Insulin-heparin infusions peritransplant substantially improve single-donor clinical islet transplant success.


BACKGROUND:Successful islet transplantation can result in insulin independence in many patients with type 1 diabetes mellitus, but it often requires more than one islet infusion. The ability to achieve insulin independence with a single donor is an important goal in clinical islet transplantation due to the limited organ supply. METHODS:We examined factors that may be associated with insulin independence after islet transplantation with islets from a single donor, using univariate and multivariate analysis. RESULTS:Thirteen of 85 (15.3%) achieved insulin independence after single-donor islet transplantation. Using multivariate analysis, only the use of insulin and heparin infusions peritransplant was a significant factor associated with insulin independence, with an adjusted odds ratio of 8.6 (95% confidence interval 2.0-37.0). Patients who had received insulin and heparin infusions peritransplant had greater indices of islet engraftment and a greater reduction in insulin use (80.1% + or - 4.3% vs. 54.2% + or - 2.8%, P<0.001) even if insulin independence was not achieved. CONCLUSIONS:Peritransplant intensive insulin and heparin enhances islet transplantation outcomes likely related in part to mitigation of the effects of the instant blood-mediated inflammatory reaction, combined with islet rest and avoidance of inflammation. It would be important to further investigate the effects of peritransplant insulin and heparin infusions on islet engraftment.






Koh A,Senior P,Salam A,Kin T,Imes S,Dinyari P,Malcolm A,Toso C,Nilsson B,Korsgren O,Shapiro AM




Has Abstract


2010-02-27 00:00:00














  • Late-onset cytomegalovirus disease in liver transplant recipients despite antiviral prophylaxis.

    abstract:BACKGROUND:The incidence and impact of cytomegalovirus (CMV) disease that occurs despite CMV prophylaxis among liver transplant recipients have been incompletely defined. METHODS:The incidence and risk factors for CMV disease during the first posttransplant year in a cohort of liver transplant recipients who received ...


    pub_type: 杂志文章


    authors: Limaye AP,Bakthavatsalam R,Kim HW,Kuhr CS,Halldorson JB,Healey PJ,Boeckh M

    更新日期:2004-11-15 00:00:00

  • Heart transplantation in diabetic recipients.

    abstract::Preexisting diabetes mellitus (DM) has been regarded as a contraindication to heart transplantation (HT). This prejudice has been based upon concern over increased infection rates and worsening DM with the initiation of prednisone immunosuppression. To better evaluate these suppositions, we reviewed our experience wit...


    pub_type: 杂志文章


    authors: Ladowski JS,Kormos RL,Uretsky BF,Griffith BP,Armitage JM,Hardesty RL

    更新日期:1990-02-01 00:00:00

  • Impact of Rural Residence on Kidney Transplant Rates Among Waitlisted Candidates in the VA Transplant Programs.

    abstract:BACKGROUND:Although proportionally more veterans live in rural areas compared to nonveterans, the impact of rurality status on kidney transplantation (KTP) access among veterans is unknown. Our objective was to study KTP rates among veterans listed for KTP and to compare the impact of rurality status on KTP rates among...


    pub_type: 杂志文章


    authors: O'Shea AMJ,Franciscus CL,Kaboli PJ,Kalil RS

    更新日期:2019-09-01 00:00:00

  • Graft-versus-host reactions within the thyroid gland may evoke pari passu autoimmune thyroiditis.

    abstract::Unilateral, intraorganal injection of parental lymph node cells into thyroid lobes of F1 hybrid rats elicited an intense, local graft-versus-host reaction within the injected lobes containing massive numbers of lymphocytes. Surprisingly, significant mononuclear cell infiltration was also seen within the contralateral ...


    pub_type: 杂志文章


    authors: Konetzki WS,Streilein JW

    更新日期:1978-05-01 00:00:00

  • HuM291(Nuvion), a humanized Fc receptor-nonbinding antibody against CD3, anergizes peripheral blood T cells as partial agonist of the T cell receptor.

