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Transplantation of the Pancreas or Pancreatic Islet Cells

A Clinical Laboratory Perspective
  • John A. Lott
Part of the Pathology and Laboratory Medicine book series (PLM, volume 2)

Abstract

Loss of the exocrine and endocrine pancreatic functions leaves the patient with serious digestive and metabolic problems. Causes of exocrine loss include cystic fibrosis, atrophic pancreatitis, chronic pancreatitis, infarction of the pancreas, surgical removal of the gland, atherosclerosis of the pancreas, pancreatic cysts, and other miscellaneous causes. More than about 85% of the acinar cells must be lost before abnormalities appear, indicating that the normal pancreas has tremendous exocrine reserves. Abdominal discomfort and abnormalities in digestion, including steatorrhea, weight loss, constipation or diarrhea, and flatulence, are typical findings.

Keywords

Major Histocompatibility Complex Human Leukocyte Antigen Human Leukocyte Antigen Class Pancreas Transplantation Artificial Pancreas 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Libman I, Songer T, LaPorte R (1993) How many people in the U.S. have IDDM? Diabetes Care 5:841, 842.Google Scholar
  2. 2.
    Karvonen M, Toumilehto J, Libman I, LaPorte R (1993) A review of the recent epidemiological data on the worldwide incidence of Type 1 (insulin-dependent) diabetes mellitus. Diabetologia 36:883–892.PubMedGoogle Scholar
  3. 3.
    Tajima N, Matsushima M (1994) Complications and prognosis of children with IDDM. Diabetes Res Clin Pract 24 Suppl:S165-S170.PubMedGoogle Scholar
  4. 4.
    Modan M, Karp M, Bauman B, Gordon O, Danon YL, Laron Z (1991) Mortality in Israeli Jewish patients with type 1 (insulin-dependent) diabetes mellitus diagnosed prior to 18 years of age: a population-based study. Diabetologia 34:515–520.PubMedGoogle Scholar
  5. 5.
    Malone JI (1994) Understanding diabetes in children. Adv Pediatr 41:33–52.PubMedGoogle Scholar
  6. 6.
    Eisenbarth GS (1986) Type 1 diabetes mellitus: a chronic autoimmune disease. N Engl J Med 314:1360–1368.PubMedGoogle Scholar
  7. 7.
    Todd JA, Bain SC (1992) A practical approach to identification of susceptibility genes for IDDM. Diabetes 41:1029–1034.PubMedGoogle Scholar
  8. 8.
    Maclaren N, Riley W, Skordis N, Atkinson M, Spillar R, Silverstein J, et al. (1988) Inherited susceptibility to insulin-dependent diabetes is associated with HLA-DR1, while DR5 is protective. Autoimmunity 1:197–205.PubMedGoogle Scholar
  9. 9.
    Olmos P, A’Hern R, Heaton DA, Millward BA, Risley D, Pyke DA, et al. (1988) The significance of the concordance rate for type I (insulin-dependent) diabetes mellitus in identical twins. Diabetologia 31:747–750.PubMedGoogle Scholar
  10. 10.
    Winter WE, Takeshi C, Schatz D (1993) The genetics of autoimmune diabetes. Am J Dis Child 147:1282–1290.PubMedGoogle Scholar
  11. 11.
    Abbas AK, Lichtman AH, Pober JS (1994) Self-tolerance and autoimmunity. In: Cellular and molecular immunology, 2nd ed., Philadelphia, Saunders Co., pp. 376–392.Google Scholar
  12. 12.
    Hagopian WA, Sanjeefi CB, Kockum I, Landin-Olsson M, Karlsen AE, Sundkvist G, et al. (1995) Glutamate decarboxylase-, insulin-, and islet cell-antibodies and HLA typing to detect diabetes in a general population-based study of Swedish children. J Clin Invest 95:1505–1511.PubMedGoogle Scholar
  13. 13.
    Crawford JM, Cotran RS (1994) The pancreas. In: Robbins pathologic basis of disease, 5th ed., Cotran RS, Kumar V, Robbins SL, Schoen FJ, eds. Philadelphia, W. B. Saunders Co., pp. 897–925.Google Scholar
  14. 14.
    Verge CF, Howard NJ, Irwig L, Simpson JM, Mackerras D, Silink M (1994) Environmental factors in childhood IDDM. Diabetes Care 17:1381–1389.PubMedGoogle Scholar
  15. 15.
