Dataset Information

Simultaneous pancreas and kidney transplantation: current trends and future directions.

ABSTRACT: Important trends are being observed in pancreas transplantation in the USA. We will describe recent trends in simultaneous pancreas kidney (SPK) transplantation related to immunosuppression, treatment of rejection, and transplantation for patients of advanced age and C-peptide positive diabetes.Rates of pancreas transplantation have declined, despite improved pancreatic graft outcomes. Regarding immunosuppression, trends in SPK transplantation include T-cell depletion induction therapy, waning mammalian target of rapamycin inhibitor use and steroid use in greater than 50% of pancreas transplant recipients with few patients undergoing late steroid weaning. Rejection of the pancreas may be discordant with the kidney after SPK and there is a greater appreciation of antibody-mediated rejection of the pancreas allograft. De-novo donor-specific antibody without graft dysfunction remains an active area of study, and the treatment for this condition is unclear. SPKs are being performed with greater frequency in type 2 diabetes mellitus patients and in patients of advanced age, with exemplary results.The current state of the art in SPK transplantation is yielding superb and improving results.

SUBMITTER: Redfield RR

PROVIDER: S-EPMC4286161 | biostudies-literature | 2015 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Simultaneous pancreas and kidney transplantation: current trends and future directions.

Redfield Robert R RR Scalea Joseph R JR Odorico Jon S JS

Current opinion in organ transplantation 20150201 1

<h4>Purpose of review</h4>Important trends are being observed in pancreas transplantation in the USA. We will describe recent trends in simultaneous pancreas kidney (SPK) transplantation related to immunosuppression, treatment of rejection, and transplantation for patients of advanced age and C-peptide positive diabetes.<h4>Recent findings</h4>Rates of pancreas transplantation have declined, despite improved pancreatic graft outcomes. Regarding immunosuppression, trends in SPK transplantation in ...[more]

PMID: 25565444

Similar Datasets

Project description:Coral transplantation has been used in reef restoration for several decades, but information on the type of projects, their scope, scale, and success is mostly limited to published scientific studies and technical reports. Many practitioners do not have the capacity to share their progress in peer-reviewed literature, yet likely have a wealth of information to share on how to improve the efficiency of transplantation efforts. In order to incorporate non-published data on coral transplantation projects and gain an overview of the general features of these projects, we conducted an initial systematic online survey of projects run by various practitioners. Surveyed projects (n = 50) covered most of the tropical belt and ranged in size from a few hundred transplanted corals to >5000 transplants. The most frequent source of coral fragments were corals already broken from some previous impact ("corals of opportunity"; 58% of projects), followed by fragments stored in different types of aquaculture systems (42% of projects). The use of sexual reproduction was very limited. Fast-growing, branching corals were used in 96% of projects, being by far the most common transplanted growth form. About half of the projects mentioned undertaking maintenance of the transplantation plots. The majority of projects undertook subsequent monitoring (80%), yet the available data indicates that duration of monitoring efforts was not adequate to evaluate long-term success. The findings underline that while some general principles for successful coral restoration projects are reasonably well established, others need to be mainstreamed better in order to improve the effectiveness of coral transplantation for reef restoration. This relates in particular to sustainable funding, adequate site assessment, and long-term monitoring using established protocols. Additional information is needed to better understand and address potential challenges with regards to the sourcing of transplants and use of slow-growing species. A better integration of practitioners is necessary to improve the understanding of coral transplantation effectiveness. The results underline a need to develop and use monitoring protocols that allow gauging and comparing the effectiveness of coral transplantation among various projects, as well as for accessible platform(s) to allow the exchange of experiences made in different projects. Regular surveys of restoration projects are recommended to collate and share information among practitioners. We provide a number of recommendations for items to include in future surveys.

Dataset Information

Simultaneous pancreas and kidney transplantation: current trends and future directions.

Publications

Simultaneous pancreas and kidney transplantation: current trends and future directions.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets