Pancreas transplant registry

Sutherland, David E.R.; Moudry, K. C.

doi:10.1007/978-94-009-1083-6_15

Cited by 14 publications

(8 citation statements)

References 4 publications

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“…This is in accordance with the results of the world-wide human pancreas transplant registry which shows a significant increase in graft failure beyond 6 h of pancreas conservation when evaluating more than 1000 clinical pancreas transplantations performed until now [20]. Obviously, the possibility of transplantation after a longer time would offer advantages, also with respect to testing histocompatibility of the donor and recipient.…”

Section: Discussionsupporting

confidence: 88%

“…Apart from technical and immunologic problems, the conservation of the organ from removal to reimplantation in the recipient poses a major problem, since the pancreas is far more sensitive to ischemia than kidney or heart. For example, the success rate of human pancreas transplantation is considerably less when the time of cold ischemia exceeds 6 h [20]. This requires the search for improved pancreas-specific protective solutions.…”

Section: Introductionmentioning

confidence: 99%

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The perfused porcine pancreas as a model for testing organ protective solutions

et al. 1989

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The present study was designed to establish an in vitro perfused porcine pancreas preparation as a model for testing the effect of organ protective solutions on stimulated pancreatic endocrine and exocrine secretion. The pancreas was prepared and perfused for 10 min with Euro Collins solution, thereafter it was stored in the cold (4 degrees C) for various times. After 3-h and 6-h ischemia pancreatic insulin release in response to glucose was not significantly affected. After 12-h ischemia reduced pancreatic insulin secretin, increased perfusion pressure, and increased amylase and lipase release indicated pancreatic damage. Complete pancreatic dysfunction was seen after 24-h and 48-h ischemia with massive increase in perfusion pressure and low insulin secretion which did not follow a glucose-dependent release pattern, while amylase and lipase concentrations in the perfusion medium increased. Stimulated exocrine pancreatic secretion was significantly decreased already after 3-h ischemia and completely lost after 12 h.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

The perfused porcine pancreas as a model for testing organ protective solutions

et al. 1989

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“…In recent years pancreas transplant alone, or combined with kidney transplant, has become an innovative surgical practice in the treatment of Type i (insulin-dependent) diabetes mellitus with late complications, especially end stage renal failure [1][2][3][4][5]. The different surgical approaches have all been effective, in the short-term, correcting both hyperglycaemia [3][4][5][6][7] and the maj or metabolic alterations usually present in Type 1 diabetes [5,[7][8].…”

Section: Introductionmentioning

confidence: 99%

Reduction of insulin resistance by combined kidney-pancreas transplantation in Type 1 (insulin-dependent) diabetic patients

et al. 1990

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Summary.To evaluate the effect of combined kidney and pancreas transplantation on insulin action and glucose metabolism, 15 Type 1 (insulin-dependent) diabetic patients who were undergoing combined kidney-pancreas transplantation were studied before transplantation by means of the euglycaemic hyperinsulinaemic clamp technique combined with 3-3H-glucose infusion and indirect calorimetry. Nine of the original 15 patients were studied again after four months and six after 12 months, successful combined kidney-pancreas transplantation with the same experimental protocol. Nine volunteers formed the group of normal subjects. Combined kidney-pancreas transplantation normalised hepatic glucose production and reduced peripheral insulin resistance in Type 1 diabetic uraemic patients, despite chronic immunosuppressive therapy. To further evaluate the hypothesis that residual insulin resistance was due to chronic steroid therapy, 11 additional subjects with chronic uveitis (six of whom were treated with only prednisone, and five treated only with cyclosporin) underwent the same protocol demonstrating a normal hepatic glucose production. The insulin-stimulated peripheral glucose uptake was reduced in the prednisonetreated group, but normal in cyclosporin-treated subjects. Four additional diabetic patients with a kidney transplant were also studied. They showed a peripheral insulin sensitivity intermediate between diabetic uraemic patients and patients after combined transplant. We conclude that shortterm (one year) combined kidney-pancreas transplantation improves glucose metabolism by restoring normal rates of hepatic glucose production and reducing peripheral insulin resistance; chronic steroid therapy is the major determinant of residual reduced insulin action. Both kidney and pancreas substitution play a role in reducing peripheral insulin resistance.

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“…The Stockholm recipient rejected the graft within a month, as did two other recipients of living donor PTAs at Stockholm in 1985 [58], disappointing in that one of the original rationales for living donor transplants was to decrease the probability of rejection, high at the time with deceased donors [17][18][19][20][21][22]. However, with a living donor PAK from the same donor, the recipient was a confirmed nonresponder to the donor and theoretically at low risk to reject [59,60]. Indeed, this was the case for our same donor living donor PAK transplants, but the rejection rate for living donor PTAs remained high in the precyclosporine era [14].…”

Section: Living Donor Segmental Pancreas Transplant Experiencementioning

confidence: 99%

Pushing the envelope

Sutherland

Radosevich

Gruessner

et al. 2012

Current Opinion in Organ Transplantation

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The incentives for living donor transplants are to eliminate long-wait times for a deceased donor organ and to improve outcomes. With both the incentive is high, but either by itself is sufficient. As the number of pancreas transplant candidates increase, so will wait times for a deceased donor organ. For this reason, living donor pancreas/islet transplant volume will likely increase in the years to come.

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Pancreas transplant registry

Cited by 14 publications

References 4 publications

The perfused porcine pancreas as a model for testing organ protective solutions

The perfused porcine pancreas as a model for testing organ protective solutions

Reduction of insulin resistance by combined kidney-pancreas transplantation in Type 1 (insulin-dependent) diabetic patients

Pushing the envelope

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