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Small Donors, Big Impact: Optimizing Organ Utilization in Simultaneous Pancreas and Kidney Transplantation From Extra Small Pediatric Donors.

التفاصيل البيبلوغرافية
العنوان: Small Donors, Big Impact: Optimizing Organ Utilization in Simultaneous Pancreas and Kidney Transplantation From Extra Small Pediatric Donors.
المؤلفون: Choudhary D; Department of Renal Transplant Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India., Rally S; Department of Renal Transplant Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India., Panjathia A; Department of Renal Transplant Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India., Bamaniya B; Department of Renal Transplant Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India., Matar A; Department of Solid Organ Transplantation, MHealth Fairview University of Minnesota, Minneapolis, Minnesota, USA., Sethi J; Department of Nephrology, PGIMER, Chandigarh, India., Patil SS; Department of Renal Transplant Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India., Singh S; Department of Renal Transplant Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India., Kenwar D; Department of Renal Transplant Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India., Bhadada S; Department of Endocrinology, PGIMER, Chandigarh, India., Kandaswammy R; Department of Solid Organ Transplantation, MHealth Fairview University of Minnesota, Minneapolis, Minnesota, USA., Sharma A; Department of Renal Transplant Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
المصدر: Clinical transplantation [Clin Transplant] 2024 Sep; Vol. 38 (9), pp. e15448.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Munksgaard Country of Publication: Denmark NLM ID: 8710240 Publication Model: Print Cited Medium: Internet ISSN: 1399-0012 (Electronic) Linking ISSN: 09020063 NLM ISO Abbreviation: Clin Transplant Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Copenhagen : Munksgaard,
مواضيع طبية MeSH: Pancreas Transplantation*/methods , Kidney Transplantation* , Tissue Donors*/supply & distribution , Graft Survival* , Tissue and Organ Procurement*/methods , Diabetes Mellitus, Type 1*/surgery , Diabetes Mellitus, Type 1*/complications , Kidney Failure, Chronic*/surgery, Humans ; Male ; Female ; Prognosis ; Child, Preschool ; Child ; Follow-Up Studies ; Adult ; Retrospective Studies ; Donor Selection/standards ; Adolescent
مستخلص: Introduction: Simultaneous pancreas-kidney transplantation (SPK) is the preferred treatment for individuals with type-1 diabetes and end-stage renal disease. However, a limited supply of "Ideal Pancreas Donors" contributed to a growing disparity between available organs and recipients. Even though SPK outcomes from pediatric donors match those from adult donors, unclear guidelines on minimum age and weight criteria for extra small pediatric pancreas donors lead to hesitancy among several transplant centers to utilize these grafts due to concerns about inadequate islet mass, technical challenges, and increased risk of allograft thrombosis.
Methods: This report details the successful outcomes of SPK transplantations performed at the study center between December 2021 and January 2024, using four extra small pediatric brain-dead donors (ESPDs). Each donor was aged ≤5 years and weighed <20 kg.
Results: All SPK recipients achieved immediate posttransplant euglycemia without requiring insulin. None of the recipients experienced graft pancreatitis, graft thrombosis, allograft rejection, or required re-exploration. During a 5-27-month follow-up period, all ESPD recipients maintained optimal graft function, as evidenced by normal glucose tolerance tests and HbA1c (4.9%-5.2%), with 100% graft and patient survival.
Conclusion: This report examines the usage of ESPDs in SPK transplantation, highlighting their potential to expand the donor pool and reduce wait times in areas with scarce deceased organ donations, thereby increasing the number of available organs for transplantation with acceptable outcomes. Revising donor selection guidelines to reflect the diverse risk-benefit profiles of waitlisted individuals is crucial to addressing geographical disparities and reducing organ discard rates.
(© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
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فهرسة مساهمة: Keywords: extra small pediatric donors; ideal pancreas donors; organ procurement and allocation; simultaneous pancreas–kidney transplantation
تواريخ الأحداث: Date Created: 20240904 Date Completed: 20240904 Latest Revision: 20240904
رمز التحديث: 20240904
DOI: 10.1111/ctr.15448
PMID: 39229679
قاعدة البيانات: MEDLINE
الوصف
تدمد:1399-0012
DOI:10.1111/ctr.15448