TY - JOUR. T1 - 2007 Update on allogeneic islet transplantation from the Collaborative Islet Transplant Registry (CITR). AU - Shapiro, A. M.James. AU - Lakey, Jonathan. AU - Ryan, Edmond. AU - Baker, Shelly. AU - Bourne, Wendy. AU - Dinyari, Parastoo. AU - McCready, Tara. AU - Trasbourg, Chandra. AU - LaBranche, Kathleen. AU - McGee-Wilson, Deborah. AU - Menon, Vijay. AU - Sarmon, Donna. AU - Reswell, Barbara. AU - Wright, Janet. AU - Alejandro, Rodolfo. AU - Ricordi, Camillo. AU - Baidal, David. AU - Blanco-Jivanjee, Yvette. AU - Cereijo, Jacqueline. AU - Cure, Pablo. AU - Froud, Tatiana. AU - Hafiz, Muhammed. AU - Khan, Aisha. AU - Perez, Maria I.. AU - Rothenberg, Lisa. AU - Silva-Ramos, Maricruz. AU - Hering, Bernhard J.. AU - Ansite, Jeff. AU - Bland, Barb. AU - Duderstadt, Kathy. AU - Gibson, Carrie. AU - Hodges, Kathy. AU - Jevne, Robin. AU - Larson, Virgil. AU - Radosevich, David. AU - Spindler, Deborah. AU - Zylla, Dylan. AU - Fraga, Dan. AU - Parkey, Jamen. AU - Kramer, Carol. AU - ...
Clinical islet transplantation, also known as beta cell replacement therapy, is currently used to treat some patients with T1D. Allogeneic islet cell transplantation is safe and has yielded success as measured by graft function, absence of hypoglycemic unawareness, normalized glycemic control, and partial to complete insulin independence in T1D patients across multiple centers. However, not all centers have been able to achieve the same level of success, especially in the long term [80]. The rate of success has been observed to be influenced by the experience of the personnel managing the islet isolation and transplantation procedures [81]. A long-term (,10 years) follow up of T1D patients that had undergone allogeneic islet cell transplantation revealed that the treated patients maintained some level of islet graft function, although this function decreased considerably over time [82]. A subset of patients required multiple islet transplants and very few of them had complete insulin ...
NIH Funding Opportunities and Notices in the NIH Guide for Grants and Contracts: CLINICAL ISLET TRANSPLANTATION: DATA COORDINATING CENTER RFA-DK-04-004. NIDDK
Transplanting pancreatic islets into the liver through the portal vein is currently the most common procedure in clinical islet transplantations for treating patients with brittle type 1 diabetes. However, most islet grafts fail within a 5-year period necessitating retransplantation. The vascular connections are disrupted at islet isolation and implanted islets depend on diffusion of oxygen and nutrients in the immediate posttransplantation period. Rapid and efficient revascularization is of utmost importance for the survival and long-term function of transplanted islets. In this thesis, the influence of the implantation microenvironment for islet engraftment and function was studied. Islets were transplanted into the liver, the renal subcapsular site or the pancreas. Islets implanted into the liver contained fewer glucagon-positive cells than islets implanted to the kidney and endogenous islets. Intraportally transplanted islets responded with insulin and glucagon release to secretagogues, but ...
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88682 avhandlingar från svenska högskolor och universitet. Avhandling: Pancreatic Islet Transplantation Modifications of Islet Properties to Improve Graft Survival.
Allogeneic islet transplantation faces difficulties because (i)organ shortage is recurrent; (ii) several pancreas donors are often needed to treat one diabetic recipient; and (iii) the intrahepatic site of islet implantation may not be the most appropriate site. Another source of insulin-producing cells, therefore, would be of major interest, and pigs represent a possible and serious source for obtaining such cells. Pig islet grafts may appear difficult because of the species barrier, but recent reports demonstrate that pig islets may function in primates for at least 6 months. Pig islet xenotransplantation, however, must still overcome several hurdles prior to becoming clinically applicable. The actual consensus is to produce more preclinical data in the pig-to-primate model as a necessary requirement to envisage any pig-to-human transplantation of islets; therefore, a summary of the actual acquired knowledge of pig islet transplantation in primates seemed useful. ...
