The Outcomes of Pancreatic Transplantation from Pediatric Donors–A Single Institution Experience
Abstract
:1. Introduction
2. Patients and Methods
2.1. Patients
2.2. The Study Design
2.3. Transplantation Methods and Immunosuppression Protocols
2.4. Statistical Analyses
2.5. Ethical Aspects
3. Results
3.1. Background Factors and the Outcomes of Transplantation from Pediatric Donors
3.2. Background Factors of the Pediatric Donor and Adult Donor Groups
3.3. Pancreatic Graft Survival
3.4. The OGTT and Glucagon Stimulation Test Results at One Month after Transplantation
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
Abbreviations
References
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Case | Age | Sex | Cause of Death | BW (kg) | HbA1c (%) | s-Cre (mg/dl) | Number of HLA Mismatches | TIT (Pancreas, min) | TIT (Kidney, min) | Graft Weight (Pancreas, g) |
---|---|---|---|---|---|---|---|---|---|---|
1 | 6 | Male | Hypoxia | 20.0 | 4.7 | 0.33 | 3 | 891 | 676 | 95 |
2 | 5 | Female | Trauma | 20.8 | 5.5 | 0.19 | 3 | 630 | N/A | 71 |
3 | 9 | Male | Trauma | 27.0 | 5.4 | 0.41 | 5 | 714 | 597 | 64 |
4 | 11 | Female | Hypoxia | 43.0 | 5.3 | 0.82 | 2 | 969 | 704 | 114 |
5 | 5 | Male | Hypoxia | 21.0 | 4.9 | 0.22 | 2 | 729 | 522 | 63 |
6 | 4 | Female | Hypoxia | 18.5 | 5.2 | 0.17 | 3 | 974 | 680 | 61 |
7 | 10 | Female | CVA | 29.1 | 5.4 | 0.47 | 2 | 801 | 606 | 75 |
Case | Recipient Age | Recipient Sex | Recipient BW (kg) | Operation Type | Arterial Reconstruction | Portal Vein Elongation | Episode of Rejection | Graft Survival | HbA1c * | s-Cre * (mg/dl) | Basal CRP ** (ng/mL) | CPR after Glucagon Load ** (ng/mL) | ΔCPR ** (ng/mL) |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
(%) | |||||||||||||
1 | 61 | Male | 61.3 | SPK | Y-graft | + | - | Survive (43 M) | 5.2 | 1.42 | 2.44 | 5.1 | 2.66 |
2 | 34 | Male | 55.1 | PTA | Y-graft | + | + | Graft failure due to rejection (6 M) | 5.3 | N/A | 1.19 | 4.01 | 2.82 |
3 | 36 | Female | 49.3 | SPK | Carrel patch | SPV bypass | - | Survive (27 M) | 5.1 | 0.76 | 2.44 | 7.66 | 5.22 |
4 | 50 | Male | 59.8 | SPK | Carrel patch | - | - | Survive (14 M) | 4.7 | 1.47 | 1.48 | 3.22 | 1.74 |
5 | 34 | Female | 56 | SPK | Carrel patch | - | + | Survive (12 M) | 5.1 | 0.94 | 1.3 | 3.46 | 2.16 |
6 | 56 | Male | 65.7 | SPK | Carrel patch | - | - | Survive (5 M) | 5 | 1.4 | 1.79 | 5.68 | 3.89 |
7 | 44 | Female | 51.9 | SPK | Carrel patch | - | - | Survive (4 M) | 4.2 | 0.91 | 1.43 | 3.57 | 2.14 |
Group | Pediatric Donors | Adult Donors | p Value | ||
---|---|---|---|---|---|
n | 7 | 53 | |||
Donor factors | Age | 6 (4–11) | 48 (17–67) | <0.001 | |
Sex | Male (%) | 3 (42.9) | 26 (49.1) | 1 | |
Female (%) | 4 (57.1) | 27 (50.9) | |||
BW (kg) | 21.0 (18.5–43.0) | 59.7 (40.0–94.1) | <0.001 | ||
BMI (kg/m2) | 16.0 (12.8–20.8) | 22.2 (16.6–30.0) | <0.001 | ||
Cause of death | CVA (%) | 1 (14.3) | 27 (52.9) | 0.104 | |
Others (%) | 6 (85.7) | 24 (47.1) | |||
ICU stay (days) | 24 (7–35) | 7 (2–34) | 0.005 | ||
Preoperative HbA1c (%) | 5.3 (4.7–5.5) | 5.5 (4.9–6.3) | 0.017 | ||
Preoperative BG (mg/dl) | 97 (80–117) | 128 (81–237) | 0.003 | ||
Preoperative s-Cre (mg/dl) | 0.33 (0.17–0.82) | 0.68 (0.23–6.93) | 0.004 | ||
Preoperative LDH (U/l) | 1249 (871–2211) | 688 (248–2323) | 0.002 | ||
Preoperative Na (mmol/l) | 139 (130–143) | 141 (114–166) | 0.213 | ||
Preoperative CRP (mg/dl) | 7.43 (0.15–22.53) | 17.51 (0.38–39.57) | 0.025 | ||
Pancreatic graft weight (g) | 71 (61–114) | 191 (95–352) | <0.001 | ||
TIT (pancreas, min) | 801 (630–974) | 886 (494–1383) | 0.189 | ||
TIT (kidney, min) | 641 (522–704) | 706 (474–1124) | 0.244 | ||
Recipient factors | Age | 44 (34–61) | 44 (31–62) | 0.926 | |
Sex | Male (%) | 4 (57.1) | 17 (32.1) | 0.226 | |
Female (%) | 3 (42.9) | 36 (67.9) | |||
Preoperative HbA1c (%) | 8.1 (6.3–12.3) | 6.9 (4.9–9.8) | 0.043 | ||
Period of diabetic history (year) | 29 (21–38) | 29 (11–43) | 0.926 | ||
Period of hemodialysis history (year) | 6.0 (1.5–11.0) | 6.0 (0–20.0) | 0.893 |
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Ito, T.; Kenmochi, T.; Aida, N.; Kurihara, K.; Kawai, A.; Suzuki, A.; Shibata, M.; Hiratsuka, I.; Hasegawa, M. The Outcomes of Pancreatic Transplantation from Pediatric Donors–A Single Institution Experience. J. Clin. Med. 2019, 8, 1386. https://doi.org/10.3390/jcm8091386
Ito T, Kenmochi T, Aida N, Kurihara K, Kawai A, Suzuki A, Shibata M, Hiratsuka I, Hasegawa M. The Outcomes of Pancreatic Transplantation from Pediatric Donors–A Single Institution Experience. Journal of Clinical Medicine. 2019; 8(9):1386. https://doi.org/10.3390/jcm8091386
Chicago/Turabian StyleIto, Taihei, Takashi Kenmochi, Naohiro Aida, Kei Kurihara, Akihiro Kawai, Atsushi Suzuki, Megumi Shibata, Izumi Hiratsuka, and Midori Hasegawa. 2019. "The Outcomes of Pancreatic Transplantation from Pediatric Donors–A Single Institution Experience" Journal of Clinical Medicine 8, no. 9: 1386. https://doi.org/10.3390/jcm8091386
APA StyleIto, T., Kenmochi, T., Aida, N., Kurihara, K., Kawai, A., Suzuki, A., Shibata, M., Hiratsuka, I., & Hasegawa, M. (2019). The Outcomes of Pancreatic Transplantation from Pediatric Donors–A Single Institution Experience. Journal of Clinical Medicine, 8(9), 1386. https://doi.org/10.3390/jcm8091386