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7. First world consensus conference on pancreas transplantation: Part I-Methods and results of literature search

Author

Boggi, U., Vistoli, F., Marchetti, P., Kandaswamy, R., Berney, T., Andres, A., Arbogast, H. P., Badet, L., Baronti, W., Bartlett, S. T., Benedetti, E., Branchereau, J., Burke, G. W. 3., Buron, F., Caldara, R., Cardillo, M., Casanova, D., Cipriani, F., Cooper, M., Cupisti, A., de Koning, E. J. P., Davide, J., Drachenberg, C., Ettorre, G. M., Fernandez Cruz, L., Fridell, J. A., Friend, P. J., Furian, L., Gaber, O. A., Gruessner, A. C., Gruessner, R. W. G., Gunton, J. E., Han, D. -J., Iacopi, S., Kauffmann, E. F., Kaufman, D., Kenmochi, T., Khambalia, H. A., Lai, Q., Langer, R. M., Maffi, P., Marselli, L., Menichetti, F., Miccoli, M., Mittal, S., Morelon, E., Napoli, N., Neri, F., Oberholzer, J., Odorico, J. S., Ollinger, R., Oniscu, G., Orlando, G., Ortenzi, M., Perosa, M., Perrone, V. G., Redfield, R. R., Ricci, C., Rigotti, P., Robertson, R. P., Ross, L. F., Rossi, M., Saudek, F., Scalea, J. R., Schenker, P., Secchi, A., Socci, C., Sousa Silva, D., Squifflet, J. P., Stock, P. G., Stratta, R. J., Terrenzio, C., Uva, P., Watson, C. C. E., White, S. A., Boggi U., Vistoli F., Marchetti P., Kandaswamy R., Berney T., Andres A., Arbogast H.P., Badet L., Baronti W., Bartlett S.T., Benedetti E., Branchereau J., Burke G.W., Buron F., Caldara R., Cardillo M., Casanova D., Cipriani F., Cooper M., Cupisti A., de Koning E.J.P., Davide J., Drachenberg C., Ettorre G.M., Fernandez Cruz L., Fridell J.A., Friend P.J., Furian L., Gaber O.A., Gruessner A.C., Gruessner R.W.G., Gunton J.E., Han D.-J., Iacopi S., Kauffmann E.F., Kaufman D., Kenmochi T., Khambalia H.A., Lai Q., Langer R.M., Maffi P., Marselli L., Menichetti F., Miccoli M., Mittal S., Morelon E., Napoli N., Neri F., Oberholzer J., Odorico J.S., Ollinger R., Oniscu G., Orlando G., Ortenzi M., Perosa M., Perrone V.G., Redfield R.R., Ricci C., Rigotti P., Robertson R.P., Ross L.F., Rossi M., Saudek F., Scalea J.R., Schenker P., Secchi A., Socci C., Sousa Silva D., Squifflet J.P., Stock P.G., Stratta R.J., Terrenzio C., Uva P., Watson C.C.E., and White S.A.

Subjects
clinical research / practice, diabetes, pancreas / simultaneous pancreas-kidney transplantation, survey, Consensus, Humans, Pancreas Transplantation, medicine.medical_treatment, media_common.quotation_subject, Delphi method, Consensu, Pancreas transplantation, Session (web analytics), Jury, Voting, medicine, Immunology and Allergy, Pharmacology (medical), Grading (education), media_common, Transplantation, Medical education, business.industry, pancreas / simultaneous pancreas‐kidney transplantation, Systematic review, diabete, Special Articles, Original Article, First World, business, Human
Abstract

Comprehensive evidence‐based guidelines for the practice of pancreas transplantation are yet to be established. The First World Consensus Conference on Pancreas Transplantation was convened for this purpose. A steering committee selected the participants and defined the questions to be addressed. A group of literature reviewers identified 597 studies to be included in summaries for guidelines production. Expert groups formulated the first draft of recommendations. Two rounds of discussion and voting occurred online, using the Delphi method (agreement rate ≥85%). After each round, critical responses of experts were reviewed, and recommendations were amended accordingly. Recommendations were finalized after live discussions. Each session was preceded by expert presentations and a summary of results of systematic literature review. Up to three voting rounds were allowed for each recommendation. To avoid potential conflicts of interest, deliberations on issues regarding the impact of pancreas transplantation on the management of diabetes were conducted by an independent jury. Recommendations on technical issues were determined by experts and validated using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Quality of evidence was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) methodology. Each recommendation received a GRADE rating (Grading of Recommendations, Assessment, Development and Evaluations)., This article presents the results of literature search and the methods used to provide evidence‐based guidelines for the practice of pancreas transplantation at the First World Consensus Conference on Pancreas Transplantation.