    Karjalainen J, Martin JM, Knip M, Ilonen J, Robinson BH, Savilahti E, et al. (1992) A bovine albumin peptide as a possible trigger of insulin-dependent diabetes mellitus. N Engl J Med 327:302–307.PubMedGoogle Scholar
  16. 16.
    Federlin K, Otten A, Helmke K (1987) Islet cell antibodies and viral infections. Exp Clin Endocrinol 89:368–374.PubMedGoogle Scholar
  17. 17.
    Frisk G, Nilsson E, Tuvemo T, Friman G, Diderholm, H (1992) The possible role of Coxsackie A and ECHO viruses in the pathogenesis of type 1 diabetes mellitus studied by IgM analyses. J Infection 24:13–22.Google Scholar
  18. 18.
    Atkinson MA, Maclaren NK (1994) The pathogenesis of insulin-dependent diabetes mellitus. N Engl J Med 331:1428–1436.PubMedGoogle Scholar
  19. 19.
    Nerup J, Mandrup-Poulsen T, Helqvist S, Anderson HU, Podiot F, Reimers JI, et al. (1994) On the pathogenesis of IDDM. Diabetologia 37 Suppl 2:S82-S89.PubMedGoogle Scholar
  20. 20.
    Asayama K, Kooy NW, Burr IM (1986) Effect of vitamin E deficiency and selenium deficiency on insulin secretory reserve and free radical scavenging systems in islets; decrease of islet manganosuperoxide dismutase. J Lab Clin Med 1986; 107:464–495.Google Scholar
  21. 21.
    Shah, SC, Malone JI, Simpson NE (1989) A randomized trial of intensive insulin therapy in newly diagnosed insulin-dependent diabetes mellitus. N Engl J Med 320:350–354.Google Scholar
  22. 22.
    Koivisto VA, Aro A, Cantell K (1984) Remissions in newly-diagnosed type 1 (insulin-dependent) diabetic patients: influence of interferon as an adjunct to insulin therapy. Diabetologia 27:193–7.PubMedGoogle Scholar
  23. 23.
    Green M, Michaels MG (1992) Infectious complications of solid-organ transplantation in children. Adv Pediatr Infect Dis 7:181–204.PubMedGoogle Scholar
  24. 24.
    Paya CV (1993) Fungal infections in solid-organ transplantation. Clin Infect Dis 16:677–688.PubMedGoogle Scholar
  25. 25.
    Dummer S, Kusne S (1993) Liver transplantation and related infections. Semin Respir Infect 8; 191–198.PubMedGoogle Scholar
  26. 26.
    Stratta R (1993) J Clinical patterns and treatment of cytomegalovirus infection after solid-organ transplantation. Transplant Proc 25(5 Suppl 4): 15–21.PubMedGoogle Scholar
  27. 27.
    Lu CY, Sicher SC, Vazques MA (1993) Prevention and treatment of renal allograft rejection: new therapeutic approaches and new insights into established therapies. J Am Soc Nephrol 4:1239–1256.PubMedGoogle Scholar
  28. 28.
    Vathsala A, Woo KT, Lim CH (1991) Pharmacokinetics and nephrotoxicity of cyclosporine. Ann Acad Med Singapore 20:507–512.PubMedGoogle Scholar
  29. 29.
    Distant DA, Gonwa TA (1993) The kidney in liver transplantation. J Am Soc Nephrol 4:129–136.PubMedGoogle Scholar
  30. 30.
    Marsh JW, Vehe KL, White HM (1992) Immunosuppressants. Gastroenterol Clin N Am 21:679–693.Google Scholar
  31. 31.
    Akagi H, Reynolds A, Hjelm M (1991) Cyclosporin A and its metabolites, distribution in blood and tissues. J Int Med Res 19:1–18.PubMedGoogle Scholar
  32. 32.
    Sutherland DER, Gores PF, Farney AC, Wahoff DC, Matas AJ, Dunn DL, et al. (1993) Evolution of kidney, pancreas, and islet transplantation of patients with diabetes at the University of Minnesota. Am J Surg 166:456–491.PubMedGoogle Scholar
  33. 33.
    Alejandro R (1995) Transplantation of islets of Langerhans in patients with insulin-dependent diabetes mellitus. Scan J Gastroenterol 30 Suppl 208:125–128.Google Scholar
  34. 34.
