Over 500 solitary pancreas transplants in nonuremic patients with brittle diabetes mellitus.


BACKGROUND:A pancreas transplant alone (PTA) in a nonuremic patient with brittle diabetes mellitus remains a rare procedure because the tradeoff for insulin independence is lifelong immunosuppression. METHODS:Herein we report our results at the University of Minnesota of 513 PTAs from December 17, 1966, through December 31, 2006. Of these recipients, 87% had previously experienced hypoglycemic unawareness and 23% experienced coma and/or seizures. These transplants spanned four immunosuppressive eras: pre-cyclosporine A (pre-CsA) era (16%), CsA era (23%), tacrolimus (TAC) era (47%), and calcineurin-inhibitor (CNI)-free era (14%). RESULTS:The overall patient survival rate at 1 year posttransplant was about 95%; at 5 years, it was 90%. The pancreas graft survival rate at 1 year increased significantly from the pre-CsA era (31%) to the TAC era (75%), thanks to a significant decline in immunologic and technical failures. The CNI-free protocol, because of its high infection and hematologic infection rate, did not further improve outcome. Risk factors for subsequent kidney failure (13% at 5 years posttransplant) were serum creatinine levels>1.5 mg/dl at the time of the pancreas transplant and recipient age<30 years. CONCLUSIONS:A technically successful PTA is currently the only treatment option that allows nonuremic patients with brittle diabetes to become insulin-independent in the long term.






Gruessner RW,Sutherland DE,Kandaswamy R,Gruessner AC




Has Abstract


2008-01-15 00:00:00














  • Prevention of acute allograft rejection in nonhuman primate lung transplant recipients: induction with chimeric anti-interleukin-2 receptor monoclonal antibody improves the tolerability and potentiates the immunosuppressive activity of a regimen using low

    abstract:BACKGROUND:In previous studies of cynomolgus monkey lung allograft recipients, we demonstrated significant immunosuppressive efficacy but reduced tolerability after combined treatment with high doses of microemulsion cyclosporine (CsA) and SDZ RAD (40-O-(2-hydroxyethyl)-rapamycin). The current study was designed to com...


    pub_type: 杂志文章


    authors: Hausen B,Gummert J,Berry GJ,Christians U,Serkova N,Ikonen T,Hook L,Legay F,Schuler W,Schreier MH,Morris RE

    更新日期:2000-02-27 00:00:00

  • Section 8. Management of portal venous complications in pediatric living donor liver transplantation.

    abstract::Portal vein (PV) complications after living donor liver transplant (LDLT) have been a major concern in pediatric liver transplantation. The incidence of PV complications is more in pediatric (0%-33%) than in adult recipients. Early diagnosis and treatment of PV complications may ensure optimal graft function and good ...


    pub_type: 杂志文章


    authors: Cheng YF,Ou HY,Yu CY,Tsang LL,Huang TL,Chen TY,Concejero A,Wang CC,Wang SH,Lin TS,Liu YW,Yang CH,Yong CC,Chiu KW,Jawan B,Eng HL,Chen CL

    更新日期:2014-04-27 00:00:00

  • Deceased Organ Donors and PHS Risk Identification: Impact on Organ Usage and Outcomes.

    abstract:BACKGROUND:In 2013, the public health service (PHS) changed the criteria intended to identify organ donors that put the associated organ recipients at increased risk for acquiring human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). The changing donor demographics, organ utilization...


    pub_type: 杂志文章


    authors: Pruett TL,Clark MA,Taranto SE

    更新日期:2017-07-01 00:00:00

  • The successful allotransplantation of neonatal rat islets across multiple combined major and minor histocompatibility barriers.

    abstract::Cultured neonatal rat islets were transplanted across six strain combinations into nonimmunosuppressed allogeneic recipients. Islets were isolated nonenzymatically by an in vitro method and were cultured at 37 degrees C in 5% CO2 in air for 10 days prior to transplant. Transplants to nondiabetic recipients across four...