Defines pancreatic islets and describes the process of pancreatic islet transplantation and the risks and benefits of transplantation.​
Defines pancreatic islets and describes the process of pancreatic islet transplantation, an experimental procedure. also discusses the risks and benefits of.
article{4bc73d87-e463-4daf-8534-3032bbd37e50, abstract = {,p,Islet transplantation is a minimally invasive β-cell replacement strategy. Islet transplantation is a reimbursed treatment in Norway. Here, we summarize the cost and clinical outcome of 31 islet transplantations performed at Oslo University Hospital (OUS) from January 2010 to June 2015. Patients were retrospectively divided into three groups. Thirteen patients received either one or two islet transplantation alone (ITA), while five patients received islet transplantation after previous solid organ transplantation. For the group receiving 2 ITA, Kaplan-Meier estimates show an insulin independence of 20% more than 4 years after their last transplantation. An estimated 70% maintain at least partial graft function, defined as fasting C-peptide >0.1 nmol L,sup,−1,/sup,, and 47% maintain a HbA1c below 6.5% or 2 percent points lower than before ITA. For all groups combined, we estimate that 44% of the patients have a 50% reduction in ...
NewYork-Presbyterian/Columbia is the first center in the New York metropolitan area to offer autologous islet cell transplantation. Patients who need a total pancreatectomy for chronic pancreatitis or other benign diseases may be eligible for this procedure to prevent type 1 diabetes.
NewYork-Presbyterian/Columbia is the first center in the New York metropolitan area to offer autologous islet cell transplantation. Patients who need a total pancreatectomy for chronic pancreatitis or other benign diseases may be eligible for this procedure to prevent type 1 diabetes.
Islet transplantation requires a large number of islets required to achieve insulin independence and the function of the transplanted islets progressively declines over time. Evidence from animal studies and human islets in culture suggests that increasing GLP-1 levels could help with both of these problems. This study is designed to test this hypothesis using sitagliptin in a randomized clinical trial ...
Islet transplantation requires a large number of islets required to achieve insulin independence and the function of the transplanted islets progressively declines over time. Evidence from animal studies and human islets in culture suggests that increasing GLP-1 levels could help with both of these problems. This study is designed to test this hypothesis using sitagliptin in a randomized clinical trial ...
Dr. Posselt specializes in adult and pediatric kidney transplantation, pancreas transplantation, adult and pediatric liver transplantation, and laparoscopic and open bariatric surgery. In addition to caring for patients, he is actively involved in research that is investigating pancreatic islet cell transplantation, mechanisms of allograft rejection and tolerance, and the metabolic and biochemical consequences of bariatric surgery. Dr. Posselt is also a member of several professional and honorary societies and has given a number of presentations on issues regarding clinic and basic transplantation. He holds the position of associate professor in residency in surgery at UCSF, where he supervises residents and fellows on both the transplant and general surgery services. University of California. Return to Who is in the CIT Consortium. ...
Abstract. A closed loop, glucose sensing, and insulin responsive system could dramatically improve treatment options for insulin dependent diabetics. Clinical islet transplantation, the intrahepatic loading of allogeneic islets, shows the potential to provide this intimate control, by transplanting the very cells with this inherent glucose sensing/insulin secreting capacity. The success of clinical islet transplantation is hindered by the location of the implant site, which is prone to mechanical stresses, inflammatory responses, and exposure to high drug and toxin loads, as well as the strong inflammatory and immunological response to the transplant in spite of systemic immunosuppression. To address these challenges, we are focused on three primary strategies: the development of scaffolds to house islets at alternative transplant sites; the fabrication of encapsulation protocols for the immuno-camouflage of the transplant; and the production of bioactive biomaterials for the local delivery of ...
In this study, we examined the effect of Ang-1, a proangiogenic and antiapoptotic factor, on islet survival, function, and revascularization posttransplantation in diabetic mice. To determine the net effect of Ang-1 on islet mass in the absence of variable immune rejections, we used a syngeneic islet transplantation model. We show that diabetic mice receiving a marginal islet mass that was pretransduced by Ang-1 vector exhibited significantly improved glycemic control and glucose-stimulated insulin secretion compared with diabetic mice receiving control vector-transduced islets. Furthermore, islet grafts with elevated Ang-1 production displayed a relatively higher content of intragraft capillaries than that displayed by control islet grafts. To account for the beneficial effect of Ang-1 on marginal islet transplantation, we investigated the effect of Ang-1 on the survival and function of cultured islets in the absence and presence of cytokines. We show that cultured islets were associated with ...