    Federlin KF (1993) The connection of experiment and clinic exemplified by the transplantation of islets of Langerhans. Exp Clin Endocrinol 101:334–345.PubMedGoogle Scholar
  35. 35.
    Hering BJ, Browatzki CC, Schultz A, Bretzel RG, Federlin KF (1993) Clinical islet transplantation—registry report, accomplishments in the past and future research needs. Cell Transplant 2:269–282.PubMedGoogle Scholar
  36. 36.
    Maki T, Mullon CJP, Solomon BA, Monaco AP (1995) Novel delivery of pancreatic islet cells to treat insulin-dependent diabetes mellitus. Clin Pharmacokinet 28:471–482.PubMedGoogle Scholar
  37. 37.
    London NJM, Donnelly PK (1994) Techniques of pancreas and islet transplantation. Baili Clin Gastroenterol 8:517–532.Google Scholar
  38. 38.
    Phillips MG, Ed., (1994) UNOS organ procurement, preservation, and distribution in transplantation. UNOS, Richmond, VA, 10:38–45.Google Scholar
  39. 39.
    Superdock KR, Helderman JH (1993) Immunosuppressive drugs and their effect. Sem Respir Infect 8:152–159.Google Scholar
  40. 40.
    Thomson AW, Starzl TE (1993) New immunosuppressive drugs: mechanistic insights and potential therapeutic advances. Immunol Rev 136:71–98.PubMedGoogle Scholar
  41. 41.
    Tocci MJ, Sigal NH (1992) Recent advances in the mechanism of action of cyclosporine and FK506. Curr Opinion Nephrol Hyperten 1:236–242.Google Scholar
  42. 42.
    Morris RE (1993) New small molecule immunosuppressants for transplantation: review of essential concepts. J Heart Lung Transplant 12:S275-S286.PubMedGoogle Scholar
  43. 43.
    Fontes P, Rao AS, Demetris AJ, Zeevi A, Trucco M, Carroll P, et al. (1994) Bone marrow augmentation of donor-cell chimerism in kidney, liver, and pancreas islet transplantation. Lancet 334:151–155.Google Scholar
  44. 44.
    Wallemacq PE, Reding R (1993) FK506 (tacrolimus) a novel immunosuppressant in organ transplantation: clinical, biomedical, and analytical aspects. Clin Chem 39:2219–2228.PubMedGoogle Scholar
  45. 45.
    Shaw LM, Bowers L, Demers L, Freeman D, Moyer T, Sanghvi A, et al. (1987) Critical issues in cyclosporine monitoring: report of the task force on cyclosporine monitoring. Clin Chem 33:1269–1288.Google Scholar
  46. 46.
    LeGatt DF, Coates JE, Simpson AI, Shalapay CE, Rintoul BJ, Yatscoff RW (1994) A comparison of cyclosporine assays using sequential samples from selected transplant patients. Clin Biochem 27:43–48.PubMedGoogle Scholar
  47. 47.
    Janeway CA Jr, Travers P (1994) Recognition of antigen. In: Immunobiology, The immune system in health and disease; Garland Publishing, pp. 4:18–4:30.Google Scholar
  48. 48.
    Suthanthiran M, Strom TB (1994) Renal transplantation. N Engl J Med 331:365–376.PubMedGoogle Scholar
  49. 49.
    Johnson AH, Hurley CK, Alper CA, Yunis EJ (1991) HLA: The major histocompatibility complex of man. In: Clinical diagnosis and management by laboratory methods, 18th ed., Philadelphia, W. B. Saunders Co., pp. 761–794.Google Scholar
  50. 50.
    Ogura K (1993) Sensitization, Clin Transplants 1992;357–359.Google Scholar
  51. 51.
    Shoskes DA, Wood KJ (1994) Indirect presentation of MHC antigens in transplantation. Immunol Today 15:32–38.PubMedGoogle Scholar
  52. 52.
    Miceli MC, Parnes JR (1991) The roles of CD4 and CD8 in T cell activation. Semin Immunol 3:133–141.PubMedGoogle Scholar
  53. 53.
    Karuppan SS, Lindholm A, Moller E (1992) Fewer acute rejection episodes and improved outcome in kidney-transplanted patients with selection criteria based on crossmatching. Transplantation 53:666–673.PubMedGoogle Scholar
  54. 54.
