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














  • Duodenal histology for monitoring treatment of acute rejection in pancreaticoduodenal allografts in rats.

    abstract:BACKGROUND:Although the value of duodenal histology as a means to diagnose acute rejection in pancreaticoduodenal allografts has been validated, it is not known how the duodenum responds to antirejection treatment in comparison with the pancreas. METHODS:Diabetic Lewis rats received a pancreaticoduodenal allograft. Cy...


    pub_type: 杂志文章


    authors: Mark W,Hechenleitner P,Dietze O,Klima G,Schneeberger S,Steurer W,Candinas D,Margreiter R,Königsrainer A

    更新日期:2002-01-27 00:00:00

  • Nitric oxide synthase activity in renal ischemia-reperfusion injury in the rat: implications for renal transplantation.

    abstract::Cadaveric kidney transplants with delayed graft function have poorer graft survival by an unknown mechanism. Nitric oxide, produced by nitric oxide synthase (NOS), has a proven role in both recovery of ischemia and promotion of rejection. We therefore wished to study the patterns of NOS activity in a model of renal is...


    pub_type: 杂志文章


    authors: Shoskes DA,Xie Y,Gonzalez-Cadavid NF

    更新日期:1997-02-27 00:00:00

  • Comparative analysis of the DST and Imuran-plus-DST protocols for live donor renal transplantation.

    abstract::We have done a comparative analysis of two consecutive clinical trials at our center: the first in 56 patients who received blood transfusions from their prospective donors (DST group), and the second in 36 patients who received such transfusions while they were taking Imuran in an attempt to reduce the incidence of s...


    pub_type: 杂志文章


    authors: Glass NR,Miller DT,Sollinger HW,Belzer FO

    更新日期:1983-12-01 00:00:00

  • Blood transfusions in liver recipients: a conundrum or a clear benefit in the cyclosporine/tacrolimus era?

    abstract::Blood transfusions are common in patients with end-stage liver disease (ESLD), and their effects on sensitization, rejection, and liver graft survival are not well known. These effects were examined in 121 recipients of primary liver grafts, surviving > or = 30 days. Ninety-six (79%) patients received transfusions bef...


    pub_type: 杂志文章


    authors: Koneru B,Harrison D,Rizwan M,Holland BK,Ippolito T,Holman MJ,Leevy CB

    更新日期:1997-06-15 00:00:00

  • alpha1,3-Galactosyltransferase-gene knockout in cattle using a single targeting vector with loxP sequences and cre-expressing adenovirus.

    abstract:BACKGROUND:Gene targeting in large animals has the potential to be useful in medicine as well as in agriculture. Previously, we reported the first successful targeting of the bovine alpha1,3-galactosyltransferase (alpha1,3GT) gene and establishment of a heterozygous knockout cell line. In this report, we generated both...


    pub_type: 杂志文章


    authors: Sendai Y,Sawada T,Urakawa M,Shinkai Y,Kubota K,Hoshi H,Aoyagi Y

    更新日期:2006-03-15 00:00:00

  • Effect of transplantation site and alpha L3T4 treatment on survival of rat, hamster, and rabbit islet xenografts in mice.

    abstract::Rat, hamster, and rabbit islets were transplanted into diabetic C57BL/B6 mice. The effect on islet xenograft survival of low-temperature culture of the donor islets, alpha L3T4 treatment of the recipients for seven days, and transplantation of the grafts either in the renal capsule or in the liver via the portal vein ...


    pub_type: 杂志文章


    authors: Lacy PE,Ricordi C,Finke EH

    更新日期:1989-05-01 00:00:00

  • CXCR3 antagonism impairs the development of donor-reactive, IFN-gamma-producing effectors and prolongs allograft survival.

    abstract:BACKGROUND:Current immunosuppression regimens are toxic to transplant recipients and, in many cases, acute rejection episodes occur because of escape of donor-reactive lymphocytes from the immunosuppression. T cells are the mediators of acute, cell-mediated graft damage and are hypothesized to use the CXCR3 chemokine a...


    pub_type: 杂志文章


    authors: Rosenblum JM,Zhang QW,Siu G,Collins TL,Sullivan T,Dairaghi DJ,Medina JC,Fairchild RL

    更新日期:2009-02-15 00:00:00

  • Failure of cyclosporine-treated renal allograft recipients to increase glomerular filtration rate following an amino acid infusion.

    abstract::Renal allograft recipients treated with cyclosporine (CsA) have increased renal vascular resistance that falls when CsA is stopped. With the aim of identifying whether CsA-treated patients with excellent renal function also have an alteration in renal vascular tone and to investigate which vessels are affected, we hav...