TY - JOUR. T1 - The start of an islet transplantation program in Japan. AU - Saito, T.. AU - Ise, K.. AU - Sato, Y.. AU - Gotoh, M.. AU - Matsumoto, S.. AU - Kenmochi, T.. AU - Kuroda, Y.. AU - Yasunami, Y.. AU - Inoue, K.. AU - Teraoka, S.. PY - 2005/10/1. Y1 - 2005/10/1. N2 - In Japan, pancreas donation had become possible from cadaveric donor sources, both heart-beating or non-heart-beating (NHB). Pancreas allografts have been distributed in the organ allocation system of the Japan Organ Transplant Network. Meanwhile, islet transplantation has been categorized as a tissue transplantation; it is free from legal restraints. Thus, pancreata for islet isolation must be obtained from NHB donors. Herein we report the starting program and preliminary results of islet transplantation in Japan. Selection and listing criteria for transplantation include regional priority, ABO blood type, previous islet transplant status with insulin independence, and a longer waiting time. Five institutes in Japan ...
Two studies published in the current issue of Cell Transplantation (19:12) investigate frontiers of islet cell transplantation for treating diabetes. Researchers in Milan, Italy re-examine the role of bone marrow stem cells in diabetic therapy and islet cell regeneration and Canadian researchers offer improved strategies for optimizing pancreatic islet culture in vitro.. Both studies are in the current issue of Cell Transplantation, freely available on-line at http://www.ingentaconnect.com/content/cog/ct/.. New perspectives on role of bone marrow stem cells in islet transplantation. The role of bone marrow (BM)-derived stem cells in the islet cell regeneration process continues to evolve. A team of Italian researchers reports that employing BM-derived stem cells as "feeder tissue," playing a protective role in supporting pancreatic islet repair for clinical use in treating diabetes, presents new therapeutic possibilities. Which cellular components of BM play the feeder role has not been ...
To circumvent rejection of allogeneic pancreatic islet grafts, we have examined the use of ultraviolet (UV) irradiation to inactivate allostimulatory cells
Abstract. Intrahepatic transplantation of islets requires a lot of islets because more than 50% of the graft is lost during the 24 hours following transplantation. We analyzed, in a rat model, early post-transplantation inflammation using systemic inflammatory markers, or directly in islet-transplanted livers by immunohistochemistry. 1H HRMAS NMR was employed to investigate metabolic responses associated with the transplantation. Inflammatory markers (Interleukin-6, α2-macroglobulin) are not suitable to follow islet reactions as they are not islet specific. To study islet specific inflammatory events, immunohistochemistry was performed on sections of islet transplanted livers for thrombin (indicator of the instant blood-mediated inflammatory reaction (IBMIR)) and granulocytes and macrophages. We observed a specific correlation between IBMIR and granulocyte and macrophage infiltration after 12 h. In parallel, we identified a metabolic response associated with transplantation: after 12 h, ...
An intrinsic relationship between endogenous β-cell function and CGM parameters of improved overall glycemic control/reduced glucose variability has been demonstrated in islet transplant recipients. Studying this relatively homogeneous insulin-sensitive group with rapidly changing graft function over a short period of time confirmed incremental benefits through restoration of even low concentrations of stimulated C-peptide.. Evidence that attainment of C-peptide positivity following islet transplantation can restore hypoglycemia awareness and prevent recurrent severe hypoglycemia is now incontrovertible (6,27,28). As demonstrated again in the current study, this can be achieved even without insulin cessation.. Significant HbA1c lowering is also an established benefit of a functioning islet transplant with previous studies showing that target (,7.0% [53 mmol/mol]) can be achieved both with and without sustained insulin independence (27). In this study, we have demonstrated a clear relationship ...
Clinical Trials - clinicaltrials.gov The purpose of this study is to determine if islet cell transplantation , is an effective treatment for type 1 diabetes. St...