    Mahoney RJ, Ault KA, Given SR, Adams RJ, Breggia AC, Paris PA, et al. (1990) The flow cytometric crossmatch and early renal transplant loss. Transplantation 49:527–535.PubMedGoogle Scholar
  55. 55.
    Ogura K, Terasaki PI, Koyama H, Chia J, Imagawa DK, Busuttil RW (1994) High one-month liver graft failure rates in flow cytometry crossmatch-positive recipients. Clin Transplant 8:111–115.PubMedGoogle Scholar
  56. 56.
    Ogura K, Terasaki PI, Johnson C, Mendez R, Rosenthal JT, Ettenger R, et al. (1993) The significance of a positive flow cytometry crossmatch test in primary kidney transplantation. Transplantation 56:294–298.PubMedGoogle Scholar
  57. 57.
    Scornik JC, Brunson ME, Schaub B, Howard RJ, Pfaff WW (1994) The crossmatch in renal transplantation. Evaluation of flow cytometry as a replacement for standard cytotoxicity. Transplantation 57:621–625.PubMedGoogle Scholar
  58. 58.
    al Hussein KA, Shenton BK, Bell A, Talbot D, Clark KR, Rigg KM (1994) Characterization of donor-directed antibody class in the post-transplant period using flow cytometry in renal transplantation. Transplant Int 7:182–189.Google Scholar
  59. 59.
    Scornik JC, LeFor WM, Cicciarelli JC, Brunson ME, Bogaard T, Howard RJ, et al. (1992) Hyperacute and acute kidney graft rejection due to antibodies against B cells. Transplantation 54:61–64.PubMedGoogle Scholar
  60. 60.
    Reinke P, Fietze E, Docke WD, Kern F, Ewert R, Volk HD (1994) Late acute rejection in long-term renal allograft recipients. Diagnostic and predictive value of circulating activated T cells. Transplantation 58:35–41.PubMedGoogle Scholar
  61. 61.
    Garavoy MR, Reinschmidt MA, Bigos M, Perkins H, Colombe B, Feduska N, et al. (1983) Transplant Proc 15:1939–1944.Google Scholar
  62. 62.
    Wang GX, Terashita GY, Terasaki PI (1989) Platelet crossmatching for kidney transplants by flow cytometry. Transplantation 48:959–961.PubMedGoogle Scholar
  63. 63.
    Wahlberg J, Bengtsson M, Bergstrom C, Gannedahl G, Festin R, Lewen G, et al. (1994) Impact of flow cytometry cross-matching results on the outcome of cadaveric kidney transplantation. Transplant Proc 26:1752–1753.PubMedGoogle Scholar
  64. 64.
    Eisenstein BI (1990) The polymerase chain reaction. N Engl J Med 322:178–183.PubMedGoogle Scholar
  65. 65.
    Housman D (1995) Human DNA polymorphism. N Engl J Med 332:318–320.PubMedGoogle Scholar
  66. 66.
    Opelz G, Mytilineos J, Scherer S, Dunckley H, Trejaut J, Chapman J, et al. (1991) Lancet 338:461–463.PubMedGoogle Scholar
  67. 67.
    Williams GM, Hume DM, Hudson RP Jr, Morris PJ, Kano K, Milgrom F (1968) “Hyperacute” renal-homograft rejection in man. N Engl J Med 279:611–618.PubMedGoogle Scholar
  68. 68.
    Terasaki PI, Cecka JM, Lim E, Takemoto S, Cho Y, Gjentson D, et al. Clin Transplants 1991;409–430.Google Scholar
  69. 69.
    Squifflet JP, Moudry K, Sutherland DER (1988) Is HLA matching relevant in pancreas transplantation? Transplant Int 1:26–29.Google Scholar
  70. 70.
    Waldman WJ, Knight DA, Adams PW, Orosz CG, Sedmak DD (1993) In vitro induction of endothelial HLA class II antigen expression by cytomegalovirus-activated CD4+ T cells. Transplantation 56:1504–1512.PubMedGoogle Scholar
  71. 71.
    Sherlock CH, Denegri JF, Ashley RL (1991) Serological responses to cytomegalovirus during renal transplant rejection. Transplantation 52:272–275.PubMedGoogle Scholar
  72. 72.
    Dunn DL, Mayoral JL, Gillingham KJ, Loeffler CM, Brayman KL, Kramer MA, et al. (1991) Treatment of invasive cytomegalovirus disease in solid organ transplant patients with ganciclovir. Transplantation 51:98–106.PubMedGoogle Scholar
  73. 73.
