A5032821658- Pancreatic function and diabetes
- Diabetes and associated disorders
- Diabetes Management and Research
- Pancreatitis Pathology and Treatment
- Renal Transplantation Outcomes and Treatments
- Pancreatic and Hepatic Oncology Research
- Cannabis and Cannabinoid Research
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Genetics and Neurodevelopmental Disorders
- Xenotransplantation and immune response
- Childhood Cancer Survivors' Quality of Life
- Diabetes Treatment and Management
- SARS-CoV-2 and COVID-19 Research
- Cardiovascular Function and Risk Factors
- Diet, Metabolism, and Disease
- Organ Transplantation Techniques and Outcomes
- Signaling Pathways in Disease
- Immune responses and vaccinations
- Adenosine and Purinergic Signaling
- Pluripotent Stem Cells Research
- Acute Myocardial Infarction Research
- Cancer Diagnosis and Treatment
- Cardiac Imaging and Diagnostics
- Oral and gingival health research
- COVID-19 Impact on Reproduction
University of Chicago
2017-2023
Riverside Transplantation Institute
2021
ORT Israel
2020
Beth Israel Deaconess Medical Center
2020
University of Chicago Medical Center
2019
Total pancreatectomy (TP) is offered as a last treatment option for pain relief in patients with chronic pancreatitis. Concurrent islets autotransplantation (TP-IAT) may improve glucose control. We analyzed results 20 recent who underwent TP-IAT at The University of Chicago. median observation period was 28 months (2–38). Data were collected prospectively then retrospectively. number requiring opioids daily control decreased from 16 (80%) prior to surgery 2 (13%) 1 year after, only (6.5%)...
This study aimed to evaluate whether the BETA-2 score is a reliable early predictor of graft decline and loss insulin independence after islet allotransplantation. Islet transplant procedures were stratified into 3 groups according clinical outcome: long-term without (group 1, N = 9), initial with subsequent 2, 13), no 3, 13). was calculated on day 75 multiple times afterwards for up 145 months posttransplantation. A cut-off 17.4 posttransplantation discerned between group 1 2 (area under...
Six single fasting blood sample–based indices—Secretory Unit of Islet Transplant Objects (SUITO), Estimated Function (TEF), Homeostasis Model Assessment (HOMA)2-B%, C-peptide/glucose ratio (CP/G), creatinine (CP/GCr), and BETA-2 score—were compared against commonly used 90-minute mixed meal tolerance test (MMTT) serum glucose beta score to assess which them best recognizes the state acceptable control without insulin supplementation after islet allotransplantation (ITx). We also tested...
Total pancreatectomy with islet autotransplantation (TPIAT) is an effective treatment option for non-diabetic patients intractable chronic pancreatitis. The outcome and potential benefits pre-diabetic diabetic are less well established. Thirty-four underwent TPIAT were retrospectively divided into 3 groups according to pre-operative glycemic control: diabetes mellitus (DM) (n=5, 15%), pre-DM (n=11, 32%) non-DM (n=18, 54%). Pre-operative fasting c-peptide was detectable similar in all groups....
A recent randomized, multicenter trial did not show benefit of a CXCR1/2 receptor inhibitor (Reparixin) when analysis included marginal islet mass (>3,000 IEQ/kg) for allotransplantation and immunosuppression regimens were standardized among participating centers. We present post-hoc patients from our center at the University Chicago who received an over 5,000 IEQ/kg regimen anti-thymocyte globulin (ATG) induction. Twelve (ITx) recipients randomized (2:1) to receive Reparixin (N = 8) or...
The selection of optimal pancreas donors is one the key factors in determining ultimate outcome clinical islet isolation. North American Islet Donor Score (NAIDS) allows for estimating chance success It was developed based on data from over 1000 11 isolation centers and validated University Alberta, Edmonton, cohort most active transplant center. Now we aimed to also validate it our much less program. Areas under receiver operating characteristic curves (AUROCs) logistic regression analyses...
BETA-2 score using a single fasting blood sample was developed to estimate beta-cell function after islet transplantation (ITx) and validated internally by high ITx volume center (Edmonton). The goal validate externally, in our center. Areas under receiver operating characteristic curves (AUROCs) were obtained see if beta or would better detect insulin independence glucose intolerance. We analyzed values from 48 mixed meal tolerance tests (MMTTs) 4 recipients with long-term follow-up 140...
(1) Background: The correlation between titers of islet autoantibodies (IAbs) and the loss transplanted islets remains controversial. We sought to evaluate prognostic utility monitoring IAbs in diabetic patients after transplantation (ITx); (2) Methods: Twelve with Type 1 diabetes mellitus severe hypoglycemia underwent ITx. Serum concentration glutamic acid decarboxylase (GAD), insulinoma antigen 2 (IA-2), zinc transport 8 (ZnT8) was assessed before ITx 0, 7, 75 days every 3 months...