    pub_type: 杂志文章


    authors: Cairns HS,Raval U,Neild GH

    更新日期:1988-07-01 00:00:00

  • Hyperexpression of Foxp3 and IDO during acute rejection of islet allografts.

    abstract:BACKGROUND:We investigated the hypothesis that Foxp3+ cells are an integral component of antiallograft immunity but are dominated by pathogenic effectors. METHODS:Wild-type H-2b C57BL/6 (B6) mice or B6 mice with a targeted disruption of c-Rel gene (c-Rel-/-) were used as recipients of islet grafts from allogeneic DBA/...


    pub_type: 杂志文章


    authors: Yang H,Ding R,Sharma VK,Hilaire FS,Lagman M,Li B,Thomas DA,Luo X,Song P,Stauffer C,August P,Suthanthiran M

    更新日期:2007-06-27 00:00:00

  • The use of a prostacyclin analog, iloprost, as an adjunct to pulmonary preservation with Euro-Collins solution.

    abstract::The addition of prostaglandin to the single-flush technique of lung preservation is considered to enhance subsequent graft function. We have evaluated the use of the prostacyclin analog, Iloprost, in an animal model of unilateral lung transplantation. Group 1 (n = 5) received Iloprost as a pretreatment intravenously (...


    pub_type: 杂志文章


    authors: Hooper TL,Fetherston GJ,Flecknell PA,Dark JH,McGregor CG

    更新日期:1990-03-01 00:00:00

  • Improved phagocyte response by co-amoxiclav in renal transplant recipients.

    abstract:BACKGROUND:Infectious diseases are a major source of morbidity and mortality for immunosuppressed transplant recipients and the antimicrobial chemotherapy can be often less effective in these individuals, because the contribution of underlying host defenses is absent. METHODS:The influence of co-amoxiclav on the funct...


    pub_type: 杂志文章


    authors: Cuffini AM,Tullio V,Giacchino F,Bonino A,Mandras N,Bianchi N,Roana J,Scalas D,Bonello F,Carlone NA

    更新日期:2001-02-27 00:00:00

  • Transplantation and 2-year follow-up of kidneys procured from a cadaver donor with a history of lupus nephritis.

    abstract:BACKGROUND:Two patients underwent cadaver transplantation with kidneys from a donor with a history of World Health Organization Class IV/V lupus nephritis, and we report their clinical and pathological outcome. METHODS:The donor had a diagnosis of lupus nephritis made by renal biopsy 5 years before donation. At the ti...


    pub_type: 杂志文章


    authors: Lipkowitz GS,Madden RL,Kurbanov A,Mulhern JG,O'Shea MH,Germain MJ,Freeman J,Braden GL

    更新日期:2000-03-27 00:00:00

  • Evaluation of the drug interaction between intravenous high-dose fluconazole and cyclosporine or tacrolimus in bone marrow transplant patients.

    abstract::The purpose of this open-label, prospective study was to compare steady state concentrations and clearances of intravenously administered cyclosporine or tacrolimus with and without concomitant high-dose (400 mg/day) fluconazole in allogeneic BMT patients. Twenty-one patients were evaluable. The mean steady state cycl...


    pub_type: 临床试验,杂志文章


    authors: Osowski CL,Dix SP,Lin LS,Mullins RE,Geller RB,Wingard JR

    更新日期:1996-04-27 00:00:00

  • Fractionation of feline bone marrow with the soybean agglutinin lectin yields populations enriched for erythroid and myeloid elements: transplantation of soybean agglutinin-negative cells into lethally irradiated recipients.

    abstract::Feline bone marrow cells treated with the soybean agglutinin (SBA) lectin are separated into two populations, the agglutinated SBA(+) fraction containing predominantly cells of myeloid origin and the nonagglutinated SBA(-) fraction consisting of cells primarily of the erythroid lineage. FACScan analyses revealed a cle...


    pub_type: 杂志文章


    authors: Gengozian N,Reyes L,Pu R,Homer BL,Bova FJ,Yamamoto JK

    更新日期:1997-08-15 00:00:00

  • The diagnosis of CMV pneumonitis in lung and heart/lung transplant patients by PCR compared with traditional laboratory criteria.

    abstract::Polymerase chain reaction (PCR) amplification of CMV DNA recovered from bronchial alveolar lavage (BAL) and peripheral blood samples was compared with tissue culture, cytology, and/or histology for the earlier detection of CMV pneumonitis in 12 recipients of single-lung or heart/lung transplants. In patients with conf...