    Wold AD (1992) Shell vial assay for the rapid detection of viral infections. In: Clinical microbiology procedures handbook, section 8.6; Isenbert HD., ed, Washington, DC, American Society for Microbiology. Vol 2, pp. 8.6.1–8.6.10.Google Scholar
  74. 74.
    Masih AS, Linder J, Shaw BW Jr, Wood RP, Donovan JP, White R, et al. (1988) Rapid identification of cytomegalovirus in liver allograft biopsies by in situ hybridization. Am J Surg Pathol 12:362–367.PubMedGoogle Scholar
  75. 75.
    Plotkin SA, Starr SE, Friedman HM, Brayman K, Harris S, Jackson S, et al. (1991) Effect of Towne live virus vaccine on cytomegalovirus disease after renal transplant. Ann Intern Med 114:525–531.PubMedGoogle Scholar
  76. 76.
    Marsano L, Perrillo RP, Flye MW, Hanto DW, Spitzer ED, Thomas JR, et al. (1990) Comparison of culture and serology for the diagnosis of cytomegalovirus infection in kidney and liver transplant recipients. J Infect Dis 161:454–461.PubMedGoogle Scholar
  77. 77.
    Halwachs G, Zach R, Pogglitsch H, Holzer H, Tiran A, Iberer F, et al. (1993) A rapid immunocytochemical assay for CMV detection in peripheral blood of organ-transplanted patients in clinical practice. Transplantation 56:338–342.PubMedGoogle Scholar
  78. 78.
    Sherlock DS (1994) Chronic hepatitis C. Dis Month 40:117–196.Google Scholar
  79. 79.
    Belli L, Dusheiko G, Rolles K, Burroughs AK (1991) Liver transplantation for chronic viral hepatitis. [Review] Ital J Gastroenterol 23:36–41.PubMedGoogle Scholar
  80. 80.
    Shah G, Demetris AJ, Irish W, Scheffel J, Mimms L, Van Thiel DH (1993) Frequency and severity of HCV infection following orthotopic liver transplantation. Effect of donor and recipient serology for HCV using a second generation ELISA test. J Hepatol 18:279–283.PubMedGoogle Scholar
  81. 81.
    Pereira BJ, Milford EL, Kirkman RL, Quan S, Sayre KR, Johnson PJ, et al. (1992) Prevalence of hepatitis C virus RNA in organ donors positive for hepatitis C antibody and in the recipients of their organs. N Engl J Med 327:910–915.PubMedGoogle Scholar
  82. 82.
    Martin P, Munoz SJ, Di Bisceglie AM, Rubin R, Waggoner JG, Armenti VT, et al. (1991) Recurrence of hepatitis C virus infection after orthotopic liver transplantation. Hepatol-ogy 13:719–721.Google Scholar
  83. 83.
    Rochlani M, Lewis JH, Ramsey GE, Bontempo FA, Shah G, Bowman RA, et al. (1992) Hepatitis C testing. Comparison of Ortho’s EIA and RIBA II tests in 1 182 patients undergoing primary liver transplantation. Am J Clin Pathol 98:8–12.PubMedGoogle Scholar
  84. 84.
    Poterucha JJ, Rakela J, Lumeng L, Lee CH, Taswell HF, Wiesner RH (1992) Diagnosis of chronic hepatitis C after liver transplantation by the detection of viral sequences with polymerase chain reaction. Hepatology 15:42–45.PubMedGoogle Scholar
  85. 85.
    Rohr MS, Lesniewski RR, Rubin CA, Johnson RG, Heise ER, McDonald JC, et al. (1993) Risk of liver disease in HCV-seropositive kidney transplant recipients. Ann Surg 217:512–517.PubMedGoogle Scholar
  86. 86.
    Milfred SK, Lake KD, Anderson DJ, Hayney MS, Love KR, Emery RW, et al. (1994) Practices of cardiothoracic transplant centers regarding hepatitis C-seropositive candidates and donors. Transplantation 57:568–572.PubMedGoogle Scholar
  87. 87.
    Lim HL, Lau GK, Davis GL, Dolson DJ, Lau JY (1994) Cholestatic hepatitis leading to hepatic failure in a patient with organ-transmitted hepatitis C virus infection. Gastroenterology 106:248–551.PubMedGoogle Scholar
  88. 88.
