scholarly journals Stem Cells as a Tool to Improve Outcomes of Islet Transplantation

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Emily Sims ◽  
Carmella Evans-Molina
Keyword(s):  
Stem Cells ◽  
Islet Transplantation ◽  
Insulin Independence ◽  
Islet Transplant ◽  
Edmonton Protocol ◽  
Transplant Registry ◽  
Incremental Improvement ◽  
And Function

The publication of the promising results of the Edmonton protocol in 2000 generated optimism for islet transplantation as a potential cure for Type 1 Diabetes Mellitus. Unfortunately, follow-up data revealed that less than 10% of patients achieved long-term insulin independence. More recent data from other large trials like the Collaborative Islet Transplant Registry show incremental improvement with 44% of islet transplant recipients maintaining insulin independence at three years of follow-up. Multiple underlying issues have been identified that contribute to islet graft failure, and newer research has attempted to address these problems. Stem cells have been utilized not only as a functional replacement forβcells, but also as companion or supportive cells to address a variety of different obstacles that prevent ideal graft viability and function. In this paper, we outline the manners in which stem cells have been applied to address barriers to the achievement of long-term insulin independence following islet transplantation.

Long Term Outcomes of Allogeneic Islet Transplantation: The Collaborative Islet Transplant Registry (CITR) 1999-2010

2012 ◽  
Vol 94 (10S) ◽  
pp. 159 ◽  
Author(s):  
M. R. Rickels ◽  
T. Berney ◽  
P. Stock ◽  
P. A. Senior ◽  
R. Alejandro ◽  
...  
Keyword(s):  
Islet Transplantation ◽  
Long Term Outcomes ◽  
Islet Transplant ◽  
Transplant Registry ◽  
Islet Transplant Registry

scholarly journals Long-Term Follow-Up of the Edmonton Protocol of Islet Transplantation in the United States

2015 ◽  
Vol 16 (2) ◽  
pp. 509-517 ◽  
Author(s):  
D. C. Brennan ◽  
H. A. Kopetskie ◽  
P. H. Sayre ◽  
R. Alejandro ◽  
E. Cagliero ◽  
...  
Keyword(s):  
United States ◽  
Islet Transplantation ◽  
The United States ◽  
Edmonton Protocol ◽  
Long Term Follow Up

260-LB: Continuous Glucose Monitoring Metrics in Islet Transplant Recipients with Long-Term Insulin Independence

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 260-LB ◽  
Author(s):  
DAVID BAIDAL ◽  
ANA M. ALVAREZ GIL ◽  
NATHALIA PADILLA ◽  
CAMILLO RICORDI ◽  
RODOLFO ALEJANDRO
Keyword(s):  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Transplant Recipients ◽  
Insulin Independence ◽  
Islet Transplant

Lung Structure And Function Relation In Elastase-Treated Rats: A Long-Term Follow Up Study

2012 ◽  
Author(s):  
Margit V. Szabari ◽  
Jozsef Tolnai ◽  
Balazs Maar ◽  
Harikrishnan Parameswaran ◽  
Elizabeth Bartolak-Suki ◽  
...  
Keyword(s):  
Structure And Function ◽  
Follow Up Study ◽  
Lung Structure ◽  
Long Term Follow Up ◽  
And Function ◽  
Function Relation

scholarly journals 13-year Follow-up of Treatment of Osteochondral Lesions with MACI

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0004 ◽  
Author(s):  
Chris Kreulen ◽  
Trevor Shelton ◽  
Jacqueline Nguyen ◽  
Eric Giza ◽  
Martin Sullivan
Keyword(s):  
Social Functioning ◽  
Physical Functioning ◽  
Bodily Pain ◽  
Long Term Results ◽  
Osteochondral Lesions ◽  
Sf 36 ◽  
Significant Difference ◽  
And Function

Category: Ankle, Arthroscopy, Hindfoot, Sports, Trauma Introduction/Purpose: Surgical management of osteochondral lesions of the talus (OLT) present an ongoing treatment challenge. Previously, matrix-induced autologous chondrocyte implantation (MACI) demonstrated improved pain and function at 7-years postoperative, providing evidence that MACI is a reliable method for treating cartilage. However, it is unknown the long- term results of MACI in OLT. The purpose of this study was to assess 13-year clinical follow-up data and the long-term success of this implant by comparing patient reported outcome measures (PROMs) pre-operatively, at 7-years post-operative, and at 13- years post-operative. Methods: A prospective investigation of MACI was performed on 10 patients with OLTs who had failed previous arthroscopic treatment. Of the 10 patients, 9 were available for 7-year and 13-year follow-up. Short Form Health Survey (SF-36) and the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot evaluation were utilized at pre-operative, 7-year, a 13-year postoperative. For each patient, a paired t-test was used to compare 13-year post-operative PROMs to pre-operative PROMs. A single factor analysis of variance (ANOVA) determined whether PROMs were different between pre-operative, 7-year post- operative, and 13-year post-operative time intervals. When a significant difference was detected, a post-hoc Tukey’s determined which time periods were different. Results: SF-36 data at 13-years showed significant improvements in Physical Functioning (p=0.012), Lack of Bodily Pain (p=0.017), and Social Functioning (p=0.007) compared with preoperative data. There were no differences in other components of the SF-36 outcomes (p>0.05). Although the AOFAS was on average 12 points higher at 13-years postoperative, this was not statistically significant (p=0.173). As for comparing PROMs over time, 13-years post-operative PROMs were comparable to 7-years post- operative (Table 1). There were better PROMs for Physical Functioning, Bodily Pain, and Social Functioning at 7- and 13-years post-operative compared to pre-operative while Physical Role Functioning was also better at 7-years post-operative compared to pre-operative. Conclusion: This study shows MACI provides greater pain relief and function at 13-years post-operative with stable long-term follow-up. MACI should be considered for osteochondral lesions that fail initial microfracture.