    pub_type: 杂志文章


    authors: Serie JR,Hegre OD,Eide CR,Weinhaus AJ,Marshall S

    更新日期:1987-12-01 00:00:00

  • Evaluation of posttransplantation soluble CD30 for diagnosis of acute renal allograft rejection.

    abstract:BACKGROUND:Posttransplantation measurement of soluble CD30 (sCD30) may be useful for identifying kidney graft recipients at risk of impending graft rejection in the early posttransplantation period. METHODS:We measured plasma sCD30 levels and evaluated the levels in relation to the diagnosis of rejection. RESULTS:Rec...


    pub_type: 杂志文章


    authors: Pelzl S,Opelz G,Daniel V,Wiesel M,Süsal C

    更新日期:2003-02-15 00:00:00

  • Interstitial pneumonitis and lymphocytic bronchiolitis/bronchitis as a direct result of acute lethal graft-versus-host disease duplicate the histopathology of lung allograft rejection.

    abstract::Pulmonary complications are often lethal components of acute graft-vs.-host disease (GVHD). Although interstitial pneumonitis and lymphocytic bronchitis have been implicated as elements of acute GVHD, previous studies have not determined a correlation between the onset of these histopathologies or their contribution t...


    pub_type: 杂志文章


    authors: Workman DL,Clancy J Jr

    更新日期:1994-07-27 00:00:00

  • Prominent HLA-G Expression in Liver Disease But Not After Liver Transplantation.

    abstract:BACKGROUND:HLA-G is a nonclassical MHC class I molecule and its physiological expression restricted to placental extravillous trophoblasts contributes to maternal tolerance to the semiallogeneic fetus. Aberrant expression of HLA-G in human organ grafts has been proposed to contribute to graft acceptance. METHODS:We st...


    pub_type: 杂志文章


    authors: Moroso V,van Cranenbroek B,Mancham S,Sideras K,Boor PP,Biermann K,de Vogel L,de Knegt RJ,van der Eijk A,van der Laan LJ,de Jonge J,Metselaar HJ,Joosten I,Kwekkeboom J

    更新日期:2015-12-01 00:00:00

  • Absence of specific mixed leukocyte culture reactivity during graft-versus-host disease and following bone marrow transplant rejection.

    abstract::Retrospective mixed leukocyte culture studies were performed in eight patients who had either rejected their marrow grafts or experienced graft-versus-host disease and in seven patients with successful marrow engraftment. In tests of pre-and post-transplant lymphocytes we found no evidence that rejection or graft-vers...


    pub_type: 杂志文章


    authors: Opelz G,Gale RP

    更新日期:1976-11-01 00:00:00

  • Parvovirus B19 infection-related complications in renal transplant recipients: treatment with intravenous immunoglobulin.

    abstract:BACKGROUND:Chronic red cell aplasia can develop in immunocompromised patients including transplant recipients infected with parvovirus B19 (PV B19). Renal involvement with PV B19 infection is not well-recognized. METHODS:We diagnosed erythroid hypoplasia associated with PV B19 infection in three renal transplant recip...


    pub_type: 杂志文章


    authors: Moudgil A,Shidban H,Nast CC,Bagga A,Aswad S,Graham SL,Mendez R,Jordan SC

    更新日期:1997-12-27 00:00:00

  • Real-time direct measurement of human liver allograft temperature from recovery to transplantation.

    abstract::Temperature is a key parameter in organ preservation that has been consistently linked to primary nonfunction (PNF). In this communication, and for the first time anywhere, continued and direct measurements of human liver intraparenchymal temperatures are reported in six clinical cases of orthotopic liver transplantat...


    pub_type: 杂志文章


    authors: Villa R,Fondevila C,Erill I,Guimerà A,Bombuy E,Gómez-Suárez C,Sacristán JC,García-Valdecasas JC

    更新日期:2006-02-15 00:00:00

  • Lymphocyte function in patients treated with monoclonal anti-T3 antibody for acute cadaveric renal allograft rejection.