    Hopt UT, Buesing M, Schareck WD, Becker HD (1992) Management der exokrinen Pan-creassekretion-ein zentrales Problem der allogenen Pankreastransplantation. Chirurg 63: 186–192.PubMedGoogle Scholar
  89. 89.
    Sollinger HW, Beizer FO (1988) Pancreatic transplantation with urinary tract drainage. In: Pancreatic transplantation, Groth CG, ed. Philadelphia, W.B. Saunders Co., pp. 131–146.Google Scholar
  90. 90.
    Koenigsrainer A, Steurer W, Aichberger C, Gassner R, Schmid Th, Margreiter R (1991) Pancreatic transplantation with delayed duct occlusion versus bladder drainage: long-term results. Diabetologia 34 Suppl 1:S4-S7.Google Scholar
  91. 91.
    Secchi A, Dubernard JM, La Rocca E, LeFrancois N, Melandri M, Martin X, et al. (1991) Endocrinometabolic effects of whole versus segmental pancreas allotransplantation in diabetic patients- a two year follow-up. Transplantation 51:635–629.Google Scholar
  92. 92.
    Rosenlof LK, Earnhardt RC, Pruett TL, Stevenson W C, Douglas MT, Cornett GC, et al. (1992) Pancreas transplantation. An initial experience with systemic and portal drainage of pancreatic allografts. Ann Surg 215:586–597.PubMedGoogle Scholar
  93. 93.
    Esmatjes E, Fernandez-Cruz L, Ricart MJ, Casamitjana R, Lopez-Boado MA, Astudillo E (1991) Metabolic characteristics in patients with long-term pancreas graft with systemic or portal drainage. Diabetologia 34 Suppl 1:S40-S43.PubMedGoogle Scholar
  94. 94.
    Lott JA (1995) Enzyme tests in gastroenterology. In: Principles and practice of diagnostic enzymology, 2nd ed., Moss DW, Rosalki SB, eds, London, Edward Arnold Publishers, pp. 60–89.Google Scholar
  95. 95.
    Johnson & Johnson Company, Diagnostics Division, Rochester, NY 14650.Google Scholar
  96. 96.
    Stratta RJ, Sollinger HW, Perlman SB, D’Alessandro AM, Groshek M, Kalayoglu M, et al. (1989) Early detection of rejection in pancreas transplantation. Diabetes 38 Suppl 1:63–67.PubMedGoogle Scholar
  97. 97.
    Smith JL, Hunsicker LG, Yuh WT, Wright F H Jr, Van Voorhis L, Corry RJ (1989) Appearance of type II diabetes mellitus in type I diabetic recipients of pancreas allografts. Transplantation 47:304–311.PubMedGoogle Scholar
  98. 98.
    Steiner E, Klima G, Niederweiser D, Koenigsrainer A, Herold M, Margreiter R (1987) Monitoring of the pancreatic allograft by analysis of exocrine secretions. Transplant Proc 19:2336–2338.PubMedGoogle Scholar
  99. 99.
    Steiner E, Koller J, Geleff S, Dietze O, Koenigsrainer A, Margeiter R (1988) Viability of pancreatic transplants. Chirurg 59:469–471.PubMedGoogle Scholar
  100. 100.
    Bolinder J, Wahrenberg H, Persson A, Linde B, Tyden G, Groth CG, et al. (1991) Effect of pancreas transplantation on glucose counter-regulation in insulin-depended diabetic patients prone to severe hypoglycemia. J Intern Med 230:527–533.PubMedGoogle Scholar
  101. 101.
    Boucek P, Bartos V, Vanek I, Hyza Z, Skibova J (1991) Diabetic autonomic neuropathy after pancreas and kidney transplantation. Diabetologia 34 Suppl 1:S121-S124.PubMedGoogle Scholar
  102. 102.
    Caldara R, Martin X, Secchi A, Lefancois N, Touraine JL, Pozza G, et al. (1991) Metabolic control after kidney and pancreas transplantation: whole series results and effects of segmental duct obstruction versus whole pancreas with bladder diversion technique. Diabetologia 34 Suppl 1:S51-S52.PubMedGoogle Scholar
  103. 103.
    Drexel H, Palos G, Koenigsrainer A, Miesenboeck G, Aichberger C, Margreiter R, et al. (1991) Long-term follow-up of glycaemic control and parameters of lipid transport after pancreas transplantation. Diabetologia 34 Suppl 1:S47-S50.PubMedGoogle Scholar
  104. 104.
