Protocol Duodenal Graft Biopsies Aid Pancreas Graft Surveillance. 2019

Jens Gunther Brockmann, and Amir Butt, and Hussa F AlHussaini, and Hadeel AlMana, and Khaled AlSaad, and Moheeb Al-Awwami, and Dieter Clemens Broering, and Tariq Ali
Department of Surgery, Organ Transplant Center, Riyadh, Kingdom of Saudi Arabia.

Histological evaluation of the pancreas graft is usually done on demand resulting in significant delays. This analysis reports on endoscopic protocol duodenal graft biopsies at regular intervals to determine feasibility, safety, and monitoring benefits. Protocol duodenal graft biopsies in 27 consecutive pancreas transplants (10 simultaneous pancreas kidney [SPK], 17 pancreas after kidney [PAK]) with a follow-up of a minimum of 12 months were performed at days 14, 30, 90, 180, 360, 430. University of Pittsburgh Medical Center classification for intestinal rejection was used. C4d staining was performed when antibody-mediated rejection was suspected. Overall patient and pancreas graft survival was 100% and 93% at a mean follow-up of 2.8 years. One hundred sixty-seven endoscopic biopsy procedures were performed in 27 grafts without any complication. Biopsies revealed rejection in 3 (30%) SPK recipients and in 15 (82%) of PAK recipients as early as 14 days posttransplant. Two patients underwent PAK retransplantation diagnosed with acute rejection at day 180. All except 1 recipient being treated for rejection, showed histological improvement following antirejection treatment. Following transient treatment success, a total of 3 pancreas grafts were lost for immunological reason. One loss was immediate despite antirejection treatment, 1 secondary to nonresolving rejection at 7 months and the third due to recurrent rejection 15 months posttransplantation. Additionally, biopsies detected vascular (venous thrombosis) and overimmunosuppression (cytomegalovirus infection) complications. Protocol graft duodenal biopsies detect complications after whole-organ pancreas transplantation, are useful in guiding therapy, and carry potential for improving outcome.

UI MeSH Term Description Entries
D007165 Immunosuppression Therapy Deliberate prevention or diminution of the host's immune response. It may be nonspecific as in the administration of immunosuppressive agents (drugs or radiation) or by lymphocyte depletion or may be specific as in desensitization or the simultaneous administration of antigen and immunosuppressive drugs. Antirejection Therapy,Immunosuppression,Immunosuppressive Therapy,Anti-Rejection Therapy,Therapy, Anti-Rejection,Therapy, Antirejection,Anti Rejection Therapy,Anti-Rejection Therapies,Antirejection Therapies,Immunosuppression Therapies,Immunosuppressions,Immunosuppressive Therapies,Therapies, Immunosuppression,Therapies, Immunosuppressive,Therapy, Immunosuppression,Therapy, Immunosuppressive
D007166 Immunosuppressive Agents Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of T-CELLS or by inhibiting the activation of HELPER CELLS. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of INTERLEUKINS and other CYTOKINES are emerging. Immunosuppressant,Immunosuppressive Agent,Immunosuppressants,Agent, Immunosuppressive,Agents, Immunosuppressive
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003586 Cytomegalovirus Infections Infection with CYTOMEGALOVIRUS, characterized by enlarged cells bearing intranuclear inclusions. Infection may be in almost any organ, but the salivary glands are the most common site in children, as are the lungs in adults. CMV Inclusion,CMV Inclusions,Congenital CMV Infection,Congenital Cytomegalovirus Infection,Cytomegalic Inclusion Disease,Cytomegalovirus Colitis,Cytomegalovirus Inclusion,Cytomegalovirus Inclusion Disease,Cytomegalovirus Inclusions,Inclusion Disease,Perinatal CMV Infection,Perinatal Cytomegalovirus Infection,Renal Tubular Cytomegalovirus Inclusion,Renal Tubular Cytomegalovirus Inclusions,Salivary Gland Virus Disease,Severe Cytomegalovirus Infection,Severe Cytomegalovirus Infections,Infections, Cytomegalovirus,CMV Infection, Congenital,CMV Infection, Perinatal,Colitis, Cytomegalovirus,Congenital CMV Infections,Congenital Cytomegalovirus Infections,Cytomegalic Inclusion Diseases,Cytomegalovirus Colitides,Cytomegalovirus Inclusion Diseases,Cytomegalovirus Infection,Cytomegalovirus Infection, Congenital,Cytomegalovirus Infection, Perinatal,Cytomegalovirus Infection, Severe,Cytomegalovirus Infections, Severe,Disease, Cytomegalic Inclusion,Disease, Cytomegalovirus Inclusion,Diseases, Cytomegalovirus Inclusion,Inclusion Disease, Cytomegalic,Inclusion Disease, Cytomegalovirus,Inclusion Diseases,Inclusion Diseases, Cytomegalovirus,Inclusion, CMV,Inclusion, Cytomegalovirus,Infection, Congenital CMV,Infection, Congenital Cytomegalovirus,Infection, Cytomegalovirus,Infection, Perinatal CMV,Infection, Perinatal Cytomegalovirus,Infection, Severe Cytomegalovirus,Perinatal CMV Infections,Perinatal Cytomegalovirus Infections
D004386 Duodenum The shortest and widest portion of the SMALL INTESTINE adjacent to the PYLORUS of the STOMACH. It is named for having the length equal to about the width of 12 fingers. Duodenums
D004724 Endoscopy Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body. Endoscopic Surgical Procedures,Surgical Procedures, Endoscopic,Endoscopic Surgical Procedure,Endoscopy, Surgical,Surgical Endoscopy,Surgical Procedure, Endoscopic,Procedure, Endoscopic Surgical,Procedures, Endoscopic Surgical
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006084 Graft Rejection An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. Transplant Rejection,Rejection, Transplant,Transplantation Rejection,Graft Rejections,Rejection, Graft,Rejection, Transplantation,Rejections, Graft,Rejections, Transplant,Rejections, Transplantation,Transplant Rejections,Transplantation Rejections

