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Open Access

ISSN 2577-5820

© 2019 by the authors; CC BY 4.0 licence

OBM Transplantation , Volume 3 , Issue 2 (2019)

Pages: 205

Published: November 2019

(This book is a printed edition that was published in OBM Transplantation)

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Cover story: Alpha cells within human islets actively secrete the prosurvival peptide GLP-1. Treatment of human islets with the DPP4 inhibitor sitagliptin resulted in elevated levels in the active form of GLP-1. This increase in active GLP-1 may enhance protection from islet cell death and pre-treatment of islets with DPP4 inhibitors prior to transplantation has the potential to improve post-transplant islet survival.  View this paper.

Volume 3,Issue 2

Open Access Review

Clinical Tolerance Trials in Renal Transplantation – Where Do We Stand?

Received: 05 November 2018;  Published: 27 June 2019;  doi: 10.21926/obm.transplant.1902070

Abstract

In recent years, the potential of hematopoietic stem cells, regulatory T-cells and mesenchymal stem cells resulted in a variety of clinical tolerance trials. Every approach has yielded promising results. However, the riddle of transplant tolerance has not been solved as of yet. The results of the ongoing trials in this field will provide additional information regarding the risks and benefits of these therapy approaches.

Open Access Research Article

The DPP4 Inhibitor Sitagliptin Increases Active GLP-1 Levels from Human Islets and May Increase Islet Cell Survival Prior to Transplantation

Received: 12 March 2019;  Published: 26 June 2019;  doi: 10.21926/obm.transplant.1902069

Abstract

Background One of the goals of clinical islet transplantation is to achieve a single-donor transplant that is dependent on obtaining enough quality  cell mass from one donor pancreas. Human islets are routinely cultured prior to transplantation, and pro-survival factors such as GLP-1 analogues have been reported to maintain  cell mass and survival. Interestingly, human islets may secrete GLP-1 and they also express the enzyme DPP4 that proteolytically cleaves GLP-1 into an inactive form. The a [...]

Open Access Review

Human Islet Isolation and Distribution Efforts for Clinical and Basic Research

Received: 11 March 2019;  Published: 21 June 2019;  doi: 10.21926/obm.transplant.1902068

Abstract

The ability to obtain purified human islets routinely and reproducibly has enabled substantial progress in providing a safe and reliable treatment option for adult Type 1 diabetes patients. The availability of human islets for basic research has also significantly impacted the progress of understanding human islet biology and consequently, diabetes pathophysiology. There are now approximately 70 human islet isolation centers documented around the world, as well as multiple coordinated human isle [...]

Open Access Original Research

Ex-Vivo Perfusion of Donor Hearts: The Feasibility of Banked Blood for Normothermic Machine Perfusion

Received: 09 March 2019;  Published: 18 June 2019;  doi: 10.21926/obm.transplant.1902067

Abstract

Background: Normothermic machine perfusion (NMP) utilises 1.2-1.5L of donor blood (DB) with a target perfusate haematocrit of 25% to reanimate the donor heart. Limitations to current practise include small donor size and donor anaemia which can impact on the recovery of these hearts. Furthermore, in DCD, blood collection delays delivery of cardio-protective solution resulting in longer warm ischaemic times. Banked blood (BB) is a potential alternative to donor blood. We investigate the effect of [...]

Open Access Review

Non-CMV Viral Infections Following Solid-Organ Transplantation – Focus on Human T-Cell Lymphotropic Virus Type-1 and Human Herpesviruses-6,-7 and -8

Received: 14 February 2019;  Published: 17 June 2019;  doi: 10.21926/obm.transplant.1902066

Abstract

In non-endemic areas, HTLV-1 is an uncommon pathogen in the transplant host but can be associated with significant morbidity and mortality. Careful assessment of risk factors, targeted screening and heightened awareness of the clinical presentation of HTLV-1 associated disease is necessary for timely recognition and management in the transplant host. The use of antiretroviral agents in the management of symptomatic disease due to HTLV-1 remains controversial. HHV-6 has long been recognized as a [...]

