| 1. |
- Benoni, Henrik, et al.
(författare)
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Relative and absolute cancer risks among Nordic kidney transplant recipients-a population-based study
- 2020
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Ingår i: Transplant International. - : WILEY. - 0934-0874 .- 1432-2277. ; 33:12, s. 1700-1710
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Tidskriftsartikel (refereegranskat)abstract
- Kidney transplant recipients (KTRs) have an increased cancer risk compared to the general population, but absolute risks that better reflect the clinical impact of cancer are seldom estimated. All KTRs in Sweden, Norway, Denmark, and Finland, with a first transplantation between 1995 and 2011, were identified through national registries. Post-transplantation cancer occurrence was assessed through linkage with cancer registries. We estimated standardized incidence ratios (SIR), absolute excess risks (AER), and cumulative incidence of cancer in the presence of competing risks. Overall, 12 984 KTRs developed 2215 cancers. The incidence rate of cancer overall was threefold increased (SIR 3.3, 95% confidence interval [CI]: 3.2-3.4). The AER of any cancer was 1560 cases (95% CI: 1468-1656) per 100 000 person-years. The highest AERs were observed for nonmelanoma skin cancer (838, 95% CI: 778-901), non-Hodgkin lymphoma (145, 95% CI: 119-174), lung cancer (126, 95% CI: 98.2-149), and kidney cancer (122, 95% CI: 98.0-149). The five- and ten-year cumulative incidence of any cancer was 8.1% (95% CI: 7.6-8.6%) and 16.8% (95% CI: 16.0-17.6%), respectively. Excess cancer risks were observed among Nordic KTRs for a wide range of cancers. Overall, 1 in 6 patients developed cancer within ten years, supporting extensive post-transplantation cancer vigilance.
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| 2. |
- Schive, Simen W., et al.
(författare)
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Cost and clinical outcome of islet transplantation in Norway 2010-2015
- 2017
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Ingår i: Clinical Transplantation. - : Wiley. - 0902-0063 .- 1399-0012. ; 31:1
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Tidskriftsartikel (refereegranskat)abstract
- Islet transplantation is a minimally invasive β-cell replacement strategy. Islet transplantation is a reimbursed treatment in Norway. Here, we summarize the cost and clinical outcome of 31 islet transplantations performed at Oslo University Hospital (OUS) from January 2010 to June 2015. Patients were retrospectively divided into three groups. Thirteen patients received either one or two islet transplantation alone (ITA), while five patients received islet transplantation after previous solid organ transplantation. For the group receiving 2 ITA, Kaplan-Meier estimates show an insulin independence of 20% more than 4 years after their last transplantation. An estimated 70% maintain at least partial graft function, defined as fasting C-peptide >0.1 nmol L−1, and 47% maintain a HbA1c below 6.5% or 2 percent points lower than before ITA. For all groups combined, we estimate that 44% of the patients have a 50% reduction in insulin requirement 4 years after the initial islet transplantation. The average cost for an islet transplantation procedure was 347 297±60 588 NOK, or 35 424±6182 EUR, of which isolation expenses represent 34%. We hereby add to the common pool of growing experience with islet transplantation and also describe the cost of the treatment at our center.
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| 3. |
- Ståhle, Magnus, 1973-, et al.
(författare)
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Clostripain, the Missing Link in the Enzyme Blend for Efficient Human Islet Isolation
- 2015
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Ingår i: Transplantation Direct. - 2373-8731. ; 1:5, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Effective digestive enzymes are crucial for successful islet isolation. Supplemental proteases are essential as they synergize with collagenase for effective pancreas digestion. The presence of tryptic-like activity has been implicated in efficient enzyme blends and the present study aimed to evaluate if addition of clostripain, an enzyme with tryptic-like activity, could improve efficacy of the islet isolation procedure.Methods: Clostripain was added to the enzyme blend just before pancreas perfusion. Islets were isolated per standard method and numerous isolation parameters, islet quality control, and the number of isolations fulfilling standard transplantation criteria were evaluated. Two control organs per clostripain organ were chosen by blindly matching against body mass index, cold ischemia time, hemoglobin A1c, donor sex, and donor age.Results: There were no differences in pancreas weight, dissection time, digestion time, harvest time, percent digested pancreas, or total pellet volume before islet purification between control or clostripain pancreases. Glucose-stimulated insulin release results were similar between groups. Total isolation islet equivalents, purified tissue volume and islet equivalents/g pancreas as well as fulfillment of transplantation criteria favored clostripain processed pancreases.Conclusions: The addition of clostripain to the enzyme blend soundly improved islet yields and transplantation rates. It gently aided pancreas digestion and maintained proper islet functionality. The addition of clostripain to the enzyme blend has now been implemented into standard isolation protocols at the isolation centers in Uppsala and in Oslo.