    pub_type: 杂志文章


    authors: Buffone GJ,Frost A,Samo T,Demmler GJ,Cagle PT,Lawrence EC

    更新日期:1993-08-01 00:00:00

  • Hypersensitivity reactions in the small intestine. 6. Pathogenesis of the graft-versus-host reaction in the small intestinal mucosa of the mouse.

    abstract::The intestinal phase of the graft-versus-host reaction (GVHR) has been investigated in adult F1 mice bearing grafts of fetal gut using an H-2-incompatible and an H-2-compatible, Mls-incompatible combination. The results indicate that the mitotic activity of the intestinal crypts and the number of intraepithelial lymph...


    pub_type: 杂志文章


    authors: Mowat AM,Ferguson A

    更新日期:1981-09-01 00:00:00

  • Interstitial pneumonitis following autologous bone marrow transplantation.

    abstract::The incidence of interstitial pneumonitis (IP) was reviewed in 70 consecutive patients who received autologous marrow transplants for hematologic malignancies. All patients were treated with total-body irradiation (TBI), with or without other chemotherapeutic agents. Seven patients (10%) developed IP, 3 were due to cy...


    pub_type: 杂志文章


    authors: Pecego R,Hill R,Appelbaum FR,Amos D,Buckner CD,Fefer A,Thomas ED

    更新日期:1986-11-01 00:00:00

  • The effects of FK506 and cyclosporine on the exocrine function of the rat pancreas.

    abstract::The effects of FK506 on exocrine function of the pancreas in Sprague-Dawley rats were examined and compared with those of cyclosporine. FK506 did not affect the levels of amylase and lipase in the pancreas of rats given the drug orally in a daily dose of 1 or 5 mg/kg for 2 weeks. Furthermore, the pancreas of the rats ...


    pub_type: 杂志文章


    authors: Hirano Y,Hisatomi A,Ohara K,Noguchi H

    更新日期:1992-11-01 00:00:00

  • Clinically relevant doses and blood levels produce experimental cyclosporine nephrotoxicity when combined with nitric oxide inhibition.

    abstract::Cyclosporine (CsA) administration and nitric oxide (NO) blockade promote similar chronic renal hemodynamic alterations in rats. We evaluated various clinical CsA doses under conditions of NO blockade using L-NAME (N-nitro L-arginine methyl ester). Groups of Sprague-Dawley rats kept on a normal salt (+NaCl) or low-salt...


    pub_type: 杂志文章


    authors: Gardner MP,Houghton DC,Andoh TF,Lindsley J,Bennett WM

    更新日期:1996-05-27 00:00:00

  • Activation of T lymphocytes for adhesion and cytokine expression by toxin-conjugated anti-CD3 monoclonal antibodies.

    abstract:BACKGROUND:Immunosuppressive drugs that target T cells are useful for prolonging allograft survival. The anti-CD3 immunotoxin FN18-CRM9 has been shown to effectively prolong renal allograft survival in a rhesus monkey model of transplantation. However, immunotoxin-treated monkeys showed increased levels of inflammatory...


    pub_type: 杂志文章


    authors: Hamawy MM,Tsuchida M,Manthei ER,Dong Y,Fechner JE,Knechtle JS

    更新日期:1999-09-15 00:00:00

  • Prolongation of allograft survival by combination therapy with anti-thymocyte serum and anti-immunoglobulin.

    abstract::Heterologous anti-immunoglobulin (AI) is a potent immunosuppressive agent which compares favorably to anti-thymocyte serum (ATS) in inhibiting E and EAC-rosette formation and diminishing the secondary antibody response to sheep erythrocytes and E. coli lipopolysaccharide. AI prolongs H-2 incompatible skin allograft su...


    pub_type: 杂志文章


    authors: Constantian MB,Couser WG,French PJ,Davis RC

    更新日期:1976-09-01 00:00:00

  • Variability in donation after cardiac death protocols: a national survey.

    abstract::As donation after cardiac death practices expand, the number of institutional policies is increasing. We contacted organ procurement organizations throughout the United States and requested protocols in hospitals in their donor service areas. Sixty-four protocols were obtained with representation from 16 different sta...


    pub_type: 杂志文章


    authors: Fugate JE,Stadtler M,Rabinstein AA,Wijdicks EF

    更新日期:2011-02-27 00:00:00

  • Aspergillus infection in single and double lung transplant recipients.

    abstract::To investigate the clinical manifestations of Aspergillus infections in lung transplant recipients, we reviewed the mycology and autopsy reports of all double (DLT=93) and single (SLT=48) lung transplant recipients from November 1983 to May 1993. Positive Aspergillus cultures were identified in 22% of the recipients (...


