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Rashidi, Armin; Brennan, Daniel C.; Amarillo, Ina; Wellen, Jason R.; Cashen, Amanda F.

doi:10.6002/ect.2016.0299

Cited by 3 publications

(4 citation statements)

References 31 publications

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“…It usually presents acutely after liver or small bowel transplants although there have been 15 reported cases of GVHD after pancreas transplants alone or in combination with renal transplants. 3,6–16 The diagnosis of SOT-associated GVHD is challenging, and the management remains controversial.…”

Section: Discussionmentioning

confidence: 99%

“…None of the 7 patients included in the study demonstrated chimerism at either time points, and none ultimately developed GVHD. 6 Although XY FISH and STR PCR-based assays using peripheral blood have been successfully used to diagnose SOT-associated GVHD and are now being used more routinely, the sensitivity and specificity of these modalities to detect chimerism and predict GVHD after SOTs are not well-defined. Consistent with the observations we reported, there have been several other reported instances in which blood-based testing was later inconsistent with tissue-based PCR, FISH, or histopathology.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 There are 15 case reports of GVHD related to pancreas transplants, 7 of which represent simultaneous pancreas-kidney transplants and 2 of which represent sequential pancreas-kidney transplants. 3,6–16 Diagnosis is typically confirmed by performing routine histopathology or polymerase chain reaction (PCR) assays aimed at detecting donor-derived short-tandem repeats (STRs) in involved tissue or peripheral blood to demonstrate the presence of donor T-cell chimerism. Endoscopy is often a critical step in the diagnostic workup because the GI tract is typically affected.…”

Section: Introductionmentioning

confidence: 99%

“…In reported cases of pancreatic transplant-associated GVHD, 9 of 15 patients died, most commonly because of complications related to sepsis. 6…”

Section: Introductionmentioning

confidence: 99%

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Graft-Versus-Host Disease After Pancreatic Transplantation

et al. 2019

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Graft-versus-host disease (GVHD) is a common complication of hematopoietic stem cell transplantation but can rarely occur after solid organ transplants. Small bowel and liver transplants are typically implicated, but solid organ transplant-associated GVHD has also been associated with other organs. We present a 40-year-old diabetic woman who underwent renal followed by pancreatic transplantation over a span of 21 months and ultimately developed acute classic GVHD. The diagnosis proved to be challenging in the context of confounding infections and inconclusive bone marrow and skin biopsy findings. She had multiorgan failure at the time of endoscopic confirmation and died after having minimal response to aggressive immunosuppression.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…In reported cases of pancreatic transplant-associated GVHD, 9 of 15 patients died, most commonly because of complications related to sepsis. 6…”

Section: Introductionmentioning

confidence: 99%

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Graft-Versus-Host Disease After Pancreatic Transplantation

et al. 2019

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Chronic graft-versus-host disease in pancreas after kidney transplant recipients – An unrecognized entity

Singh

Razonable

Lorenz

et al. 2021

American Journal of Transplantation

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Graft‐versus‐host disease (GVHD), a common complication after peripheral blood stem cell or bone marrow transplantation, rarely occurs in kidney and pancreas transplant recipients. The true incidence may be confounded by the rarity of the disorder, with a resultant lack of appreciation of the diagnosis as a potential cause of common clinical manifestations such as cytopenias and immune dysfunction. Reports of GVHD in kidney and pancreas transplant recipients almost uniformly describe patients in the early posttransplant period (days to months) with the typical manifestations of acute GVHD involving the skin, liver, and intestines. In contrast, reports of solid organ transplant recipients with clinical features more consistent with chronic GVHD (cGVHD) are lacking, raising concern of underrecognition of this severe complication. Occurrence later after transplant may be even more likely to result in lack of recognition. We report 2 cases of possible cGVHD occurring in recipients of pancreas after kidney transplantation, which were diagnosed at 5.5 and 42 months after pancreas transplant. Both patients presented with severe pancytopenia, multiple opportunistic infections, and features suggestive of cGVHD. Transplant professionals should be aware of the possibility of acute and cGVHD in pancreas after kidney transplant recipients and be able to recognize the clinical manifestations.

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Simultaneous Pancreas-Kidney Transplant: A Positive Stimulus in the Medical World

Ali

Khan

2020

Cureus

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Kidneys are one of the essential organs of our body, with chronic kidney disease being a very prevalent and emotionally, mentally and physically straining condition affecting 1 in 15 people worldwide. The prevalence is further escalating with every passing year. It is slowly progressive in nature, and many times goes unnoticed until symptoms start manifesting and presenting themselves much later in life. In this article, end-stage renal disease (ESRD) due to diabetes mellitus and its effect on different organs is examined, along with the role of simultaneous pancreas-kidney transplant (SPKT) in the management of this condition. Although proven to be an assured treatment with an outstanding allograft acceptance rate, the fact that it is still not widely adopted in many healthcare setups due to financial implications is also studied. Online databases such as PubMed and Google Scholar were searched for the purpose of data collection; due to the very limited number of randomized controlled trials conducted on this given topic, a limited discussion was retrieved. By applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method and several inclusion/exclusion criteria, approximately 66 articles were assessed for eligibility based on the title and abstract. A total of 44 articles were shortlisted and considered in the final review. Several systematic reviews that have been conducted in the past reveal the importance of SPKT at an early stage of diagnosis towards increasing longevity of the patient with freedom from multiple medications. Transplant is a cost-effective therapy when compared to the prolonged dependence on dialysis, insulin pens, and increased susceptibility to infections. A greater number of specialists must also train to carry out SPKT and identify the early stages of ESRD, and medical centers should be encouraged to carry out transplant procedures effectively both financially and medically. This can be achieved through the development of global policy mechanisms and establishment of universally adoptable standards.

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Untitled

Cited by 3 publications

References 31 publications

Graft-Versus-Host Disease After Pancreatic Transplantation

Graft-Versus-Host Disease After Pancreatic Transplantation

Chronic graft-versus-host disease in pancreas after kidney transplant recipients – An unrecognized entity

Simultaneous Pancreas-Kidney Transplant: A Positive Stimulus in the Medical World

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