Published
2021

8. First World Consensus Conference on Pancreas Transplantation: Part II - recommendations

Author

Jonathan A. Fridell, Gabriel C. Oniscu, Marcelo Perosa, Quirino Lai, Helmut Arbogast, Jean-Paul Squifflet, Paola Maffi, Axel Andres, Jose Oberholzer, Claudio Ricci, Eelco J.P. de Koning, Daniel Casanova, Osama Gaber, Stephen T. Bartlett, Giuseppe Orlando, Ugo Boggi, Peter Schenker, Giuseppe Maria Ettorre, Piero Marchetti, R. Paul Robertson, Jenny E. Gunton, Steven A. White, Sara Iacopi, Raja Kandaswamy, Robert Öllinger, Pablo Uva, Francesco Menichetti, Rainer W.G. Gruessner, Dixon B. Kaufman, Lainie Friedman Ross, Cinthia B. Drachenberg, Paolo Rigotti, Robert R. Redfield, José Davide, Joseph R. Scalea, Mario Miccoli, Fanny Buron, Chiara Terrenzio, Duck Jong Han, Vittorio Perrone, Henry Pleass, Laureano Fernandez Cruz, Hussein A. Khambalia, Walter Baronti, Lucrezia Furian, Thierry Berney, Donzilia Sousa Silva, Robert Langer, Emmanuel Morelon, Peter G. Stock, Niccolò Napoli, Peter J. Friend, Robert J. Stratta, Fabio Vistoli, Matthew Cooper, Massimo Cardillo, Shruti Mittal, Frantisek Saudek, Adamasco Cupisti, Federica Cipriani, Emanuele Federico Kauffmann, Lionel Badet, Monica Ortenzi, Massimo Rossi, Lorella Marselli, Christopher J.E. Watson, Enrico Benedetti, George W. Burke, Jon S. Odorico, Carlo Socci, Rossana Caldara, Julien Branchereau, Angelika C. Gruessner, Antonio Secchi, Flavia Neri, Takashi Kenmochi, Boggi, Ugo, Vistoli, Fabio, Andres, Axel, Arbogast, Helmut, Badet, Lionel, Baronti, Walter, Bartlett, Stephen T, Benedetti, Enrico, Branchereau, Julien, W Rd Burke, George, Buron, Fanny, Caldara, Rossana, Cardillo, Massimo, Casanova, Daniel, Cipriani, Federica, Cooper, Matthew, Cupisti, Adamasco, Davide, Josè, Drachenberg, Cinthia, de Koning, Eelco Jp, Ettorre, Giuseppe Maria, Fernandez Cruz, Laureano, Fridell, Jonathan, Friend, Peter J, Furian, Lucrezia, Gaber, Osama, Gruessner, Angelika C, Gruessner, Rainer W, Gunton, Jenny, Han, Duck Jong, Iacopi, Sara, Kauffmann, Emanuele Federico, Kaufman, Dixon, Kenmochi, Takashi, Khambalia, Hussein A, Lai, Quirino, Langer, Robert M, Maffi, Paola, Marselli, Lorella, Menichetti, Francesco, Miccoli, Mario, Mittal, Shruti, Morelon, Emmanuel, Napoli, Niccolò, Neri, Flavia, Oberholzer, Jose, Odorico, Jon, Öllinger, Robert, Oniscu, Gabriel, Orlando, Giuseppe, Ortenzi, Monica, Perosa, Marcelo, Perrone, Vittorio Grazio, Pleass, Henry, Redfield, Robert R, Ricci, Claudio, Rigotti, Paolo, Robertson, Paul R, Ross, Lainie, Rossi, Massimo, Saudek, Frantisek, Scalea, Joseph, Schenker, Peter, Secchi, Antonio, Socci, Carlo, Sousa Silva, Donzilia, Squifflet, Jean Paul, Stock, Peter, Stratta, Robert, Terrenzio, Chiara, Uva, Pablo, Watson, Christopher, White, Steven A, Marchetti, Piero, Kandaswamy, Raja, Berney, Thierry, Boggi, Ugo [0000-0002-7505-5896], Vistoli, Fabio [0000-0003-2115-4191], Andres, Axel [0000-0003-3329-0801], Arbogast, Helmut P [0000-0001-5410-8699], Badet, Lionel [0000-0002-9596-0279], Baronti, Walter [0000-0002-4532-3028], Bartlett, Stephen T [0000-0002-3980-2559], Benedetti, Enrico [0000-0003-1120-6058], Branchereau, Julien [0000-0002-8460-9352], Burke, George W [0000-0002-6888-2842], Buron, Fanny [0000-0003-0404-6746], Caldara, Rossana [0000-0001-7115-5681], Cardillo, Massimo [0000-0002-2776-2297], Casanova, Daniel [0000-0003-3863-5039], Cipriani, Federica [0000-0002-8651-5982], Cooper, Matthew [0000-0002-3438-9638], Cupisti, Adamasco [0000-0002-8995-936X], Davide, Josè [0000-0003-3174-2456], Drachenberg, Cinthia [0000-0002-3104-5661], de Koning, Eelco JP [0000-0002-1232-7022], Ettorre, Giuseppe Maria [0000-0002-7501-5472], Fernandez Cruz, Laureano [0000-0001-5652-1209], Fridell, Jonathan A [0000-0002-8708-1506], Friend, Peter J [0000-0003-0841-9685], Furian, Lucrezia [0000-0002-2264-7986], Gaber, Osama A [0000-0002-9444-3202], Gruessner, Angelika C [0000-0001-5961-5913], Gruessner, Rainer WG [0000-0002-2094-9817], Gunton, Jenny E [0000-0002-8127-9773], Han, Duck-Jong [0000-0002-0990-6824], Kauffmann, Emanuele Federico [0000-0001-7634-4844], Kaufman, Dixon [0000-0003-3615-0994], Kenmochi, Takashi [0000-0002-9090-8770], Khambalia, Hussein A [0000-0002-7553-3026], Lai, Quirino [0000-0003-1487-3235], Langer, Robert M [0000-0001-8349-1260], Maffi, Paola [0000-0001-5011-6499], Marselli, Lorella [0000-0002-6698-2962], Menichetti, Francesco [0000-0003-0824-7166], Miccoli, Mario [0000-0002-8632-6145], Mittal, Shruti [0000-0003-2390-5366], Morelon, Emmanuel [0000-0001-9928-1671], Napoli, Niccolò [0000-0003-2538-9158], Neri, Flavia [0000-0002-2677-8967], Oberholzer, Jose [0000-0002-1069-2501], Odorico, Jon S [0000-0003-1096-464X], Öllinger, Robert [0000-0002-4499-1673], Oniscu, Gabriel [0000-0003-1714-920X], Orlando, Giuseppe [0000-0002-6460-7974], Ortenzi, Monica [0000-0002-6508-6488], Perosa, Marcelo [0000-0002-8576-9761], Pleass, Henry [0000-0002-9814-0452], Redfield, Robert R [0000-0001-5986-3466], Ricci, Claudio [0000-0002-6638-4479], Rigotti, Paolo [0000-0002-8895-935X], Ross, Lainie F [0000-0002-7395-3000], Rossi, Massimo [0000-0001-5105-4656], Saudek, Frantisek [0000-0002-0448-4351], Scalea, Joseph R [0000-0001-8278-2859], Schenker, Peter [0000-0002-3607-6993], Secchi, Antonio [0000-0002-4208-5116], Socci, Carlo [0000-0002-3276-5556], Sousa Silva, Donzilia [0000-0002-7165-3581], Squifflet, Jean Paul [0000-0002-0467-7559], Stock, Peter G [0000-0002-5806-0167], Stratta, Robert J [0000-0001-7634-094X], Terrenzio, Chiara [0000-0002-0629-2134], Uva, Pablo [0000-0001-7317-3875], Watson, Christopher JE [0000-0002-0590-4901], Marchetti, Piero [0000-0003-4907-0635], Kandaswamy, Raja [0000-0003-4302-0119], Berney, Thierry [0000-0002-4230-9378], Apollo - University of Cambridge Repository, Boggi U., Vistoli F., Andres A., Arbogast H.P., Badet L., Baronti W., Bartlett S.T., Benedetti E., Branchereau J., Burke G.W., Buron F., Caldara R., Cardillo M., Casanova D., Cipriani F., Cooper M., Cupisti A., Davide J., Drachenberg C., de Koning E.J.P., Ettorre G.M., Fernandez Cruz L., Fridell J.A., Friend P.J., Furian L., Gaber O.A., Gruessner A.C., Gruessner R.W.G., Gunton J.E., Han D.-J., Iacopi S., Kauffmann E.F., Kaufman D., Kenmochi T., Khambalia H.A., Lai Q., Langer R.M., Maffi P., Marselli L., Menichetti F., Miccoli M., Mittal S., Morelon E., Napoli N., Neri F., Oberholzer J., Odorico J.S., Ollinger R., Oniscu G., Orlando G., Ortenzi M., Perosa M., Perrone V.G., Pleass H., Redfield R.R., Ricci C., Rigotti P., Paul Robertson R., Ross L.F., Rossi M., Saudek F., Scalea J.R., Schenker P., Secchi A., Socci C., Sousa Silva D., Squifflet J.P., Stock P.G., Stratta R.J., Terrenzio C., Uva P., Watson C.J.E., White S.A., Marchetti P., Kandaswamy R., and Berney T.