VP40 Comprehensive Evaluation Of Islet Transplantation For Type I Diabetes

2017 ◽  
Vol 33 (S1) ◽  
pp. 166-167
Author(s):  
Danni Chen ◽  
Kun Xiong ◽  
Di Xue
Keyword(s):  
Cost Effectiveness ◽  
Islet Transplantation ◽  
Type I Diabetes ◽  
Insulin Dose ◽  
Cochrane Library ◽  
Type I ◽  
Islet Graft ◽  
Pancreatic Islet Transplantation ◽  
Insulin Independence

INTRODUCTION:Despite several therapeutic options existing for the patients with type I diabetes, the patients are still at high risk for severe acute and chronic complications (1). Pancreatic islet transplantation is a promising therapy to achieve good glycemic control with no or little additional insulin (2). This study was to evaluate the effectiveness, safety, economics and social ethics of islet transplantation (IT) for the patients with type I diabetes.METHODS:We searched PubMed, Cochrane Library, CNKI and CBM to retrieve eligible literatures. The values of H1bAc before and after transplantation, the rates of insulin independence and functional islet graft at the last follow-up, and the insulin dose per patient-day were analyzed. Descriptive statistics, t tests and random effects meta-analyses were used in the study.RESULTS:Totally 21 original papers with 488 cases from 9 different countries were reviewed and analyzed. The studies showed that the H1bAc was decreased from 7.7 percent (95 percent Confidence Interval, CI: 7.4, 8.1) before IT to 6.2 percent (95 percent CI: 5.9, 6.4) after IT. At the last follow-up, the rate of insulin independence was 48.96 percent (95 percent CI: 31.32, 66.73) and the rate of functional islet graft was 65.79 percent (95 percent CI: 47.06, 82.21). The daily insulin requirement dropped from 0.52U/kg/d to 0.21 U/kg/d. The main adverse events of islet transplantation were bleeding (7.01 percent) and the complications related to immunosuppression therapy (6.37 percent), but they were less than those of whole pancreas transplantation.Another study with a 20-year follow-up also showed that the cost-effectiveness of islet transplantation (USD47,800 per QALY) was better than that of insulin therapy (USD71,000 per QALY). In spite of the better evidences of islet transplantation, the insufficient organ donation and issues of cell purification and immunological rejection limited islet transplantation's widespread utilization (1).CONCLUSIONS:The islet transplantation therapy for the patients with type I diabetes has a potential to achieve insulin independence and better cost-effectiveness, and is relatively safe. But there are some obstacles for its wide utilization.

Progression of acromegalic arthropathy in long-term controlled acromegaly patients: 9 years of longitudinal follow-up

2020 ◽  
Vol 106 (1) ◽  
pp. 188-200
Author(s):  
Iris C M Pelsma ◽  
Nienke R Biermasz ◽  
Wouter R van Furth ◽  
Alberto M Pereira ◽  
Herman M Kroon ◽  
...  
Keyword(s):  
Radiographic Progression ◽  
Treatment Strategies ◽  
Multivariable Model ◽  
Smallest Detectable Change ◽  
Kellgren And Lawrence ◽  
And Function ◽  
Prospective Longitudinal ◽  
Acromegalic Arthropathy

Abstract Context Joint complaints in patients with acromegaly are common, although the long-term disease course is largely unknown. Objective This study aims to evaluate the long-term course of acromegalic arthropathy. Design and Setting A prospective longitudinal cohort study was conducted in controlled acromegaly patients followed at a tertial referral center, with 3 study visits: at baseline and after a median of 2.6 and 9.1 years. Patients We included 31 patients with biochemically controlled acromegaly for 2 or more years (49% female; median age, 60 years) at baseline. Main Outcome Measures Radiographic arthropathy of the knee, hip, hand, and cervical and lumbar spine were evaluated using Kellgren and Lawrence (KL) scores, developed for assessment of primary osteoarthritis (OA). Radiographic progression was defined as a KL increase above the smallest detectable change. Joint symptoms were assessed using self-reported questionnaires. Progression was defined using existing clinically important cutoff values. Risk factors for progression were investigated using a multivariable model. Results All patients had definite radiographic OA at 1 or more joints at baseline. Radiographic progression was observed in 29%, 48%, 84%, and 94% of patients in the knees, hips, hands, and axial joints, respectively. Deterioration in hand-related pain and function was observed in 10 (32.3%) and 11 patients (35.5%), respectively. Solely baseline KL scores of the hip were associated with hip OA progression (OR 1.88; 95% CI, 1.09-3.16). Conclusions Acromegalic arthropathy showed significant radiographic progression over 9.1 years of follow-up in patients in remission, whereas clinical progression was observed less frequently. Future studies should focus on adequate prevention and treatment strategies of acromegalic arthropathy.

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