Type 1 diabetes results from a T-cell-mediated autoimmune attack on pancreatic β-cells (1), which leads to a deficiency in insulin secretion and hyperglycemia. Human islet transplantation following the Edmonton protocol has the great potential to treat type 1 diabetic patients. The rate of insulin independence 1 year after islet cell transplantation has significantly improved in recent years (60% at 1 year after transplantation compared with 15% previously) (2). However, at 5 years of follow-up, only approximately 10% of transplanted patients maintain insulin independence (3). The major reason for this limited success is drastic decrease (up to 70%) of β-cell mass of the islet grafts during the first several weeks after transplantation (4,5). Multiple immunological and nonimmunological factors contribute to early graft loss and include allograft rejection, recurrence of autoimmunity, and immunosuppressant toxicity, to name a few (6). In addition, in the absence of established vasculature, lack ...
Currently, the transplantation of islets of Langerhans is a viable means to maintain control of blood sugar levels and reduce the risk of hypoglycemia in defined populations with brittle type I diabetes mellitus or those requiring pancreatectomy. However, the process of islet isolation is highly variable and not all isolations result in islet numbers or quality suitable for transplantation.. This thesis aimed to improve transplantation success through optimization and standardization of the isolation process and to identify pretransplant variables associated with early islet engraftment.. A previously disregarded enzyme activity, tryptic-like activity (TLA), has been identified to influence pancreas digestion efficiency and islet isolation success in both the preclinical and clinical situations. For human pancreases, islet isolation success rates improved from 0% in the lowest TLA group to over 50% in the highest TLA groups without affecting islet quality. These findings should help standardize ...
Speight, J., Woodcock, A. J., Reaney, M. D., Amiel, S. A., Johnson, P., Parrott, N., Senior, P. and Shaw, J. A. M. 2010, Holistic evaluation of pancreatic and islet cell transplantation : development of three novel measures of perceptions, satisfaction and impact on quality of life, in AIDPIT Study Group : 29th Workshop of the Artificial Insulin Delivery Pancreatic and Islet Transplantation (AIDPIT) Study Group, [AIDPIT], [Innsbruck, Austria]. ...
Dr. Xiaojuan Chen is a principal investigator at the CCTI and serves as Director of Islet Cell Transplantation of CCTI and the Director of Columbia Islet Processing Core at the Columbia University College of Physicians and Surgeons. Dr. Chen received her M.D. degree from Jinan University Medical College, China, M.S. degree in Biology from Marquette University, and Ph.D degree in Molecular and Cellular Physiology from University of Cincinnati, followed by a postdoctoral training at the Johns Hopkins University. She joined Columbia University in 2012 after spending 15 years at Northwestern University School of Medicine, where she conducted translational research in islet cell transplantation. Having become an expert in the exacting methodology and compliance procedures required for FDA-approved clinical cellular therapies, Dr. Chen performed islet isolation from more than 180 pancreata for research and clinical islet transplantation to patients with type 1 diabetes. At Columbia, her laboratory is
News headlines have recently referred to the breakthrough made by British surgeon, Dr James Shapiro, based in Edmonton, Canada, who successfully transplanted pancreatic islet cells into patients with Type 1 diabetes, eliminating the need for insulin injections. Islet cells secrete insulin and it is destruction of these cells which causes Type 1 diabetes. Transplantation of pancreatic islets could prove a significant step forward in curing Type 1 diabetes, which affects approximately a quarter of a million people in the UK. Researchers at the University of Bristol believe that this breakthrough will prove to be successful and reproducible outside Edmonton, and hope to establish a pancreatic islet transplant programme based at Southmead Hospital, Bristol. The Bristol team hopes to develop ways of achieving successful islet transplantation without systemic immunosuppression, lessening the risk of infection and malignancy which may be caused by the drugs traditionally used to prevent rejection of ...
After 40 years on insulin, Bob Teskey, 56, could no longer keep his blood-glucose levels under control. As his condition worsened, his hypoglycemic (low blood-glucose) episodes became more and more intrusive on his life. Teskey talked to his doctors, but there was nothing they could do except tweak his insulin regimen, which did not solve the problem. He continued to collapse unexpectedly, as his blood-glucose levels dropped without warning.. Then, a little over two years ago, his endocrinologist told him about a research study being conducted at the University of Alberta, in Edmonton, Canada, called the Edmonton Protocol. There, they were transplanting human pancreatic cells into the livers of type 1s. A requirement for taking part in the study was that participants had tried-and failed-to control their diabetes using conventional methods. Teskey was accepted. He and 22 other type 1s underwent the Edmonton Protocol.. Today, 70 percent of these patients no longer take insulin. Teskey, one of the ...