    abstract::We are participating in a multicenter trial testing the efficacy of a murine monoclonal antihuman peripheral T lymphocyte antibody (OKT3.PAN) as immunosuppressive therapy for the treatment of acute cadaveric renal allograft rejection. Although clinical data indicate that administration of this antibody clears the circ...


    pub_type: 临床试验,杂志文章


    authors: Bowen A,Edwards LC,Gailiunas P,Helderman JH

    更新日期:1984-11-01 00:00:00

  • Studies into the transplantation biology of ultraviolet light-induced tumors.

    abstract::The majority of skin tumors induced in mice by ultraviolet (UV) light are rejected when implanted into normal syngeneic recipients. Subcarcinogenic levels of UV light exposure render the normally resistant mice susceptible to tumor challenge. The immunoregulatory effect of UV light appears to be additive, since the gr...


    pub_type: 杂志文章


    authors: Daynes RA,Spellman CW,Woodward JG,Stewart DA

    更新日期:1977-04-01 00:00:00

  • Kidney transplant patients with long-term graft survival have altered expression of molecules associated with T-cell activation.

    abstract:BACKGROUND:Patients with long-term functioning organ allografts may have developed different mechanisms that explain the lack of graft rejection. However, it is not known how these mechanisms interplay or whether one of them predominates in such situations. METHODS:The authors analyzed the expression of T-cell surface...


    pub_type: 杂志文章


    authors: Alvarez CM,Paris SC,Arango L,Arbelaez M,Garcia LF,RAD B201 study group.

    更新日期:2004-11-27 00:00:00

  • Multiple pathways to allograft rejection.

    abstract::Allograft rejection results from a complex process involving both the innate and acquired immune systems. The innate immune system predominates in the early phase of the allogeneic response, during which chemokines and cell adhesion play essential roles, not only for leukocyte migration into the graft but also for fac...


    pub_type: 杂志文章,评审


    authors: Le Moine A,Goldman M,Abramowicz D

    更新日期:2002-05-15 00:00:00

  • Regulation of molecular pathways in ischemia-reperfusion injury after liver transplantation.

    abstract:BACKGROUND:Ischemia-reperfusion (I/R) injury is a multifactorial phenomenon that occurs during the transplant event and frequently compromises early graft function after liver transplantation (LT). Current comprehension of molecular mechanisms and regulation processes of I/R injury lacks clarity. MicroRNA (miRNA) regul...


    pub_type: 杂志文章


    authors: Gehrau RC,Mas VR,Dumur CI,Ladie DE,Suh JL,Luebbert S,Maluf DG

    更新日期:2013-11-27 00:00:00

  • Serum adiponectin levels and ambulatory blood pressure monitoring in pediatric renal transplant recipients.

    abstract::BACKGROUND.: Reduced levels of serum adiponectin, an adipokine, are associated with cardiovascular and obesity-related diseases; however, relations between adiponectin and hypertension are unclear. METHODS.: This cross-sectional study examined adiponectin and ambulatory blood pressure monitoring (ABPM) in 33 pediatric...


    pub_type: 杂志文章


    authors: Sethna CB,Leonard MB,Gallagher PR,Meyers KE

    更新日期:2009-10-27 00:00:00

  • Use of alemtuzumab and tacrolimus monotherapy for cadaveric liver transplantation: with particular reference to hepatitis C virus.

    abstract::We have proposed that the mechanisms of alloengraftment and variable acquired tolerance can be facilitated by minimum posttransplant immunosuppression. It was further suggested that the efficacy of minimalistic treatment could be enhanced by preoperative recipient conditioning with an antilymphoid antibody preparation...


    pub_type: 杂志文章


    authors: Marcos A,Eghtesad B,Fung JJ,Fontes P,Patel K,Devera M,Marsh W,Gayowski T,Demetris AJ,Gray EA,Flynn B,Zeevi A,Murase N,Starzl TE

    更新日期:2004-10-15 00:00:00

  • Sirolimus (rapamycin) for the treatment of steroid-refractory acute graft-versus-host disease.

