scholarly journals The impact of islet mass, number of transplants and time between transplants on graft function in a national islet transplant program

2021 ◽  
Author(s):  
Shareen Forbes ◽  
Anneliese J. Flatt ◽  
Denise Bennett ◽  
Robert Crookston ◽  
Mirka Pimkova ◽  
...  
Keyword(s):  
Mass Number ◽  
Graft Function ◽  
Islet Mass ◽  
Islet Transplant ◽  
Transplant Program ◽  
The Impact

scholarly journals Impact of HLA Mismatching on Early Subclinical Inflammation in Low-Immunological-Risk Kidney Transplant Recipients

2021 ◽  
Vol 10 (9) ◽  
pp. 1934
Author(s):  
Domingo Hernández ◽  
Teresa Vázquez ◽  
Juana Alonso-Titos ◽  
Myriam León ◽  
Abelardo Caballero ◽  
...  
Keyword(s):  
Risk Factor ◽  
Kidney Transplant ◽  
Graft Function ◽  
Human Leukocyte ◽  
Subclinical Inflammation ◽  
Kidney Transplant Recipients ◽  
Protocol Biopsy ◽  
Recipient Age ◽  
The Impact ◽  
Hla Mismatches

The impact of human leukocyte antigen (HLA)-mismatching on the early appearance of subclinical inflammation (SCI) in low-immunological-risk kidney transplant (KT) recipients is undetermined. We aimed to assess whether HLA-mismatching (A-B-C-DR-DQ) is a risk factor for early SCI. As part of a clinical trial (Clinicaltrials.gov, number NCT02284464), a total of 105 low-immunological-risk KT patients underwent a protocol biopsy on the third month post-KT. As a result, 54 presented SCI, showing a greater number of total HLA-mismatches (p = 0.008) and worse allograft function compared with the no inflammation group (48.5 ± 13.6 vs. 60 ± 23.4 mL/min; p = 0.003). Multiple logistic regression showed that the only risk factor associated with SCI was the total HLA-mismatch score (OR 1.32, 95%CI 1.06–1.64, p = 0.013) or class II HLA mismatching (OR 1.51; 95%CI 1.04–2.19, p = 0.032) after adjusting for confounder variables (recipient age, delayed graft function, transfusion prior KT, and tacrolimus levels). The ROC curve illustrated that the HLA mismatching of six antigens was the optimal value in terms of sensitivity and specificity for predicting the SCI. Finally, a significantly higher proportion of SCI was seen in patients with >6 vs. ≤6 HLA-mismatches (62.3 vs. 37.7%; p = 0.008). HLA compatibility is an independent risk factor associated with early SCI. Thus, transplant physicians should perhaps be more aware of HLA mismatching to reduce these early harmful lesions.

scholarly journals Calcium and phosphate levels after kidney transplantation and long-term patient and allograft survival

2020 ◽  
Author(s):  
Julio Chevarria ◽  
Donal J Sexton ◽  
Susan L Murray ◽  
Chaudhry E Adeel ◽  
Patrick O’Kelly ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Transplant ◽  
Graft Failure ◽  
Graft Function ◽  
Renal Transplant Recipients ◽  
Post Transplant ◽  
All Cause Mortality ◽  
Transplant Function ◽  
The Republic ◽  
The Impact

Abstract Background Non-traditional cardiovascular risk factors, including calcium and phosphate derangement, may play a role in mortality in renal transplant. The data regarding this effect are conflicting. Our aim was to assess the impact of calcium and phosphate derangements in the first 90 days post-transplant on allograft and recipient outcomes. Methods We performed a retrospective cohort review of all-adult, first renal transplants in the Republic of Ireland between 1999 and 2015. We divided patients into tertiles based on serum phosphate and calcium levels post-transplant. We assessed their effect on death-censored graft survival and all-cause mortality. We used Stata for statistical analysis and did survival analysis and spline curves to assess the association. Results We included 1525 renal transplant recipients. Of the total, 86.3% had hypophosphataemia and 36.1% hypercalcaemia. Patients in the lowest phosphate tertile were younger, more likely female, had lower weight, more time on dialysis, received a kidney from a younger donor, had less delayed graft function and better transplant function compared with other tertiles. Patients in the highest calcium tertile were younger, more likely male, had higher body mass index, more time on dialysis and better transplant function. Adjusting for differences between groups, we were unable to show any difference in death-censored graft failure [phosphate = 1.14, 95% confidence interval (CI) 0.92–1.41; calcium = 0.98, 95% CI 0.80–1.20] or all-cause mortality (phosphate = 1.10, 95% CI 0.91–1.32; calcium = 0.96, 95% CI 0.81–1.13) based on tertiles of calcium or phosphate in the initial 90 days. Conclusions Hypophosphataemia and hypercalcaemia are common occurrences post-kidney transplant. We have identified different risk factors for these metabolic derangements. The calcium and phosphate levels exhibit no independent association with death-censored graft failure and mortality.