    Goldman J, Oh HK, Webb MG, Mozes M, Turza N, Kupin WL, et al. (1990) Allogenic whole pancreas transplantation in insulin-depended diabetes mellitus. Henry Ford Hosp Med J 38:246–251.PubMedGoogle Scholar
  105. 105.
    Holdaas H, Brekke IB, Hartmann A, Bentdal OH, Ganes T, Gjellestad A, et al. (1991) Long-term metabolic control in recipients of combined pancreas and kidney transplants. Diabetologia; 34 Suppl. 1:S68-S70.PubMedGoogle Scholar
  106. 106.
    Kennedy WR, Navarro X, Goetz FC, Sutherland DER, Najarian JS (1990) Effects of pancreatic transplantation on diabetic neuropathy. N Engl J Med 322:1031–1037.PubMedGoogle Scholar
  107. 107.
    Petersen MR, Vine AK (1990) Progression of diabetic retinopathy after pancreas transplantation. Ophthalmology 97:496–502.PubMedGoogle Scholar
  108. 108.
    Christiansen E, Andersen HB, Rasmussen K, Christensen NJ, Olgaard K, Kirkegaard P, et al. (1993) Pancreatic 03b2-cell function and glucose metabolism in human segmental pancreas and kidney transplantation. Am J Physiol 264:E441-E449.PubMedGoogle Scholar
  109. 109.
    Solders G, Tyden G, Persson A, Groth CG (1992) Improvement of nerve conduction in diabetic neuropathy. Diabetes 41:946–951.PubMedGoogle Scholar
  110. 110.
    Stratta RJ, Perlman SB, Sollinger HW, Kalayoglu M, Beizer FO (1987) Early diagnosis of pancreas allograft rejection. Surg Forum 38:378–380.Google Scholar
  111. 111.
    Munn SR, Engen DE, Barr D, Carpenter HA, Perkins JD (1990) Differential diagnosis of hypoamylasuria in pancreas allograft recipients with urinary exocrine drainage. Transplantation 49:359–362.PubMedGoogle Scholar
  112. 112.
    Perkal M, Marsk C, Lorber MI, Markes WH (1992) A three-year experience with serum anodal trypsinogen as a biochemical marker for rejection in pancreatic allografts. Transplantation 53:415–419.PubMedGoogle Scholar
  113. 113.
    Moukarzel M, Benoit G, Charpentier B, Bouchard P, Bensadoun H, Verdelli G, et al. (1992) Is urinary amylase a reliable index for monitoring whole pancreas endocrine graft function? Transplant Proc 24:925–926.PubMedGoogle Scholar
  114. 114.
    Marks WH, Borgstrom A, Sollinger H, Marks C (1990) Serum immunoreactive anodal trypsinogen and urinary amylase as biochemical markers for rejection of clinical whole-organ pancreas allografts having exocrine drainage into the urinary bladder. Transplantation 49:112–115.PubMedGoogle Scholar
  115. 115.
    Brattstrom C, Tyden G, Reinholt FP, Bohman SO, Borgstrom A, Backman L, et al. (1989) Markers for pancreas-graft rejection in humans. Diabetes 38 Suppl 1:57–62.PubMedGoogle Scholar
  116. 116.
    Koenigsrainer A, Tilg H, Reibnegger G, Steurer W, Schmid T, Wachter H, Margreiter R (1992) Pancreatic juice neopterin excretion-a reliable marker of pancreas allograft rejection. Transplant Proc 24:907, 908.Google Scholar
  117. 117.
    Margreiter R, Ofner D, Reinl J, Koenigsreiter A (1992) Pancreas transplantation—a critical appraisal. Transplant Proc 24:2383–2386.PubMedGoogle Scholar
  118. 118.
    Abendroth D, Capalbo M, Illner WD, Landgraf R, Land W (1992) Critical analysis of rejection markers sIL-2R, urinary amylase, and lipase in whole-organ pancreas transplantation with exocrine bladder drainage. Transplant Proc 24:786–787.PubMedGoogle Scholar
  119. 119.
    Pleog RJ, D’Alessandro AM, Groshek M, Gange SJ, Knechtle SJ, Stegall MD, et al. (1994) Efficacy of human anodal trypsinogen for detection of rejection in clinical pancreas transplantation. Transplant Proc 26:531–533.Google Scholar
  120. 120.