    abstract:BACKGROUND:In a pilot trial we evaluated the toxicity and efficacy of sirolimus (rapamycin) as second-line therapy for the treatment of acute graft-versus-host disease (GVHD) in 21 patients (1-46 years of age) after allogeneic hematopoietic stem cell transplantation (HSCT). METHODS:All patients were treated with methy...


    pub_type: 杂志文章


    authors: Benito AI,Furlong T,Martin PJ,Anasetti C,Appelbaum FR,Doney K,Nash RA,Papayannopoulou T,Storb R,Sullivan KM,Witherspoon R,Deeg HJ

    更新日期:2001-12-27 00:00:00

  • Utilization of donors who have suffered cardiopulmonary arrest and resuscitation in intestinal transplantation.

    abstract:BACKGROUND:Cardiopulmonary resuscitation (CPR) of a person destined to become an organ donor has been associated with overall poor donor quality, especially for the intestinal donor, as splanchnic vasoconstriction that is intended to preserve coronary and cerebral blood flow may result in clinically relevant intestinal...


    pub_type: 杂志文章


    authors: Matsumoto CS,Kaufman SS,Girlanda R,Little CM,Rekhtman Y,Raofi V,Laurin JM,Shetty K,Fennelly EM,Johnson LB,Fishbein TM

    更新日期:2008-10-15 00:00:00

  • One orifice vein reconstruction in left liver plus caudate lobe grafts.

    abstract::For maximum use of left liver plus caudate lobe grafts, the short hepatic vein draining the caudate lobe should be reconstructed. We devised a new venoplasty technique. On the graft side, a wide venous orifice with a long cuff was formed by gathering the left, middle, and short hepatic veins using a conduit vein graft...


    pub_type: 临床试验,杂志文章


    authors: Hashimoto T,Sugawara Y,Tamura S,Kaneko J,Motomura N,Takamoto S,Makuuchi M

    更新日期:2007-01-27 00:00:00

  • Transplantomics: Toward Precision Medicine in Transplantation Research.

    abstract::Precision medicine is an emerging integrative approach for disease prevention, early detection, and treatment which takes into account individual variability in genetic and other molecular measurements, medical history, environmental exposures, and lifestyle. The development and availability of genomic and other molec...


    pub_type: 杂志文章,评审


    authors: Sirota M,Sarwal MM

    更新日期:2017-08-01 00:00:00

  • Normalization of circadian blood pressure profiles after renal transplantation.

    abstract::Most patients with secondary hypertension due to renal disease or on maintenance hemodialysis have lost the physiologic fall of blood pressure during sleep. To test the notion that kidney transplantation normalizes the blood pressure profile, we monitored ambulatory blood pressure over 24 hr in 45 patients (29 males a...


    pub_type: 杂志文章


    authors: Gatzka CD,Schobel HP,Klingbeil AU,Neumayer HH,Schmieder RE

    更新日期:1995-05-15 00:00:00

  • Successful tapering of immunosuppression to low-dose monotherapy steroids after living-related human leukocyte antigen-identical renal transplantation.

    abstract:BACKGROUND:Living-related (LR) human leukocyte antigen (HLA)-identical renal transplant (RTx) recipients often receive standard immunosuppression, despite the absence of mismatched major HLA-antigens and the known complications of long-term use of immunosuppression. No data are available on the need for immunosuppressi...


    pub_type: 杂志文章


    authors: van de Wetering J,Gerrits JH,van Besouw NM,Ijzermans JN,Weimar W

    更新日期:2009-03-15 00:00:00

  • The effects of pretransplant cyclosporine therapy on rats grafted with twelve-hour cold-stored livers--with special reference to reperfusion injury.

    abstract::The effect of pretreatment with cyclosporine on liver preservation was studied using a rat liver transplant model. In a preliminary 1-week survival study, 59 liver transplants were performed. In group A, neither donors nor recipients were treated. In group B, the recipients were pretreated by a 3-day course of CsA (10...