EFFECT OF DONOR TREATMENT WITH HEPARINOIDS ON GRAFT FUNCTION AFTER INTRAPORTAL TRANSPLANTATION OF A MARGINAL ISLET MASS

2003 ◽  
Vol 76 (Supplement) ◽  
pp. S34
Author(s):  
M T Juszczak ◽  
S J Hughes ◽  
S H Powis ◽  
M Press
Keyword(s):  
Graft Function ◽  
Islet Mass

SOME CHARACTERISTICS OF THE COMPOUND MULTIPLICITY IN HIGH-ENERGY NUCLEUS–NUCLEUS INTERACTIONS

2011 ◽  
Vol 20 (08) ◽  
pp. 1735-1754 ◽  
Author(s):  
M. MOHERY ◽  
M. ARAFA
Keyword(s):  
Experimental Data ◽  
Impact Parameter ◽  
Mass Number ◽  
Multiplicity Distribution ◽  
High Energy ◽  
Projectile Nucleus ◽  
Target Mass ◽  
Compound Multiplicity ◽  
Multiplicity Distributions ◽  
The Impact

The present paper deals with the interactions of 22 Ne and 28 Si nuclei at (4.1–4.5)A GeV /c with emulsion. Some characteristics of the compound multiplicity nc given by the sum of the number of shower particles ns and grey particles ng have been investigated. The present experimental data are compared with the corresponding ones calculated according to modified cascade evaporation model (MCEM). The results reveal that the compound multiplicity distributions for these two reactions are consistent with the corresponding ones of MCEM data. It can also be seen that the peak of these distributions shifts towards a higher value of nc with increasing projectile mass. It may further be seen that the compound multiplicity distributions becomes broader with increasing target size and its width increases with the size of the projectile nucleus. In addition, it has been found that the MCEM can describe the compound multiplicity characteristics of the different projectile, target and the correlation between different emitted particles. The values of average compound multiplicity increase with increasing mass of the projectile. Furthermore, it is observed that while the value of 〈nc〉 depends on the mass number of the projectile Ap and the target mass number At, the value of the ratio 〈nc〉/D(nc) seems to be independent of Ap and At. The impact parameter is found to affect the shape of the compound multiplicity distribution. Finally, the dependence of the average compound multiplicity on the numbers of grey and black particles, and the sum of them, is obvious. The values of the slope have been found to be independent of the projectile nucleus.

Pregnancy After Simultaneous Pancreas-Kidney Transplantation in Treatment of End-Stage Diabetes Mellitus: a Review

2021 ◽  
Author(s):  
Zana Stanic ◽  
Marko Vulic ◽  
Zlatko Hrgovic ◽  
Rajko Fureš ◽  
Milvija Plazibat ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Kidney Transplantation ◽  
Graft Function ◽  
Insulin Dependent Diabetes Mellitus ◽  
Organ Damage ◽  
Multiple Organ ◽  
Dependent Diabetes Mellitus ◽  
Increased Risk ◽  
Simultaneous Pancreas Kidney ◽  
The Impact

AbstractThe majority of patients with simultaneous pancreas and kidney transplant (SPKT) required transplantation owing to a long-standing history of insulin-dependent diabetes mellitus (IDDM). The disease causes multiple organ damage, impairs fertility, and affects quality of life. A successful kidney and pancreas transplant can improve health, ameliorate the consequences of pre-existent diabetes, and restore fertility. Good graft function, without any sign of rejection, and stable doses of immunosuppressant drugs are of utmost importance prior to the planned pregnancy. SPKT recipients who become pregnant may be at an increased risk for an adverse outcome and require meticulous multidisciplinary surveillance. We present experiences with SPKT pregnancies, traditional approaches, and recent considerations. In light of complex interactions between new anatomic relations and the impact of developing pregnancy and immunosuppressive medications, special stress is put on the risk of graft rejection, development of pregnancy complications, and potential harmful effects on fetal development. Recent recommendations in management of SPKT recipients who wish to commence pregnancy are presented as well. Key words: transplantation, pregnancy, pancreas, kidney, simultaneous pancreas and kidney transplantation (SPKT)