Subjects
medicine.medical_specialty, medicine.medical_treatment, Pancreas transplantation, clinical research/practice, Pancreas/simultaneous pancreas-kidney transplantation, Quality of life, Renal Dialysi, Renal Dialysis, Diabetes mellitus, medicine, Risk of mortality, Humans, Immunology and Allergy, survey, Pharmacology (medical), Survey, Intensive care medicine, Dialysis, Kidney transplantation, pancreas/simultaneous pancreas‐kidney transplantation, Transplantation, ddc:617, diabetes, pancreas/simultaneous pancreas-kidney transplantation, business.industry, Diabetes, Graft Survival, medicine.disease, Kidney Transplantation, Diabetes Mellitus, Type 1, surgical procedures, operative, diabete, Clinical research/practice, Quality of Life, Life expectancy, Special Articles, Original Article, Pancreas Transplantation, business, Human
Abstract

Funder: Fondazione Pisa, Pisa, Italy; Id: http://dx.doi.org/10.13039/100007368, Funder: Tuscany Region, Italy; Id: http://dx.doi.org/10.13039/501100009888, Funder: Pisa University Hospital, Pisa, Italy, Funder: University of Pisa, Pisa, Italy; Id: http://dx.doi.org/10.13039/501100007514, The First World Consensus Conference on Pancreas Transplantation provided 49 jury deliberations regarding the impact of pancreas transplantation on the treatment of diabetic patients, and 110 experts' recommendations for the practice of pancreas transplantation. The main message from this consensus conference is that both simultaneous pancreas-kidney transplantation (SPK) and pancreas transplantation alone can improve long-term patient survival, and all types of pancreas transplantation dramatically improve the quality of life of recipients. Pancreas transplantation may also improve the course of chronic complications of diabetes, depending on their severity. Therefore, the advantages of pancreas transplantation appear to clearly surpass potential disadvantages. Pancreas after kidney transplantation increases the risk of mortality only in the early period after transplantation, but is associated with improved life expectancy thereafter. Additionally, preemptive SPK, when compared to SPK performed in patients undergoing dialysis, appears to be associated with improved outcomes. Time on dialysis has negative prognostic implications in SPK recipients. Increased long-term survival, improvement in the course of diabetic complications, and amelioration of quality of life justify preferential allocation of kidney grafts to SPK recipients. Audience discussions and live voting are available online at the following URL address: http://mediaeventi.unipi.it/category/1st-world-consensus-conference-of-pancreas-transplantation/246.

Published
2021

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