    pub_type: 杂志文章


    authors: Westney GE,Kesten S,De Hoyos A,Chapparro C,Winton T,Maurer JR

    更新日期:1996-03-27 00:00:00

  • The association of IgA deficiency but not IgG or IgM deficiency with a reduced patient and graft survival following liver transplantation.

    abstract::Recipients of solid organ allografts require lifelong immunosuppression in order to prevent graft rejection and to maintain graft function. In general, such immunosuppression greatly impairs the cellular immune system, as this level of the immune system is principally responsible for self and non-self recognition. The...


    pub_type: 杂志文章


    authors: Van Thiel DH,Finkel R,Friedlander L,Gavaler JS,Wright HI,Gordon R

    更新日期:1992-08-01 00:00:00

  • Detection of anti-HLA antibodies with flow cytometry in needle core biopsies of renal transplants recipients with chronic allograft nephropathy.

    abstract::The aim of this study was to assess the feasibility of detecting anti-HLA antibodies in eluates from needle core biopsies of renal transplants with chronic allograft nephropathy. Two methods of screening, the enzyme-linked immunosorbent assay (ELISA) and flow cytometry (FlowPRA) were compared. Twenty renal transplants...


    pub_type: 杂志文章


    authors: Martin L,Guignier F,Bocrie O,D'Athis P,Rageot D,Rifle G,Justrabo E,Mousson C

    更新日期:2005-05-27 00:00:00

  • Protection of porcine aortic endothelial cells from complement-mediated cell lysis and activation by recombinant human CD59.

    abstract::Discordant xenogeneic organ transplantation is a potential solution to the critical shortage of suitable donor organs. However, clinical application of xenotransplantation with physiologically suitable organs such as those from the pig, is currently limited by the lack of agents to prevent antibody and complement-medi...


    pub_type: 杂志文章


    authors: Kennedy SP,Rollins SA,Burton WV,Sims PJ,Bothwell AL,Squinto SP,Zavoico GB

    更新日期:1994-05-27 00:00:00

  • Islet graft survival and function: concomitant culture and transplantation with vascular endothelial cells in diabetic rats.

    abstract:BACKGROUND:Human islet transplantation is a great potential therapy for type I diabetes. To investigate islet graft survival and function, we recently showed the improved effects after co-culture and co-transplantation with vascular endothelial cells (ECs) in diabetic rats. METHODS:ECs were isolated, and the viability...


    pub_type: 杂志文章


    authors: Pan X,Xue W,Li Y,Feng X,Tian X,Ding C

    更新日期:2011-12-15 00:00:00

  • Reversal of intrapulmonary arteriovenous shunting detected by two-dimensional contrast-enhanced echocardiography after liver transplantation.

    abstract:BACKGROUND:Intrapulmonary arteriovenous shunting (IPS), occasionally associated with advanced liver disease, may reverse after liver transplantation (LTx). Two-dimensional contrast-enhanced echocardiography, a convenient noninvasive study, has never been used to demonstrate disappearance of IPS after LTx. METHODS:For ...


    pub_type: 杂志文章


    authors: Hasegawa T,Kamiyama M,Azuma T,Sasaki T,Okada A,Miwatani T,Matsushita T

    更新日期:2000-02-27 00:00:00

  • Graft-versus-host reactivity and graft-versus-leukemia effect in murine allogeneic bone marrow chimeras conditioned with total body irradiation or total lymphoid irradiation.

    abstract::To investigate whether graft-versus-host reactivity (GVHR) and the graft-versus-leukemia (GVL) effect can be differentiated, C3H-->AKR mixed bone marrow (BM) chimeras were prepared using two different conditioning regimens. Total body irradiation (TBI) chimeras were induced by infusing 5 x 1O(6) T cell depleted syngen...


    pub_type: 杂志文章


    authors: Salam A,Waer M

    更新日期:1996-03-15 00:00:00

  • Lymphoma and hypercalcemia in a pediatric orthotopic liver transplant patient.

    abstract::We present a case report of a pediatric orthotopic liver transplant recipient who developed lymphoma with hypercalcemia on cyclosporine and prednisone immunosuppression. This is the first reported posttransplant lymphoproliferative disorder complicated by hypercalcemia, with a finding of an elevated 1,25 dihydroxyl vi...


    pub_type: 杂志文章


    authors: Nakazato P,Esquivel CO,Urbach AH,Makowka L,Scantlebury V,Jaffe R,Starzl TE

    更新日期:1989-12-01 00:00:00