    abstract:BACKGROUND:Humanized Fc receptor (FcR)-nonbinding antibodies against CD3 are promising immunosuppressive agents that may overcome both the neutralizing response to and the cytokine release syndrome seen with conventional monoclonal antibodies against CD3. In addition, evidence from several murine models suggests that t...


    pub_type: 杂志文章


    authors: Chau LA,Tso JY,Melrose J,Madrenas J

    更新日期:2001-04-15 00:00:00

  • Morphometric analysis of neointimal formation in murine cardiac grafts: III. Dissociation of intestitial fibrosis from neointimal formation.

    abstract:BACKGROUND:This study examined the relationship between transplant vascular sclerosis (TVS) and tissue fibrosis, features of chronic rejection that can develop rapidly in accepted heterotopic murine cardiac allografts. METHODS:The rate of development of interstitial fibrosis or TVS development was determined by comput...


    pub_type: 杂志文章


    authors: Armstrong AT,Strauch AR,Starling RC,Sedmak DD,Orosz CG

    更新日期:1997-10-27 00:00:00

  • Short-term combination of mycophenolate mofetil with cyclosporine as a therapeutic option for renal transplant recipients: A prospective, multicenter, randomized study.

    abstract:BACKGROUND:Mycophenolate mofetil (MMF), compared to azathioprine (AZA), reduces acute rejection and treatment failure in cyclosporine (CsA) and steroid regimens, but its effect on graft survival is unproven from prospective studies and prolonged use is costly. This study evaluated the efficacy and tolerability of repla...


    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Sadek S,Medina J,Arias M,Sennesael J,Squifflet JP,Vogt B,Neo Int-05 Study group.

    更新日期:2002-08-27 00:00:00

  • Long-term prognosis of renal transplantation after preemptive treatment of cytomegalovirus infection.

    abstract::A role for cytomegalovirus (CMV) infection in the etiologies of acute and chronic rejection in renal allograft recipients has been suggested. We previously reported that preemptive treatment of CMV infection with ganciclovir in kidney transplant patients was safe and effective. We now present a retrospective analysis ...


    pub_type: 杂志文章


    authors: Akposso K,Rondeau E,Haymann JP,Peraldi MN,Marlin C,Sraer JD

    更新日期:1997-04-15 00:00:00

  • Conversion from cyclosporine A to tacrolimus in pediatric kidney transplant recipients with chronic rejection: changes in the immune responses.

    abstract:BACKGROUND:Tacrolimus (Tac) has immunosuppressant properties similar to those of cyclosporine A (CsA), but it is more potent. At present, however, its immunosuppressive activity in renal transplant recipients with ongoing chronic rejection has not been clarified. METHODS:We studied changes in kidney function, mixed ly...


    pub_type: 临床试验,杂志文章


    authors: Ferraris JR,Tambutti ML,Cardoni RL,Prigoshin N

    更新日期:2004-02-27 00:00:00

  • Predominant role of the Fab fragment in delaying hyperacute rejection in guinea pig-to-rat xenotransplantation.

    abstract:BACKGROUND:Human intravenous immunoglobulin G delayed xenogeneic hyperacute rejection (HAR) in the guinea pig-to-rat combination. We investigated the respective roles of the Fc and Fab fragments of the IgG molecule in this inhibitory effect. METHODS:By using a guinea pig-to-rat heart transplantation model, the efficie...


    pub_type: 杂志文章


    authors: Urbani L,Fabre M,Cardoso J,Lambin P,Devillier P,Soubrane O,Houssin D,Gautreau C

    更新日期:1998-08-15 00:00:00

  • The effect of acute rejection and cyclosporin A-treatment on induction of platelet-derived growth factor and its receptors during the development of chronic rat renal allograft rejection.