Recent clinical trials introducing new immunosuppressive regimens and improved islet preparation techniques have shown that transplantation of islets of Langerhans into the liver of type 1 diabetic patients could represent an alternative to exogenous insulin treatment and allows for the normalization of metabolic control, which cannot be achieved by administration of exogenous insulin alone ( 1- 5). Although a few cases have been published in the English literature, detailed histopathologic studies of the livers of long-term recipients have not yet been conducted ( 5- 8). Thus, little is known about the paracrine effects of insulin on the adjacent hepatocytes, which may turn out to be of major clinical importance in the long term.. On the other hand, diabetes mellitus has been identified as a risk factor for hepatocellular carcinoma (HCC) in humans in Western Europe and the United States ( 9- 15). However, the mechanisms by which diabetes may contribute to the formation of HCCs in humans are ...
Because the beta cells in the pancreatic islets are selectively destroyed by an autoimmune process in type 1 diabetes, clinicians and researchers are actively pursuing islet transplantation as a means of restoring physiological beta cell function, which would offer an alternative to a complete pancreas transplant or artificial pancreas.[14][15] Islet transplantation emerged as a viable option for the treatment of insulin requiring diabetes in the early 1970s with steady progress over the last three decades.[16] Recent clinical trials have shown that insulin independence and improved metabolic control can be reproducibly obtained after transplantation of cadaveric donor islets into patients with unstable type 1 diabetes.[15] Islet transplantation for type 1 diabetes currently requires potent immunosuppression to prevent host rejection of donor islets.[17] An alternative source of beta cells, such insulin-producing cells derived from adult stem cells or progenitor cells would contribute to ...
Learn more about Pancreatic Islet Cell Transplantation at Reston Hospital Center DefinitionReasons for ProcedurePossible ComplicationsWhat to ExpectCall Your Doctorrevision ...
DESCRIPTION (provided by applicant): Clinical islet transplantation (CIT), the infusion of allogeneic islets into the liver, has shown significant promise in the long-term treatment of Type diabetes by providing a cell-based means to mimic the normal physiological response to glucose. While promising, it is dampened by the impaired function and loss of islets following implantation. This loss is attributed to strong inflammatory and immunological responses to the transplant, primarily instigated by cell surface proteins and antigens. In this application, we see to minimize detrimental host responses that lead to islet engraftment failure by encapsulating the islets in novel ultrathin polymeric layers. Ultrathin coatings are generated through the covalent layer-by-layer assembly of biomaterials functionalized with bioorthogonal chemical handles. Through the controlled, covalent linking of polymers layers on the islet cell cluster surface, resulting stable capsules are on the order of 500-fold ...
In both recipient groups - those receiving an initial islet transplant in either the eye or the kidney along with the short-term treatment with the anti-CD154 antibody - results showed immunosuppression-free islet survival for more than 300 days.. Notably, of the group that initially received islet transplants in the eye, more than 70 percent exhibited survival of the second islet transplant in the kidney for more than 400 days without continued immunosuppression, compared to 30 percent of the recipients that initially received islets in their kidney.. Additional studies in the preclinical model showed reduced donor-specific immune reactivity in the blood, consistent with induced peripheral immune tolerance.. Researchers conclude the preliminary findings in these study models of diabetes demonstrate the establishment of immune tolerance towards transplanted islets and their long-term protection from immune attack long after stopping anti-rejection therapy.. They acknowledge that further testing ...