Loss of growth hormone signaling in the mouse germline or in adulthood reduces islet mass and alters islet function with notable sex differences

2021 ◽  
Author(s):  
Silvana Duran-Ortiz ◽  
Kathryn L. Corbin ◽  
Ishrat Jahan ◽  
Nicholas B. Whitticar ◽  
Sarah E Morris ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Insulin Secretion ◽  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Body Fat ◽  
Isolated Islets ◽  
Wild Type ◽  
Cross Sectional ◽  
Islet Mass ◽  
The Impact

In the endocrine pancreas, growth hormone (GH) is known to promote pancreatic islet growth and insulin secretion. In this study, we show that GH receptor (GHR) loss in the germline and in adulthood impacts islet mass in general but more profoundly in male mice. GHR knockout (GHRKO) mice have enhanced insulin sensitivity and low circulating insulin. We show that the total cross-sectional area of isolated islets (estimated islet mass) was reduced by 72% in male but by only 29% in female GHRKO mice compared to wild type controls. Also, islets from GHRKO mice secreted ~50% less glucose-stimulated insulin compared to size-matched islets from wild type mice. We next used mice with a floxed Ghr gene to knock down the GHR in adult mice at six-months of age (6mGHRKO) and examined the impact on glucose and islet metabolism. By 12-months of age, female 6mGHRKO mice had increased body fat and reduced islet mass but had no change in glucose tolerance or insulin sensitivity. However, male 6mGHRKO mice had nearly twice as much body fat, substantially reduced islet mass, and enhanced insulin sensitivity, but no change in glucose tolerance. Despite large losses in islet mass, glucose-stimulated insulin secretion from isolated islets was not significantly different between male 6mGHRKO and controls while isolated islets from female 6mGHRKO mice showed increased glucose-stimulated insulin release. Our findings demonstrate the importance of GH to islet mass throughout life and that unique sex-specific adaptations to the loss of GH signaling allow mice to maintain normal glucose metabolism.

P1690EXPERIENCE WITH EXPANDED CRITERIA DONORS: 10-YEAR SINGLE CENTER ANALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Karol Graňák ◽  
Vnuäã¡k Matej ◽  
Petra Skálová ◽  
Juraj Miklušica ◽  
Ľudovít Laca ◽  
...  
Keyword(s):  
Graft Survival ◽  
Patient Survival ◽  
Graft Function ◽  
Organ Transplant ◽  
First Year ◽  
Transplant Program ◽  
Basic Parameters ◽  
Expanded Criteria ◽  
Expanded Criteria Donors

Abstract Background and Aims Kidneys from expanded criteria donors with diagnosis of brain death have become a part of the organ transplant program, which have thus increased the number of transplants. Method In this retrospective analysis, we identified the expanded criteria donors in a group of 156 kidney donors at our center. Basic parameters of the donors before kidney recovery were collected. Graft function, graft survival, and patient survival at 1, 3, and 5 years posttransplant were compared in expanded criteria versus standard criteria donors. Results Expanded criteria donors were significantly older than standard criteria donors (P < .001), had higher body mass index (P = .006), and had more frequent arterial hypertension (P < .001) and diabetes mellitus (P = .004) in their histories. When we considered the estimated glomerular filtration rate, graft function in the first 6 months after transplant was significantly worse in kidneys from expanded criteria donors (P = .011). In addition, recipients of grafts from expanded criteria donors had significantly worse survival in the first year posttransplant (P = .023); however, no differences in graft survival were observed. Conclusion From the long-term aspect, graft function and graft and patient survival in cases of kidneys from expanded criteria donors were comparable to results with kidneys from standard criteria donors. Expanded use of organs available for transplant is important due to the constantly increasing demands versus limited offers of organs.

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