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| 4. |
- Ståhle, Magnus, et al.
(författare)
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Evaluation of perfluorohexyloctane/polydimethylsiloxane for pancreas preservation for clinical islet isolation and transplantation
- 2016
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Ingår i: Cell Transplantation. - 0963-6897 .- 1555-3892. ; 25:12, s. 2269-2276
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to evaluate a 50:50 mix of perfluorohexyloctane/polydimethylsiloxane 5 (F6H8S5) preservation of pancreases in a clinical setting compared with standard solutions for 1) cold ischemia time (CIT) <10 h and 2) an extended CIT >20 h. Procured clinical-grade pancreases were shipped in either F6H8S5 or in standard preservation solutions, that is, University of Wisconsin (UW) or Custodiol. F6H5S5 was preoxygenated for at least 15 min. Included clinical-grade pancreases were procured in UW or Custodiol. Upon arrival at the islet isolation laboratory, the duodenum was removed followed by rough trimming while F6H8S5 was oxygenated for 15–20 min. Trimmed pancreases were immersed into oxygenated F6H8S5 and stored at 4°C overnight followed by subsequent islet isolation. Pancreas preservation using F6H8S5 proved as effective as UW and Custadiol when used within CIT up to 10 h, in terms of both isolation outcome and islet functionality. Preservation in F6H8S5 of pancreases with extended CIT gave results similar to controls with CIT <10 h for both isolated islet functionality and isolation outcome. This study of clinically obtained pancreases indicates a clear benefit of using F6H8S5 on pancreases with extended CIT as it seems to allow extended cold ischemic time without affecting islet function and islet numbers.
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| 5. |
- Ståhle, Magnus, 1973-, et al.
(författare)
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Evaluation of the new pancreas preservation solution, I-Let Protect, for clinical islet isolation and transplantation
- 2015
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundThis prospective study aimed to evaluate polydimethylsiloxane 5 (F6H8S5) preservation of pancreases in a clinical setting compared with standard solutions for 1) cold ischemia-time (CIT) <10 hour and 2) a prolonged CIT > 20 hour.MethodsPart 1. Procured clinical grade pancreases were shipped in either F6H8S5 or in standard preservation solutions, i.e., University of Wisconsin (UW) or Custodiol. F6H5S5 were pre-oxygenated for at least 15 minutes.Part 2. Included clinical grade pancreases were procured in UW or Custodiol. Upon arrival at the islet isolation laboratory, duodenum was removed followed by rough trimming while F6H8S5 was oxygenated for 15-20 minutes. Trimmed pancreases were immersed into oxygenated F6H8S5 and stored at 4°C over night followed by subsequent islet isolation.ResultsPancreas preservation using F6H8S5 proved as effective as UW and Custadiol when used within CIT up to 10 hour, both in terms of isolation outcome and islet functionality. Preservation in F6H8S5 of pancreases with prolonged CIT gave results similar to controls with CIT< 10 hours for both isolated islet functionality and isolation outcome.ConclusionsThis prospective study of clinically obtained pancreases indicate a clear benefit of using F6H8S5 on pancreases with prolonged CIT when compared with other organ preservation solutions. F6H8S5 preserved islet quality and quantity compared with islets isolated from pancreases with CIT of less than 10 hour.
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