Islet cell transplantation is a method to stabilize type 1 diabetes patients with hypoglycemia unawareness and unstable blood glucose levels by reducing insulin dependency and protecting against severe hypoglycemia through restoring endogenous insulin secretion. This study analyses the current cost-effectiveness of this technology and estimates the value of further research to reduce uncertainty around cost-effectiveness. We performed a cost-utility analysis using a Markov cohort model with a mean patient age of 49 to simulate costs and health outcomes over a life-time horizon. Our analysis used intensive insulin therapy (IIT) as comparator and took the provincial healthcare provider perspective. Cost and effectiveness data for up to four transplantations per patient came from the University of Alberta hospital. Costs are expressed in 2012 Canadian dollars and effectiveness in quality-adjusted life-years (QALYs) and life years. To characterize the uncertainty around expected outcomes, we carried out a
Destruction or dysfunction in the human pancreatic islet affects at least 23.6 million affected individuals in the U.S. alone. The inability to regulate insulin production and maintain glucose homeostasis leads to a variety of severe diabetic complications at an estimated 2007 US health care cost of $174 billion dollars. Although medical management, lifestyle changes, and pharmacological agents are successful treatment tools for some, they are less effective, and have failed, in those with unstable diabetes, indicating that an urgent need for alternative therapies exist. Pancreatic islet transplantation is a form of cellular replacement therapy that has been shown to restore glycometabolic control and render some patients insulin independent. Our long term goal is to therefore improve human islet survival and transplantation success rates by understanding the factors affecting cell function in-vitro and in-vivo both in the native pancreas and transplant environments.; A survey of the challenges ...
Destruction or dysfunction in the human pancreatic islet affects at least 23.6 million affected individuals in the U.S. alone. The inability to regulate insulin production and maintain glucose homeostasis leads to a variety of severe diabetic complications at an estimated 2007 US health care cost of $174 billion dollars. Although medical management, lifestyle changes, and pharmacological agents are successful treatment tools for some, they are less effective, and have failed, in those with unstable diabetes, indicating that an urgent need for alternative therapies exist. Pancreatic islet transplantation is a form of cellular replacement therapy that has been shown to restore glycometabolic control and render some patients insulin independent. Our long term goal is to therefore improve human islet survival and transplantation success rates by understanding the factors affecting cell function in-vitro and in-vivo both in the native pancreas and transplant environments.; A survey of the challenges ...
Aim: To evaluate if baseline serum lipids are associated with islet graft survival in type 1 diabetes mellitus islet transplant (ITx) recipients.. Research design and methods: Baseline fasting lipid profile was collected from 44 ITx recipients. Comparisons were performed between subjects below and above the median values of each lipid fraction. Differences in outcomes were compared by Kaplan-Meier curves and Cox-regression analysis.. Results: Subjects with baseline fasting plasma triglycerides and VLDL-cholesterol above median had shorter islet graft survival (triglycerides: 39.7±6.1 vs. 61.3±6.6 months, P=0.029 and VLDL: 41.5±5.7 vs. 62.8±7.3 months, P=0.032). Total, LDL and HDL-cholesterol didnt influence islet function. Triglycerides (OR=2.97, 95%CI=1.03-8.52, P=0.044) maintained its association with graft failure after adjustments for confounders.. Conclusions: Higher baseline triglycerides are associated with earlier decline in islet graft function. Prospective clinical trials should ...
Introduction: Antiproliferative effects of immunosuppressants used in human islet transplantation interfere with the capability of the beta cells to balance cell renewal and cell loss. Consequently, long-term use of these drugs might contribute to graft dysfunction in islet transplant recipients. New immunosuppressive regimens are required to improve outcomes.. Materials and methods: Syngeneic islets (300 IEQ) were injected into the right liver lobes of C57BL/6 diabetic mice. Osmotic pumps filled with Bromodeoxyuridine (group 1), Bromodeoxyuridine and Tacrolimus (group 2) or Bromodeoxyuridine and Everolimus (group 3) were implanted. Hepatectomy was performed after 4 weeks. Proliferation of beta cells was detected by BrdU incorporation. Results: In all transplanted animals normoglycemia was restored. Glucose tolerance was significantly improved after 4 weeks in group 1 (90min: P, 0.012; 120min: P,0.045). This effect was not as strong when animals were treated with Tacrolimus. In contrast, mice ...
Vol 9: Regulation of the JNK3 Signaling Pathway during Islet Isolation: JNK3 and c-fos as New Markers of Islet Quality for Transplantation.. . Biblioteca virtual para leer y descargar libros, documentos, trabajos y tesis universitarias en PDF. Material universiario, documentación y tareas realizadas por universitarios en nuestra biblioteca. Para descargar gratis y para leer online.