    abstract:BACKGROUND:In the development of chronic kidney allograft rejection acute rejection (AR) is the single most important risk factor. Although Cyclosporin A (CsA) medication has decreased the incidence of AR, chronic rejection (CR) is still the major reason for late allograft loss. Platelet-derived growth factor (PDGF) is...


    pub_type: 杂志文章


    authors: Savikko J,Kallio EA,Taskinen E,von Willebrand E

    更新日期:2002-02-27 00:00:00

  • Tacrolimus enhances transforming growth factor-beta1 expression and promotes tumor progression.

    abstract:BACKGROUND:Immunosuppressive therapy is a risk factor for the increased incidence and metastatic progression of malignancies in organ graft recipients. Transforming growth factor (TGF)-beta(1) has been associated with tumor invasion and metastasis, and we have implicated cyclosporine-associated TGF-beta(1) hyperexpress...


    pub_type: 杂志文章


    authors: Maluccio M,Sharma V,Lagman M,Vyas S,Yang H,Li B,Suthanthiran M

    更新日期:2003-08-15 00:00:00

  • HLA antibody screening: comparison of a solid phase enzyme-linked immunoassay with antiglobulin-augmented lymphocytotoxicity.

    abstract:BACKGROUND:IgG antibodies to HLA class I antigens can cause hyperacute rejection of renal allografts. Screening of sera from such transplant candidates is laborious, time-consuming, and expensive when performed by sensitive antihuman globulin-augmented lymphocytotoxicity (AHG-CDC). METHODS:Because 60-70% of our transp...


    pub_type: 临床试验,杂志文章


    authors: Moore SB,Ploeger NA,DeGoey SR

    更新日期:1997-12-15 00:00:00

  • Indications for and outcomes after combined lung and liver transplantation: a single-center experience on 13 consecutive cases.

    abstract:BACKGROUND:Combined lung and liver transplantation (Lu-LTx) is a therapeutic option for selected patients with coexisting lung and liver disease. For several reasons, Lu-LTx is performed in few centers and information about the technical issues, posttransplant management and long-term outcomes associated with this proc...


    pub_type: 杂志文章


    authors: Grannas G,Neipp M,Hoeper MM,Gottlieb J,Lück R,Becker T,Simon A,Strassburg CP,Manns MP,Welte T,Haverich A,Klempnauer J,Nashan B,Strueber M

    更新日期:2008-02-27 00:00:00

  • Novel antibodies to the donor stem cell population CD34+/VEGFR-2+ are associated with rejection after hematopoietic stem cell transplantation.

    abstract:BACKGROUND:Reconstitution of hematopoiesis after hematopoietic stem cell transplantation (HSCT) occurs through a reservoir of donor CD34+ HSC. CD34+/VEGFR-2+ is a primitive, quiescent subpopulation of HSC known to generate hematopoietic or endothelial progeny in vitro and in vivo. We hypothesized that donor-specific an...


    pub_type: 杂志文章


    authors: Nordlander A,Mattsson J,Sundberg B,Sumitran-Holgersson S

    更新日期:2008-09-15 00:00:00

  • Clinical results of an organ procurement organization effort to increase utilization of donors after cardiac death.

    abstract:BACKGROUND:To stimulate organ donation, an organ procurement organization (OPO)-wide effort was undertaken to increase donors after cardiac death (DCD) over a 5-year period. This included commonality of protocols, pulsatile perfusion of kidneys, centralization of data and a regional allocation variance designed to mini...


    pub_type: 杂志文章


    authors: Whiting JF,Delmonico F,Morrissey P,Basadonna G,Johnson S,Lewis WD,Rohrer R,O'Connor K,Bradley J,Lovewell TD,Lipkowitz G

    更新日期:2006-05-27 00:00:00

  • Effect of HLA matching on organ distribution among whites and African-Americans.

    abstract::A total of 159 patients received renal cadaveric grafts under 2 different allocation systems. System 1, a local variance (i.e., a point system different from that of United Network for Organ Sharing [UNOS]), and system 2, the current UNOS point system, differed in the relative emphasis on waiting time and HLA match. T...


