate continues to be about 16%, although this figure seems to be improving. Recent (1988 to 1990) worldwide success rate is 68%,'9 and in some centers as high as 70% for all kinds of pancreas transplantation.…”

Section: Outcomes Of Transplantationmentioning

confidence: 99%

Pancreas Transplantation: A University of Minnesota Perspective

Nettles

1992

Diabetes Educ

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Because of various difficulties, transplantation is restricted to specific situations. Surgery is considered elective by many insurers, so costs are often borne by the patient. Surgical work-up includes a thorough evaluation of diabetes-related complications, tissue typing, psychological state, and social issues. Options of cadaver versus living related donors are explored. The surgical procedure is lengthy and the hospital stay long and intensive. Once a patient is ambulatory, education is begun to meet the extensive learning needs. After discharge, surgical follow-up focuses primarily on blood chemistries, medication doses, and surgical complications. Medical follow-up includes monitoring for infections and rejection as well as addressing long-term complications of diabetes. Studies of the effects of transplantation on diabetes complications are encouraging which, when coupled with improved surgical outcomes, may increase opportunities for transplant.

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“…Für die kombinierte Pankreas-/Nierentransplantation (KPNT) werden weltweit nach den Angaben des International Pancreas Transplant Registry (IPTR) inzwischen 1-Jahres-Funktionsraten von 74% (Pankreas) und 86% (Niere) erreicht [1], Diese enorme Verbesserung hat insbesondere in den USA während der letzten Jahre zu einer breiten Akzeptanz dieses Verfahrens in der Thera pie niereninsuffizienter Typ-I-Diabetiker geführt. [4,5].…”

Section: Introductionunclassified

Immunsuppression, Abstoßungsdiagnostik und -therapie nach Pankreastransplantation

et al. 1996

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Die spezifische Abstoßungsdiagnostik im Bereich des Pankreastransplantates ist anhand von Serumparametern nach wie vor kaum möglich, so daß neben dem Monitoring der Pankreasenzyme im Urin und der Urinzytologie nur die Transplantatbiopsie möglich ist. Da jedoch 95% der Pankreastransplantationen als kombinierte Pankreas-/Nierentrans-plantationen vorgenommen werden, besteht hier die Möglichkeit der Abstoßungsdiagnostik über das Monitoring der Transplantatniere. Die immunologischen Probleme bei der Pankreastransplantation sind dadurch gekennzeichnet, daß die Inzidenz und Intensität an akuten Abstoßungsreaktionen deutlich höher als nach der Transplantation anderer solider Organe ist. Ursache dieser immunologischen Probleme ist zum Teil die durchschnittlich schlechte HLA-Identität der Transplantate. Als Standardtherapie in der In-duktionsphase gilt die Quadruple-Immunsuppression mit Cyclosporin, Steroiden, Azathioprin und antilymphozytären Antikörpern. Die Verwendung polyklonaler (ATG) oder monoklonaler Antikörper (OKT3) führt zu denselben Ergebnissen, die mit einer Inzidenz der akuten Abstoßungsreaktionen von 56-83,5% nach wie vor unbefriedigend sind. Die Verwendung eines neuen immunsuppressiven Schemas (Neo-Quadruple-Therapie) führt nach ersten Ergebnissen zu einer Reduktion der Abstoßungsreaktionen auf 31 %. Die The-rapie akuter Abstoßungsreaktionen erfolgt in erster Linie ebenfalls mittels Antikörpern (ATG/OKT3). Hinsichtlich der Effektivität neuer Immunsuppressiva wie Tacrolimus und Mycophenolat Mofetil liegen noch keine ausreichenden verwertbaren Ergebnisse vor.

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International Pancreas Transplantation Registry report

Cited by 9 publications

References 5 publications

Transplantation in patients with diabetic nephropathy: Outcome of combined pancreas and kidney transplantation compared with kidney transplantation only

Transplantation in patients with diabetic nephropathy: Outcome of combined pancreas and kidney transplantation compared with kidney transplantation only

Pancreas Transplantation: A University of Minnesota Perspective

Immunsuppression, Abstoßungsdiagnostik und -therapie nach Pankreastransplantation

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International Pancreas Transplantation Registry report

Cited by 9 publications

References 5 publications

Transplantation in patients with diabetic nephropathy: Outcome of combined pancreas and kidney transplantation compared with kidney transplantation only

Transplantation in patients with diabetic nephropathy: Outcome of combined pancreas and kidney transplantation compared with kidney transplantation only

Pancreas Transplantation: A University of Minnesota Perspective

Immunsuppression, Absto&szlig;ungsdiagnostik und -therapie nach Pankreastransplantation

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Immunsuppression, Abstoßungsdiagnostik und -therapie nach Pankreastransplantation