Related Publications

Jens Gunther Brockmann, and Amir Butt, and Hussa F AlHussaini, and Hadeel AlMana, and Khaled AlSaad, and Moheeb Al-Awwami, and Dieter Clemens Broering, and Tariq Ali
January 2013, Clinical transplantation,
Jens Gunther Brockmann, and Amir Butt, and Hussa F AlHussaini, and Hadeel AlMana, and Khaled AlSaad, and Moheeb Al-Awwami, and Dieter Clemens Broering, and Tariq Ali
September 1995, Transplantation,
Jens Gunther Brockmann, and Amir Butt, and Hussa F AlHussaini, and Hadeel AlMana, and Khaled AlSaad, and Moheeb Al-Awwami, and Dieter Clemens Broering, and Tariq Ali
March 2020, Progress in transplantation (Aliso Viejo, Calif.),
Jens Gunther Brockmann, and Amir Butt, and Hussa F AlHussaini, and Hadeel AlMana, and Khaled AlSaad, and Moheeb Al-Awwami, and Dieter Clemens Broering, and Tariq Ali
December 1995, Transplantation,
Jens Gunther Brockmann, and Amir Butt, and Hussa F AlHussaini, and Hadeel AlMana, and Khaled AlSaad, and Moheeb Al-Awwami, and Dieter Clemens Broering, and Tariq Ali
December 1995, Transplantation proceedings,
Jens Gunther Brockmann, and Amir Butt, and Hussa F AlHussaini, and Hadeel AlMana, and Khaled AlSaad, and Moheeb Al-Awwami, and Dieter Clemens Broering, and Tariq Ali
June 2018, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons,
Jens Gunther Brockmann, and Amir Butt, and Hussa F AlHussaini, and Hadeel AlMana, and Khaled AlSaad, and Moheeb Al-Awwami, and Dieter Clemens Broering, and Tariq Ali
January 1997, Kidney international,
Jens Gunther Brockmann, and Amir Butt, and Hussa F AlHussaini, and Hadeel AlMana, and Khaled AlSaad, and Moheeb Al-Awwami, and Dieter Clemens Broering, and Tariq Ali
January 2017, Case reports in transplantation,
Jens Gunther Brockmann, and Amir Butt, and Hussa F AlHussaini, and Hadeel AlMana, and Khaled AlSaad, and Moheeb Al-Awwami, and Dieter Clemens Broering, and Tariq Ali
March 2001, Current opinion in urology,
Jens Gunther Brockmann, and Amir Butt, and Hussa F AlHussaini, and Hadeel AlMana, and Khaled AlSaad, and Moheeb Al-Awwami, and Dieter Clemens Broering, and Tariq Ali
August 2023, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology,
Copied contents to your clipboard!