TY - JOUR
T1 - Medical and Surgical Management of the Failed Pancreas Transplant
AU - Casey, Michael J.
AU - Murakami, Naoka
AU - Ong, Song
AU - Adler, Joel T.
AU - Singh, Neeraj
AU - Murad, Haris
AU - Parajuli, Sandesh
AU - Concepcion, Beatrice P.
AU - Lubetzky, Michelle
AU - Pavlakis, Martha
AU - Woodside, Kenneth J.
AU - Faravardeh, Arman
AU - Basu, Arpita
AU - Tantisattamo, Ekamol
AU - Aala, Amtul
AU - Gruessner, Angelika
AU - Dadhania, Darshana
AU - Lentine, Krista
AU - Cooper, Matthew
AU - Parsons, Ronald F.
AU - Alhamad, Tarek
N1 - Publisher Copyright:
© 2023 Wolters Kluwer Health. All rights reserved.
PY - 2023/12/12
Y1 - 2023/12/12
N2 - Despite the continued improvements in pancreas transplant outcomes in recent decades, a subset of recipients experience graft failure and can experience substantial morbidity and mortality. Here, we summarize what is known about the failed pancreas allograft and what factors are important for consideration of retransplantation. The current definition of pancreas allograft failure and its challenges for the transplant community are explored. The impacts of a failed pancreas allograft are presented, including patient survival and resultant morbidities. The signs, symptoms, and medical and surgical management of a failed pancreas allograft are described, whereas the options and consequences of immunosuppression withdrawal are reviewed. Medical and surgical factors necessary for successful retransplant candidacy are detailed with emphasis on how well-selected patients may achieve excellent retransplant outcomes. To achieve substantial medical mitigation and even pancreas retransplantation, patients with a failed pancreas allograft warrant special attention to their residual renal, cardiovascular, and pulmonary function. Future studies of the failed pancreas allograft will require improved reporting of graft failure from transplant centers and continued investigation from experienced centers.
AB - Despite the continued improvements in pancreas transplant outcomes in recent decades, a subset of recipients experience graft failure and can experience substantial morbidity and mortality. Here, we summarize what is known about the failed pancreas allograft and what factors are important for consideration of retransplantation. The current definition of pancreas allograft failure and its challenges for the transplant community are explored. The impacts of a failed pancreas allograft are presented, including patient survival and resultant morbidities. The signs, symptoms, and medical and surgical management of a failed pancreas allograft are described, whereas the options and consequences of immunosuppression withdrawal are reviewed. Medical and surgical factors necessary for successful retransplant candidacy are detailed with emphasis on how well-selected patients may achieve excellent retransplant outcomes. To achieve substantial medical mitigation and even pancreas retransplantation, patients with a failed pancreas allograft warrant special attention to their residual renal, cardiovascular, and pulmonary function. Future studies of the failed pancreas allograft will require improved reporting of graft failure from transplant centers and continued investigation from experienced centers.
UR - http://www.scopus.com/inward/record.url?scp=85179917156&partnerID=8YFLogxK
U2 - 10.1097/TXD.0000000000001543
DO - 10.1097/TXD.0000000000001543
M3 - Article
C2 - 38094134
AN - SCOPUS:85179917156
SN - 2373-8731
VL - 10
SP - E1543
JO - Transplantation Direct
JF - Transplantation Direct
IS - 1
ER -