    pub_type: 杂志文章


    authors: Zachary AA,Braun WE,Hayes JM,McElroy JB,Novick AC,Schulak JA,Sharp WV

    更新日期:1994-04-15 00:00:00

  • OSAKA trial: a randomized, controlled trial comparing tacrolimus QD and BD in kidney transplantation.

    abstract:BACKGROUND:The once-daily (QD), prolonged-release formulation of tacrolimus has been shown to improve adherence versus twice-daily (BD) tacrolimus. Treatment nonadherence in transplant recipients has been associated with poor graft outcomes. METHODS:This open-label, parallel-group study randomized adults with end-stag...


    pub_type: 杂志文章,随机对照试验


    authors: Albano L,Banas B,Klempnauer JL,Glyda M,Viklicky O,Kamar N,Optimising immunoSuppression After Kidney transplantation with ADVAGRAF Study Group.

    更新日期:2013-11-27 00:00:00

  • Formation of epidermis by serially cultivated human epidermal cells transplanted as an epithelium to athymic mice.

    abstract::Human epidermal cells were grown serially in surface culture by inoculation of suspensions of disaggregated cells. Single cells grew into colonies and the colonies fused to make a confluent epithelium. The epithelium was detached as a unit and transplanted onto a graft bed prepared in athymic mice. Such grafts formed ...


    pub_type: 杂志文章


    authors: Banks-Schlegel S,Green H

    更新日期:1980-04-01 00:00:00

  • T suppressor cells induced by transfusions and cyclosporine. Studies in the murine cardiac allograft model.

    abstract::Pregraft transfusion combined with immunosuppression at the time of grafting improves the survival of clinical and experimental allografts. The mechanisms responsible for this effect were investigated in the murine model of cardiac transplantation, combining transfusions 7 to 30 days prior to transplantation with cycl...


    pub_type: 杂志文章


    authors: Mottram PL,Mirisklavos A,Dumble LJ,Clunie GJ

    更新日期:1990-12-01 00:00:00

  • Cytomegalovirus infection and gastric emptying.

    abstract::Gastrointestinal infection due to cytomegalovirus occurs frequently in liver transplant recipients. Upper gastrointestinal cytomegalovirus infection is associated with subjective complaints of nausea, a sense of abdominal fullness, and occasionally emesis and/or dysphagia. In order to determine whether these symptoms ...


    pub_type: 杂志文章


    authors: Van Thiel DH,Gavaler JS,Schade RR,Chien MC,Starzl TE

    更新日期:1992-07-01 00:00:00

  • Evaluation and clinical significance of circulating immune complexes after renal transplantation.

    abstract::Using C1q binding, Kg binding, and Raji cell radioimmunoassays, the relationship between renal allograft rejection and the circulating immune complexes was examined in 90 patients with renal transplants. The data showed that there was a significant quantitative correlation between C1q-binding and Raji-cell-binding act...


    pub_type: 杂志文章


    authors: Fukuda M

    更新日期:1983-08-01 00:00:00

  • Detection of cardiac allograft rejection and myocyte necrosis by monoclonal antibody to cardiac myosin.

    abstract::Indium 111-labeled monoclonal antibody to cardiac myosin was examined for efficacy in the detection of cardiac graft rejection and rejection-related myocyte necrosis. Heterotopic heart transplants were performed in isogenic and allogenic groups of rats (n = 56). At selected intervals posttransplant, uptake of injected...


    pub_type: 杂志文章


    authors: Allen MD,Tsuboi H,Togo T,Eary JF,Gordon D,Thomas R,Reichenbach DD

    更新日期:1989-12-01 00:00:00

  • A novel risk score for mortality in renal transplant recipients beyond the first posttransplant year.

    abstract:BACKGROUND:All-cause mortality is high after kidney transplantation (KT), but no prognostic index has focused on predicting mortality in KT using baseline and emergent comorbidity after KT. METHODS:A total of 4928 KT recipients were used to derive a risk score predicting mortality. Patients were randomly assigned to t...


    pub_type: 杂志文章


    authors: Hernández D,Sánchez-Fructuoso A,González-Posada JM,Arias M,Campistol JM,Rufino M,Morales JM,Moreso F,Pérez G,Torres A,Serón D,Spanish Late Allograft Dysfunction Study Group.