Open Access Review

Respiratory Viral Infections in Lung Transplant Recipients: Implications for Long Term Outcomes and Emerging Therapies

Received: 18 February 2019;  Published: 10 June 2019;  doi: 10.21926/obm.transplant.1902065

Abstract

Lung transplant recipients are at greater risk of respiratory viral infections as compared to other solid organ transplant recipients due to constant exposure of the allograft to the external environment. There are no standardized methods for surveillance, prevention, or treatment of these infections despite their association with increased morbidity and mortality. Various studies have linked respiratory viral infections with acute cellular rejection and chronic allograft dysfunction, and emerg [...]

Open Access Original Research

Low Cost, Enriched Collagenase-Purified Protease Enzyme Mixtures Successfully Used for Human Islet Isolation

Received: 29 March 2019;  Published: 24 May 2019;  doi: 10.21926/obm.transplant.1902064

Abstract

Background: Purified bacterial collagenase and protease enzymes are commonly used to recover human islets from clinical grade pancreata for subsequent clinical islet transplantation. The high cost of purified enzymes can be prohibitive for recovering human islets from research pancreata used for translational research or pre-clinical studies. In this study, we successfully isolated islets from human research pancreata using enriched collagenase products supplemented with BP Protease (DE Collagen [...]

Open Access Original Research

Liver Transplantation or Resection for Treatment of Hepatocellular Carcinoma in Patients with Well-Compensated Cirrhosis: A Decision Analysis Model

Received: 18 March 2019;  Published: 13 May 2019;  doi: 10.21926/obm.transplant.1902063

Abstract

Hepatocellular carcinoma (HCC) is a lethal tumor, for which liver resection and transplantation are the only potentially curative treatments. No prospective, randomized study has compared survival in patients with compensated cirrhosis after the two operations. Decision analysis modeling is an objective method to quantify risks and benefits. This study aimed to use decision analysis with a Markov model to estimate the impact of liver transplant and surgical resection on survival for patients wit [...]

Open Access Editorial

Pancreatic Islet Transplantation: State of the Art and Future Perspectives

Received: 08 April 2019;  Published: 15 April 2019;  doi: 10.21926/obm.transplant.1902062

Abstract

Pancreatic islet transplantation represents an effective therapy with lower morbidity for patients carriers of type 1 diabetes compared to whole pancreas transplantation. Although complete insulin independence is usually not achieved it allows control of glycemia balance reducing the risk of severe hypoglycaemia events and impaired awareness of hypoglycaemia. Recent trials had demonstrated islet transplantation to be more effective than current medical treatment and improvements in outcomes als [...]

Open Access Review

Update in the Use of Percutaneous Coronary Intervention for Cardiac Allograft Vasculopathy After Heart Transplantation

Received: 23 January 2019;  Published: 09 April 2019;  doi: 10.21926/obm.transplant.1902061

Abstract

Cardiac allograft vasculopathy (CAV) limits long-term survival after heart transplantation. CAV with discrete or tubular lesions can be treated with percutaneous coronary intervention (PCI) with high procedural success. Revascularization with balloon angioplasty, bare-metal stents, and first-generation drug-eluting stents has been associated with high and unacceptable restenosis rates. However, second-generation drug-eluting stents are associated with favorable stent and lesion patency. Stent an [...]

Open Access Review

Right Heart Failure in Left Ventricular Assist Device Patients

Received: 13 February 2019;  Published: 08 April 2019;  doi: 10.21926/obm.transplant.1902060

Abstract

Left ventricular assist devices (LVADs) improve quality of life in end-stage heart failure patients but a frequent complication is Right heart failure (RHF) causing significant morbidity and mortality. This review article discusses key issues that need to be considered in the assessment and clinical management of RHF in LVAD patients including the use of Right Ventricle (RV) support devices and off-label LVADs as temporary or permanent RV support.

Open Access Review

Islet Autotransplantations for Total Pancreatectomy

Received: 15 January 2019;  Published: 03 April 2019;  doi: 10.21926/obm.transplant.1902059

Abstract

Total pancreatectomy (TP) is performed for not only malignant pancreatic diseases but also benign disease like chronic pancreatitis or pancreatic injury. However, it always abolishes the pancreatic exo- and endocrine functions and the nutritional condition of the patients is significantly impaired. Thus, especially in the case of benign diseases, the additional treatment for recovering endocrine function is recommended because the permanent endocrine dysfunction must influence their quality of l [...]
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