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Thanks to the generous travel grant from the Simon Wolff Charitable Foundation I was able to attend the International Pancreas and Islet Transplant Association 13th Congress in Monterey, California. The IPITA meeting is held every two years and is the premier meeting concerning the use of pancreas or islet cell transplantation as a therapy for type 1 diabetes mellitus.. The pancreas has both exocrine and endocrine functions. The exocrine functions are carried out by cells which product digestive enzymes for the gut. The endocrine functions are performed by the islets of Langerhans which are little clusters of cells found through the pancreas responsible for the monitoring and control of blood glucose levels.. Patients suffering from type I diabetes mellitus have experienced an autoimmune reaction leading to the loss of the insulin-producing ? cells in the islets of Langerhans. In many cases these patients use daily injections of insulin to control their blood sugar levels. In a few cases ...
Successful pancreas preservation during storage in oxygenated perfluorodecalin (PFD) is mainly related to oxidative ATP generation during storage. Increasing the storage temperature would accelerate this process essential for resuscitation of ischemically damaged pancreatic tissue. The present study aimed at comparing islet isolation outcome from adult pig pancreata preserved in oxygenated PFD by means of a one-layer method during storage on ice or at 20 degrees C. Resected pancreata were intraductally flushed with cold UW solution and promptly processed (n = 6) or stored for 3 h in continuously oxygenated PFD at 4 degrees C (n = 5) or 20 degrees C (n = 7). Prior to digestion-filtration pancreata were intraductally injected with UW supplemented with Serva collagenase NB8 and neutral protease. Islet quality assessment determined viability, glucose stimulation index, mitochondrial activity, intracellular ATP content, and transplant function in diabetic nude mice. Pancreata oxygenated for 3 h at 20 degrees
A lack of donors and high cost are the major limiting factors. Each successful islet transplant currently needs five donor pancreases, though some groups have had success with a single donor pancreas. There are a very small number of donors in relation to very large numbers of people with diabetes. Worldwide, it is thought there are only enough organs to transplant 1 in 200 (0.5%) people with type 1 diabetes.. Your immune system is programmed to destroy foreign cells. At present immunosuppressive drugs are needed to prevent rejection of these transplantated cells by the body. These drugs are associated with side effects which may be harmful. The long term effects of these drugs are not yet known. It is thought that taking immunosuppressive drugs increases the risk of cancer as well.. ...
Semantic Scholar extracted view of Insulin independence after conversion from tacrolimus to cyclosporine in islet transplantation. by Bengt von Zur-Mühlen et al.
Pancreatic islet transplantation can be a more permanent treatment for type 1 diabetes compared to daily insulin administration. Quantitative and longitudinal noninvasive imaging of viable transplanted islets might help to further improve this novel therapy. Since islets express dopamine 2 (D2) rece …
Single-donor islet transplantation in type 1 diabetes: patient selection and special considerations Jacob A Tatum,* Max O Meneveau,* Kenneth L Brayman Department of Surgery, Division of Transplantation, The University of Virginia Health System, Charlottesville, VA, USA *These authors contributed equally to this work. Abstract: Type 1 diabetes mellitus is an autoimmune disorder of the endocrine pancreas that currently affects millions of people in the United States. Although the disease can be managed with exogenous insulin administration, the ultimate cure for the condition lies in restoring a patient’s ability to produce their own insulin. Islet cell allotransplantation provides a means of endogenous insulin production. Though far from perfected, islet transplants are now a proven treatment for type 1 diabetics. However, proper patient selection is critical for achieving optimal outcomes. Given the shortage of transplantable organs, selecting appropriate candidates for whom the
In this study, the initial experience of the authors using the lower rectum as a novel site for transplantation of free islets is reported. The reasons for selecting the rectum as a potential site are, firstly, that there is a rich plexus of veins draining into the portal venous system, secondly, that it is safe and convenient for access, both for grafting procedures and biopsies and thirdly, that repeat procedures are possible. About 1500 intact islets from three donor PVG rat pancreases were implanted, using an injection technique,into the submucosa of the lower rectum circumferentially above the dentate line of recipient syngeneic PVG rats (n=31). Biopsy of these transplanted islets showed revascularisation of islet clusters in the submucosa of the rectum for greater than 60 days. Clinical trials of islet cell grafting have commenced worldwide over the last 18 months, and this study describes a simple technique for islet cell grafting which could potentially be applied in diabetic patients. ...