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

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).

Published
2021

2. First World Consensus Conference on pancreas transplantation: Part II – recommendations

Author

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

Abstract

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

3. 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

4. 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

5. Thyroid Function Rather Than Thyroid Antibodies Affects Pregnancy and Perinatal Outcomes: Results of a Prospective Study.

Author

Orsolini F, Gianetti E, Terrenzio C, Montanelli L, Benelli E, Bagattini B, Fiore E, and Tonacchera M

Subjects
Female, Infant, Newborn, Pregnancy, Humans, Thyroid Gland, Prospective Studies, Autoantibodies, Thyroxine therapeutic use, Thyroid Hormones, Thyrotropin, Abortion, Spontaneous epidemiology, Premature Birth
Abstract

Context: Thyroid autoantibody positivity has been associated with an increased rate of obstetrical complications., Objective: We aimed to evaluate the role of thyroid autoantibodies in adverse pregnancy outcomes., Methods: This prospective study was conducted in the Endocrinology Unit of Pisa Hospital. A total of 975 pregnant women were studied from 2012 to 2021; 572 (59%) were diagnosed with autoimmune thyroid (AT) diseases; 403 (41%) served as controls. Levothyroxine (LT4) treatment was introduced when TSH was > 2.5 mIU/L in the AT group and when TSH was > 4 mIU/L in the controls. Rates of obstetrical complications in each group were measured., Results: Although the frequency of miscarriage in the AT group was greater (4.8%) than in the controls (2.9%), no significant differences were detected (P = 0.181). There were no differences between the 2 groups concerning the other pregnancy complications, and no association with the titer of thyroid antibodies was observed. The frequency of congenital malformations was greater in the AT group than in the controls (P = 0.019), but no correlation with major congenital malformations was detected (P = 0.872). Given that thyroid hormone concentrations were strictly controlled in our population, we documented a tendency (not significant) toward an increase in miscarriage and preterm birth among women with TSH > 4 mIU/L., Conclusion: If thyroid function is adequately controlled, the presence and titer of thyroid autoantibodies does not negatively influence gestation. Although not significant, suboptimal thyroid hormone status seems to affect pregnancy outcomes more than thyroid autoimmunity., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2022
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6. Treating Type 1 Diabetes by Pancreas Transplant Alone: A Cohort Study on Actual Long-term (10 Years) Efficacy and Safety.

Author

Boggi U, Baronti W, Amorese G, Pilotti S, Occhipinti M, Perrone V, Marselli L, Barsotti M, Campani D, Gianetti E, Insilla AC, Bosi E, Kaufmann E, Terrenzio C, Vistoli F, and Marchetti P

Subjects
Cohort Studies, Glomerular Filtration Rate, Graft Survival physiology, Humans, Diabetes Mellitus, Type 1 diagnosis, Diabetes Mellitus, Type 1 surgery, Pancreas Transplantation adverse effects
Abstract

Background: Physiologically regulated insulin secretion and euglycemia are achievable in type 1 diabetes (T1D) by islet or pancreas transplantation. However, pancreas transplant alone (PTA) remains a debated approach, with uncertainties on its relative benefits and risks. We determined the actual long-term (10 y) efficacy and safety of PTA in carefully characterized T1D subjects., Methods: This is a single-center, cohort study in 66 consecutive T1D subjects who received a PTA between April 2001 and December 2007, and were then all followed until 10 y since transplant. Main features evaluated were patient survival, pancreas graft function, C-peptide levels, glycemic parameters, and the function of the native kidneys., Results: Ten-year actual patient survival was 92.4%. Optimal (insulin independence) or good (minimal insulin requirement) graft function was observed in 57.4% and 3.2% of patients, respectively. Six (9.0%) patients developed stage 5 or 4 chronic kidney disease. In the remaining individuals bearing a successful PTA, estimated glomerular filtration rate (eGFR) decline per year was -2.29 ± 2.69 mL/min/1.73 m2. Reduction of eGFR at 1 y post-PTA was higher in those with pre-PTA hyperfiltration and higher HbA1c concentrations; eGFR changes afterward significantly correlated with diabetes duration. In recipients with normoglycemia at 10 y, 74% of normoalbuminuric or microalbuminuric subjects pre-PTA remained stable, and 26% progressed toward a worse stage; conversely, in 62.5% of the macroalbuminuric individuals albuminuria severity regressed., Conclusions: These long-term effects of PTA on patient survival, graft function, and the native kidneys support PTA as a suitable approach to treat diabetes in selected T1D patients., Competing Interests: The authors declare no funding or conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Published
2022
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7. First World Consensus Conference on pancreas transplantation: Part II - recommendations.

Author

Boggi U, Vistoli F, Andres A, Arbogast HP, Badet L, Baronti W, Bartlett ST, Benedetti E, Branchereau J, Burke GW 3rd, Buron F, Caldara R, Cardillo M, Casanova D, Cipriani F, Cooper M, Cupisti A, Davide J, Drachenberg C, de Koning EJP, Ettorre GM, Fernandez Cruz L, Fridell JA, Friend PJ, Furian L, Gaber OA, Gruessner AC, Gruessner RWG, Gunton JE, Han DJ, Iacopi S, Kauffmann EF, Kaufman D, Kenmochi T, Khambalia HA, Lai Q, Langer RM, Maffi P, Marselli L, Menichetti F, Miccoli M, Mittal S, Morelon E, Napoli N, Neri F, Oberholzer J, Odorico JS, Öllinger R, Oniscu G, Orlando G, Ortenzi M, Perosa M, Perrone VG, Pleass H, Redfield RR, Ricci C, Rigotti P, Paul Robertson R, Ross LF, Rossi M, Saudek F, Scalea JR, Schenker P, Secchi A, Socci C, Sousa Silva D, Squifflet JP, Stock PG, Stratta RJ, Terrenzio C, Uva P, Watson CJE, White SA, Marchetti P, Kandaswamy R, and Berney T

Subjects
Graft Survival, Humans, Quality of Life, Renal Dialysis, Diabetes Mellitus, Type 1, Kidney Transplantation, Pancreas Transplantation
Abstract

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., (© 2021 The Authors. American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons.)

Published
2021
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8. Subcapsular Renal Hematoma in Simultaneous Pancreas Kidney Transplantation.

Author

Cappellani D, Terrenzio C, Gianetti E, Baronti W, Borrelli V, Marselli L, Vistoli F, Campatelli A, Boggi U, and Marchetti P

Abstract

Subcapsular renal hematoma (SRH) is a challenging condition, which may jeopardize kidney function or constitute a life-threatening event. This is particularly true in single-kidney patients, such as kidney-transplant recipients. SRH may exert an excessive pressure on the surrounding parenchyma, thus resulting in hypoperfusion and ischemia, with high risk of acute kidney failure and graft loss. Moreover, SRH may precede an overt renal rupture with subsequent hemorrhage and hemodynamic instability. The indication to an interventional management for this condition is still a matter of debate, with some authors advocating the high possibilities of spontaneous resolution and others advocating the high-risk of graft loss and even internal bleeding in case of overt renal rupture. Herein, we report the case of a 51-year-old simultaneous pancreas-kidney transplantation recipient who presented a SRH following a mild trauma. The therapeutic choices were carefully balanced on the specific case, and the conservative management proved successful., Competing Interests: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported., (Copyright © 2020 Daniele Cappellani et al.)

Published
2020
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