Introduction: After the first-in-human pilot study which showed safety of pre-vascularized Sernova Cell Pouch (SCP) in subcutaneous space, we modified islet transplantation (ITx) conditions for improved engraftment SCP. Methods: Two sets SCP were implanted abdominal anterior rectus sheath seven patients with longstanding type 1 diabetes mellitus, problematic hypoglycemia and no stimulated C-peptide. Only highly purified islets used ITx suspended patient’s own serum. Immunosuppression was...
Pregnancy increases metabolic demand for insulin and may lead to the exhaustion of intraportally transplanted islets post-gestational hyperglycemia. To prevent these complications, we implemented preemptive supplementation during two subsequent pregnancies in an insulin-independent islet transplant recipient. This strategy resulted optimal blood glucose control pregnancies, preservation graft function postpartum maintenance long-term independence.
Background: Islet after kidney transplantation (IAK) could be an alternative to pancreas transplant in patients with T1DM but clinical outcomes of IAK are inconsistent and the experience is very limited. Here, we present our pilot study islet transplantation, which provided insulin independence optimal blood glucose control. Material: was performed 5 (2-5.5) years initial four at a median age 50(45-59) BMI 25(23-26) HbA1c 8.6(6.8-10.2). Median serum creatinine eGFR were 1.5 (0.9-2.1) 50...
We present a patient with intractable and debilitating pain secondary to chronic pancreatitis who was effectively treated total pancreatectomy islet autotransplantation (TPIAT). Islets engrafted into his liver significantly contributed improved blood glucose control quality of life. Subsequently, the developed alcohol related acute failure en bloc pancreas transplantation performed replace failing islets. Pancreas required resolve life-threatening severe hypoglycemic episodes. Herein, we...
Introduction: Prospective randomized multicenter trial did not find advantage of CXCR1/2 blocker (Reparixin) over placebo in islet transplantation patients with type 1 diabetes mellitus and problematic hypoglycemia at year follow-up. We present favorable metabolic outcomes 5-year follow-up cohort from our center. Material Methods: 12 nonuremic received a total 19 transplants (ITx) (up to 2 ITx per patient) within year. Eight were randomly assigned Reparixin 4 first week after each transplant...
Introduction BETA-2 was developed to more conveniently and precisely assess islet graft function than commonly used beta-score, which requires a stimulation test. After validation of in our cohort patients relation 90-min glucose mixed meal tolerance test we decided the practical utility monitoring allograft individual patients. Methods We retrospectively analyzed calculations during clinical evaluations allotransplantation (ITx) recipients with up 3 infusions. specifically looked reference...
Introduction: Pre-vascularized Sernova Cell Pouch (SCP) device was developed to provide an optimal environment for cell/islet engraftment in the extravascular space. A first-in-human pilot study showed SCP safety/islet vascularization; however, conditions did not allow detectable islet function. We present preliminary results of phase I/II testing safety and efficacy modified SCPs allotransplantation (ITx). Material Methods: 6 patients with longstanding T1DM multiple severe hypoglycemic...
Background: Anti-thymocyte globulin (ATG) is a potent immunosuppression agent associated with superior long-term islet graft survival compared to anti-IL2R monoclonal antibodies. However, ATG infusion often leads vibrant inflammatory response compromising engraftment after intraportal transplantation. Therefore, we analyzed in relation the timing of anti-thymocyte and transplantation (ITx). Material: In this retrospective single-center study, assessed single allogeneic following groups:...
Background: Islet, as well pancreas transplantations, are alternative procedures providing diabetic patients with insulin independence and optimal blood glucose control. Here, we assessed the utility of islet transplantation after failure a graft in declining function. Materials Methods: Four insulin-deficient diabetes problematic hypoglycemia were transplanted islets allografts prior transplants (IAP). Another four who had previously received allotransplants their function declined (PAI...
Aims: The goal of the study was to assess safety, tolerability and effectiveness prevascularized Sernova Cell Pouch (SCP) for pancreatic islet transplantation. Material: Each 6 patients with T1DM problematic hypoglycemia received 2 cadaveric transplants into SCPs pre-implanted onto muscles abdominal wall. transplant involved open surgical access infusion islets two 8-channel one mini sentinel SCP. Patient thymoglobulin/basiliximab induction, tacrolimus mycophenolate maintenance...
Background Precise, yet logistically feasible evaluation of beta-cell function is extremely important after total pancreatectomy with islet autotransplantation (TP-IAT). We investigated the utility and possible limitations indices using only a single fasting blood glucose C-peptide levels: The Secretory Unit Islet Transplant Objects (SUITO), transplant estimated (TEF), homeostasis model assessment (HOMA)2-B%, C-peptide/glucose ratio (CP/G), creatinine (CP/GCr) BETA-2 score as we did it...