The Effect of Ischemic Preconditioning of the Pancreas on Severity of Ischemia/Reperfusion-Induced Pancreatitis After a Long Period of Ischemia in the Rat

Nikeghbalian, S; Mardani, Parviz; Mansoorian, Mohsen Reza; Salahi, Hamid Reza; Bahador, Ali; Geramizadeh, Bita; Kakaei, Farzad; Johari, Hamed Ghoddusi; Malekhosseini, Seyed Ali

doi:10.1016/j.transproceed.2009.07.026

Cited by 10 publications

(7 citation statements)

References 10 publications

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“…However, none of these strategies has yet been tested in prospective randomized trials. Remote ischaemic preconditioning is a promising new approach; originally applied in paediatric cardiac surgery [59], this has been shown to prevent IRI in experimental pancreas transplantation [60,61]. Antiadhesive prophylaxis with a recombinant P-selectin antagonist (YSPSL) has been recently tested in human kidney transplantation showing prevention of inflammatory gene transcription without, however, decreasing delayed graft function [57,58].…”

Section: Ischemia/reperfusion Injurymentioning

confidence: 99%

Donor risk factors, retrieval technique, preservation and ischemia/reperfusion injury in pancreas transplantation

Maglione¹,

Ploeg

Friend

2013

Current Opinion in Organ Transplantation

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Section: Ischemia/reperfusion Injurymentioning

confidence: 99%

Donor risk factors, retrieval technique, preservation and ischemia/reperfusion injury in pancreas transplantation

Maglione¹,

Ploeg

Friend

2013

Current Opinion in Organ Transplantation

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“…Even though CA and CPR have been regarded as injurious to donor organs , reports exist that show that ischemia and subsequent reperfusion may actually have a protective influence. Ischemic preconditioning, effectively an outcome of donor CA, has been repeatedly reported to improve outcomes after transplantation in other solid organ transplant as well as pancreas . With an ischemic episode and subsequent restoration of blood flow, the preconditioning effect has the potential to decrease the ischemia‐reperfusion injury seen with all organs subject to ischemia time in transplantation, though exact mechanisms have not been identified in this context .…”

Section: Discussionmentioning

confidence: 99%

Donor cardiac arrest and cardiopulmonary resuscitation: impact on outcomes after simultaneous pancreas–kidney transplantation – a retrospective study

Messner

Etra

et al. 2020

Transpl Int

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Donor cardiac arrest and cardiopulmonary resuscitation (CACPR) has been considered critically because of concerns over hypoperfusion and mechanical trauma to the donor organs. We retrospectively analyzed 371 first simultaneous pancreas-kidney transplants performed at the Medical University of Innsbruck between 1997 and 2017. We evaluated short-and long-term outcomes from recipients of organs from donors with and without a history of CACPR. A total of 63 recipients received a pancreas and kidney graft from a CACPR donor. At 1, and 5-years, patient survival was similar with 98.3%, and 96.5% in the CACPR and 97.0%, and 90.2% in the non-CACPR group (log rank P = 0.652). Death-censored pancreas graft survival was superior in the CACPR group with 98.3%, and 91.4% compared to 86.3%, and 77.4% (log rank P = 0.028) in the non-CACPR group, which remained statistically significant even after adjustment [aHR 0.49 (95% CI 0.24-0.98), P = 0.044]. Similar relative risks for postoperative complications Clavien Dindo > 3a, pancreatitis, abscess, immunologic complications, delayed pancreas graft function, and relative length of stay were observed for both groups. Donors with a history of CACPR are, in the current practice, safe for transplantation. Stringent donor selection and short CPR durations may allow for outcomes surpassing those of donors without CACPR.

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“…This effect has been seen in a number of organs and has been detected up to 72 h poststimulation . Several animal models have already indicated that such preconditioning is also possible in interventions involving the pancreas, and has a protective effect against postoperative complications . Even if CPR is adequately administered or is uninterrupted, the macro‐ and microcirculation produced does not reach physiological baseline levels and the patient will undergo a relative ischemia or insufficient blood supply .…”

Section: Discussionmentioning

confidence: 99%

Impact of donor cardiopulmonary resuscitation on the outcome of simultaneous pancreas–kidney transplantation—a retrospective study

et al. 2020

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Previous cardiac arrest in brain-dead donors has been discussed as a potential risk factor in pancreas transplantation (PT), leading to a higher rate of organ refusal. This study aimed to assess the impact of cardiopulmonary resuscitation (CPR) in brain-dead donors on pancreas transplant outcome. A total of 518 type 1 diabetics underwent primary simultaneous pancreas-kidney (SPK) transplantation at our center between 1994 and 2018. Patients were divided into groups, depending on whether their donor had been resuscitated or not. A total of 91 (17.6%) post-CPR donors had been accepted for transplantation (mean duration of cardiac arrest, 19.4 AE 15.6 min). Those donors were younger (P < 0.001), had lower pancreas donor risk index (PDRI, P = 0.003), and had higher serum creatinine levels (P = 0.021). With a median follow-up of 167 months (IQR 82-229), both groups demonstrated comparable short-and long-term patient and graft survival. The resuscitation time (<20 min vs. ≥20 min) also showed no impact, with similar survival rates for both groups. A multivariable Cox regression analysis suggested no statistically significant association between donor CPR and patient or graft survival. Our results indicate that post-CPR brain-dead donors are suitable for PT without increasing the risk of complications.

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The Effect of Ischemic Preconditioning of the Pancreas on Severity of Ischemia/Reperfusion-Induced Pancreatitis After a Long Period of Ischemia in the Rat

Cited by 10 publications

References 10 publications

Donor risk factors, retrieval technique, preservation and ischemia/reperfusion injury in pancreas transplantation

Donor risk factors, retrieval technique, preservation and ischemia/reperfusion injury in pancreas transplantation

Donor cardiac arrest and cardiopulmonary resuscitation: impact on outcomes after simultaneous pancreas–kidney transplantation – a retrospective study

Impact of donor cardiopulmonary resuscitation on the outcome of simultaneous pancreas–kidney transplantation—a retrospective study

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