    pub_type: 杂志文章


    authors: Goto S,Kim YI,Shimada T,Kawano K,Kobayashi M

    更新日期:1991-10-01 00:00:00

  • Endothelial cell preservation using organ storage solutions.

    abstract::The development of organ preservation solutions has been primarily accomplished in whole organ animal models. This study examines the toxicity of commonly used organ preservation solutions on endothelial cells in vitro. Primary human umbilical-vein endothelial cell cultures were incubated at 4 degrees C in solutions o...


    pub_type: 杂志文章


    authors: Killinger WA Jr,Dorofi DB,Keagy BA,Johnson G Jr

    更新日期:1992-05-01 00:00:00

  • H-2 complex and Ia antigens on cells dissociated from mouse thyroid glands and islets of Langerhans.

    abstract::Mouse thyroid tissue was dissociated with collagenase, fixed in periodate-lysine-paraformaldehyde (PLP), and further dissociated with EDTA and trypsin to yield cell suspensions containing mainly follicle epithelial cells and vascular endothelial cells. H-2 complex antigens were detected on the vascular endothelial cel...


    pub_type: 杂志文章


    authors: Parr EL,Lafferty KJ,Bowen KM,McKenzie IF

    更新日期:1980-08-01 00:00:00

  • KIR/HLA ligand incompatibility in kidney transplantation.

    abstract:BACKGROUND:The polymorphic family of killer-cell immunoglobulin-like receptors (KIRs) consists of activating and inhibitory receptors expressed by natural killer (NK) cells and effector T cells that recognize human leukocyte antigen (HLA) class I ligands. It has been suggested that KIR/HLA incompatibility exerts benefi...


    pub_type: 杂志文章


    authors: Kunert K,Seiler M,Mashreghi MF,Klippert K,Schönemann C,Neumann K,Pratschke J,Reinke P,Volk HD,Kotsch K

    更新日期:2007-12-15 00:00:00

  • Release of tumor necrosis factor, interleukin-2, and gamma-interferon in serum after injection of OKT3 monoclonal antibody in kidney transplant recipients.

    abstract::High levels of tumor necrosis factor-alpha, interleukin-2, and gamma-interferon appeared in the circulation of kidney transplant recipients after the first injection of the monoclonal antibody OKT3. This initial injection was systematically followed by fever. The three cytokines were released in all patients (n = 9), ...


    pub_type: 杂志文章


    authors: Abramowicz D,Schandene L,Goldman M,Crusiaux A,Vereerstraeten P,De Pauw L,Wybran J,Kinnaert P,Dupont E,Toussaint C

    更新日期:1989-04-01 00:00:00

  • Plasma polymerase chain reaction for cytomegalovirus DNA after allogeneic marrow transplantation: comparison with polymerase chain reaction using peripheral blood leukocytes, pp65 antigenemia, and viral culture.

    abstract::In a prospective longitudinal study, detection of cytomegalovirus (CMV) DNA in plasma (plasma polymerase chain reaction [PCR]) was compared with PCR of CMV DNA in peripheral blood leukocytes (PBL PCR), the CMV pp65 antigenemia assay, and viral cultures from blood, urine, and throat of 29 patients, 14 of whom received ...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Boeckh M,Gallez-Hawkins GM,Myerson D,Zaia JA,Bowden RA

    更新日期:1997-07-15 00:00:00

  • Absence of c4d deposition in human composite tissue (hands and face) allograft biopsies: an immunoperoxidase study.

    abstract::Deposition of the C4d complement degradation product has been shown to be a marker of antibody-mediated rejection of solid organ allografts, including kidney, heart, liver, and lung. We investigated whether C4d deposition also would be useful in monitoring rejection in human composite tissue allografts. A total of 60 ...


    pub_type: 杂志文章


    authors: Kanitakis J,McGregor B,Badet L,Petruzzo P,Morelon E,Devauchelle B,Dubernard JM

    更新日期:2007-07-27 00:00:00