    更新日期:2009-09-27 00:00:00

  • Prevention of early loss of transplanted islets in the liver of mice by adenosine.

    abstract:BACKGROUND:The low efficiency of islet transplantation necessitating sequential transplantations with the use of 2 to 3 donors for a recipient has been a major obstacle facing clinical islet transplantation. We determined whether adenosine has any beneficial effects on preventing early loss of transplanted islets in th...


    pub_type: 杂志文章


    authors: Nitta T,Itoh T,Matsuoka N,Mera T,Kojima D,Nakano M,Yamashita Y,Yasunami Y

    更新日期:2009-07-15 00:00:00

  • Factors influencing weight gain after renal transplantation.

    abstract::Weight gain following renal transplantation occurs frequently but has not been investigated quantitatively. A retrospective chart review of 115 adult renal transplant recipients was used to describe patterns of weight gain during the first 5 years after transplantation. Only 23 subjects (21%) were overweight before th...


    pub_type: 杂志文章


    authors: Johnson CP,Gallagher-Lepak S,Zhu YR,Porth C,Kelber S,Roza AM,Adams MB

    更新日期:1993-10-01 00:00:00

  • Leflunomide in experimental transplantation. Control of rejection and alloantibody production, reversal of acute rejection, and interaction with cyclosporine.

    abstract::Leflunomide is a compound recently shown to reduce T and B cell-mediated responses in a number of experimental rat, mouse, and human systems. To explore its potential as an immunosuppressant, we studied leflunomide in 128 Brown-Norway/Lewis cardiac transplants and in 48 unoperated Lewis rats. At doses ranging from 0.6...


    pub_type: 杂志文章


    authors: Williams JW,Xiao F,Foster P,Clardy C,McChesney L,Sankary H,Chong AS

    更新日期:1994-04-27 00:00:00

  • Profile of anemia in children after liver transplantation.

    abstract:BACKGROUND:Clinical and hematological profile of chronic anemia in children after orthotopic liver transplantation (OLT) is unknown. METHODS:We prospectively studied children after orthotopic liver transplantation (OLT) with hemoglobin levels < 2 standard deviation of age appropriate mean for > 6 months. Investigation...


    pub_type: 杂志文章


    authors: Misra S,Moore TB,Ament ME,Vargas JH,Busutill RW,McDiarmid SV

    更新日期:2000-11-27 00:00:00

  • Functional evaluation of T helper, T suppressor, and B lymphocytes in lethally irradiated rhesus monkeys injected with autologous bone marrow.

    abstract::Lethally irradiated rhesus monkeys were treated with autologous bone marrow that had either been (1) nontreated, i.e., normal; (2) depleted of T lymphocytes with a monoclonal antibody directed against rhesus T lymphocytes; (3) fractionated with the soybean agglutinin (SBA- fraction); or (4) fractionated with SBA and f...


    pub_type: 杂志文章


    authors: Gengozian N,Moriarty C,Good RA

    更新日期:1992-06-01 00:00:00

  • Alloreactive cytotoxic T lymphocytes focus on specific major histocompatibility complex-bound peptides.

    abstract::Alloreactive T cells are often specific for individual peptides that are bound to allogeneic major histocompatibility complex (MHC) molecules. Other alloreactive T cells are reported to be peptide-independent or to recognize MHC conformational changes that are induced by multiple peptides. We tested 12 anti-HLA-B7 all...


    pub_type: 杂志文章


    authors: Smith KD,Huczko E,Engelhard VH,Li YY,Lutz CT

    更新日期:1997-07-27 00:00:00