    Ogawa M, Matsusda K, Shibata T, Matsuda Y, Ukai T, Ohta M, et al. (1985) Elevation of serum pancreatic secretory trypsin inhibitor (PSTI) in patients with serious injury. Res Commun Chem Pathol Pharmacol 50:259–266.PubMedGoogle Scholar
  121. 121.
    Nyberg G, Olausson M, Norden G, Mjornsted L, Blohme I, Hedman L (1991) Pancreas specific protein (RASP) monitoring in pancreas transplantation. Transplant Proc 23:1604, 1605.PubMedGoogle Scholar
  122. 122.
    Scharp DW, Laci PE, Santiago JV, McCullough CS, Weide LG, Falqui L, et al. (1990) Insulin independence after islet transplantation into type I diabetic patient. Diabetes 39:515–518.PubMedGoogle Scholar
  123. 123.
    Groth CG, Orsgren O, Tibell A, Tollemar J, Moeller E, Bolinder J, et al. (1994) Transplantation of porcine fetal pancreas to diabetic patients. Lancet 344:1402–1404.PubMedGoogle Scholar
  124. 124.
    Socci C, Falqui L, Davalli A. M, Ricordi C, Braghi S, Bertuzzi F, et al. (1991) Fresh human islet transplantation to replace pancreatic endocrine function in type 1 diabetic patients. Report of six cases. Acta Diabet 28:151–157.Google Scholar
  125. 125.
    Ricordi, C, ed. (1992) Pancreatic islet cell transplantation. Austin, RG Landes Company.Google Scholar
  126. 126.
    Peakman M, McNab GL, Heaton ND, Tan KC, Vergani D (1994) Development of techniques for obtaining monodispersed human islet cells. Transplantation 57:384–393.PubMedGoogle Scholar
  127. 127.
    Zeng Y, Torre MA, Karrison T, Thistlewaite JR (1994) The correlation between donor characteristics and the success of human islet isolation. Transplantation 57:954–958.PubMedGoogle Scholar
  128. 128.
    Robertson GSM, Chadwick DR, Davies J, Rose S, Contractor H, James RFL, et al. (1994) The effectiveness of components of University of Wisconsin solution in improving human pancreatic islet purification. Transplantation 57:346–354.PubMedGoogle Scholar
  129. 129.
    Gores PF, Sutherland DER (1993) Pancreatic islet transplantation: is purification necessary? Am J Surg 166:538–542.PubMedGoogle Scholar
  130. 130.
    Farney AC, Sutherland DER (1993) Pancreas and islet transplantation. In: Go VLW, ed., (1993) The pancreas: biology, pathobiology, and disease, 2nd ed. New York: Raven, pp. 815–835.Google Scholar
  131. 131.
    Morel P, Kaufman DB, Field MJ, Lloveras JK, Matas AJ, Sutherland DER (1991) Detrimental effect of prednisone on canine islet autograft function. Transplant Proc 24: 1048–1050.Google Scholar
  132. 132.
    Popkin MK, Callies AL, Colon EA, Lentz RD, Sutherland DER (1993) Psychiatric diagnosis and the surgical outcome of pancreas transplantation in patients with type I diabetes mellitus. Psychosomatics 34:251–258.PubMedGoogle Scholar
  133. 133.
    Colton CK, Avgoustiniatos ES (1991) Bioengineering in development of the hybrid artificial pancreas. J Biomech Eng 113:152–170.PubMedGoogle Scholar
  134. 134.
    Soon-Shiong P, Heintz RE, Merideth N, et al. (1994) Insulin independence in a type I diabetic patient after encapsulated islet transplantation. Lancet 343:950–951.PubMedGoogle Scholar
  135. 135.
    Federlin KF, Bretzel RG, Hering BJ (1992) Islet transplant registry. In Pancreatic islet cell transplantation, Ricordi, C, ed., Austin, RG Landes Company, pp. 463–472.Google Scholar
  136. 136.
    Hering BJ, Browatzki CC, Schultz A, Bretzel RG, Federlin KF (1993) Clinical islet transplantation-registry report, accomplishments in the past and future research needs. Cell Transplant 2:269–282.PubMedGoogle Scholar

Copyright information

© Humana Press Inc. 1997

Authors and Affiliations

  • John A. Lott

There are no affiliations available

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