Stratégie de transplantation chez le patient diabétique de type 1. Transplantation strategy in Type 1 diabetic patient
|
|
|
- Gervase McKinney
- 5 years ago
- Views:
Transcription
1 Stratégie de transplantation chez le patient diabétique de type 1 Transplantation strategy in Type 1 diabetic patient Emmanuel Morelon Service de Transplantation, Néphrologie et Immunologie Clinique Hôpital Edouard Herriot LYON Inserm U 1111 Actualités Néphrologiques Jean Hamburger Hôpital Necker 23 avril 2018
2 Disclosure Advisory Boards : Novartis, Chiesi, Astellas, Sanofi Symposium: BMS, Sanofi, Astellas, Chiesi, Sandoz, Roche, IGL Research grants: Novartis, Astellas, Chiesi
3 Case report 1 Female 42 years old Type 1 diabetes Diabetes duration: 24 years Hb A1C 8.5% Insulin therapy: Implantable pump Hypoglycemia: once a day, no severe hypoglycemia Diabetes complication: neuropathy, retinopathy, nephropathy GFR : 44 ml/mn/1.73m 2 (CKD EPI) Blood Group: AB No evidence for macroangiopathy
4 Case report 1: which transplantation? Pancreas transplantation? Islet transplantation? Simultaneous pancreas kidney transplantation? Simultaneous islet kidney transplantation? Kidney transplantation followed by pancreas after kidney? Kidney transplantation followed by islet after kidney? No transplantation, optimal insulin therapy and nephroprotection?
5 Case report 2 Female 27 years old Type 1 diabetes Diabetes duration: 18 years Hb A1C 10.5% Insulin therapy: Lantus 24 UI/day Hypoglycemia: 3/weeks, no severe hypoglycemia Diabetes complication: neuropathy, retinopathy, nephropathy Hemodialysis for 4 years Blood Group: AB No evidence for macroangiopathy Anti HLA antibodies: PRA class I 70%
6 Case report 2: which transplantation? Pancreas transplantation? Islet transplantation? Simultaneous pancreas kidney transplantation? Simultaneous islet kidney transplantation? Kidney transplantation followed by pancreas after kidney? Kidney transplantation followed by islet after kidney?
7 Outline Procedure: Pancreas transplantation Islet graft Outcome and beneficial impact: Pancreas transplantation Islet graft Transplantation strategy
8 Outline Procedure: Pancreas transplantation Islet graft Outcome and beneficial impact: Pancreas transplantation Islet graft Transplantation strategy
9 ß cell replacement for T1D patients Pancreas transplantation Langerhans Islets
10 ß cell replacement for T1D patients Simultaneous pancreas and kidney transplantation Pancreas transplant alone Pancreas Kidney Pancreas T1D patients in ESRD Unstable T1D patients Brittle diabetes
11 Venous and enteric drainage S Y S T E M I C Enteric drainage Roux-en-Y loop Latero-lateral loop
12 Venous and enteric drainage P O R T A L Enteric drainage Roux-en-Y loop Latero-lateral loop
13 ß cell replacement for T1D patients Pancreas transplantation - a major operation High incidence of post-operative complications Recipient T1D patients Leakage Hemorrhage Thrombus of pancreas.. Sollinger, Ann Surg, 2009
14 Early technical failures and graft losses Simultaneous pancreas and kidney transplantation Graft thrombosis or graft removal because of bleeding, anastomotic leaks, pancreatitis, and/or infection. Biomedecine agency registry 2016
15 Islet graft Diapo T Berney
16 ß cell replacement for T1D patients: islet transplantation Islet transplant alone Islet after kidney transplantation Islets Kidney 2-3 Islet preparations per patient Unstable T1D patients Brittle diabetes T1D patients in ESRD Robertson, N Engl J Med, 2004
17 Islet Isolation in France/Geneva Rapport ABM 2015
18 The GRAGIL Network 1992: Geneva program Nantes Nancy Dijon Strasbourg Besançon 1997: GRAGIL network 1999: First patient in France Clermont-Ferrand Lyon Geneva Grenoble 272 islet transplantations 157 patients Montpellier Berney et al. Curr Opin Organ Transplant 2004; 9: 72. Kempf et al. Transplantation 2005; 79: Diapo T Berney
19 Outline Procedure: Pancreas transplantation Islet graft Outcome and beneficial impact: Pancreas transplantation Islet graft Transplantation strategy
20 Pancreas and kidney survival in simultaneous pancreas and kidney transplantation Biomedecine agency registry 2016
21 Pancreatic re-transplantation Pancreas graft survival. Lyon experience. 2D. p= p= Buron F et al, Transplantation 2013
22 Metabolic follow-up after long-term pancreas graft survival Dieterle C et al, European Journal of endocrinology 2007
23 SPK patient survival by pancreas and kidney graft status Gruessner AC et al, The review of Diabetic studies, 2016
24 Impact of simultaneous pancreas and transplantation in Type 1 diabetic patients with ESRD Improvement of patient survival (vs Kidney TR or Dialysis) Stabilization or improvement of diabetes-related complications Microvascular Nephropathy: Reversal of lesions of diabetic nephropathy on the long term Prevention of diabetic recurrence in kidney graft Neuropathy: Improvement of motor and sensory nerve conduction velocity Retinopathy stabilization/improvement Macrovascular: coronary disease et carotid intima media thickness Improvement of quality of life
25 Reversal of lesions of diabetic nephropathy after pancreas transplantation Before TR 5 years 10 years Fioretto P,. N Eng J Med 1998; 339: 69.
26 Outline Procedure: Pancreas transplantation Islet graft Outcome and beneficial impact: Pancreas transplantation Islet graft Transplantation strategy
27 Barton FB et al Diabetes Care, Vol 35, July 2012 Improvement in Islet transplant outcome 29 % 38% 41 % N=659 p=0.02 Percentage of insulin independence (ITA and IAK)
28 Lablanche S, Diabetes care 2015
29 Lablanche S, Diabetes care 2015
30 Assessing Islet transplantation compared to insulin therapy in type 1 diabetes: a randomized parallel study Lablanche S et al, The Lancet Diabetes and Endocrinology in press
31 Assessing Islet transplantation compared to insulin therapy in type 1 diabetes: a randomized parallel study Lablanche S et al, The Lancet Diabetes and Endocrinology in press
32 Improvement of Electrophysiological Neuropathy after Islet Transplantation for Type 1 Diabetes: A 5-year Prospective study Vantyghem MC et al, Diabetes Care 2014
33 Reduced progression of diabetic microvascular complications with Islet cells transplantation compared with intensive medical therapy Thompson DM et al, Transplantation 2011
34 Glycemic control in Islet versus Pancreas Transplantation in Type 1 diabetes with ESRD Lehmann R et al, Diabetes Care 2015
35 Renal function in simultaneous Islet Kidney versus Pancreas Kidney Transplantation in Type 1 diabetes Lehmann R et al, Diabetes Care 2015
36 Simultaneous Islet Kidney versus Pancreas Kidney Transplantation in Type 1 diabetes Lehmann R et al, Diabetes Care 2015
37 Antibody mediated rejection in pancreas transplantation Mittal, Am J transplant, 2014
38 Islet cells are resistant to ABMR About a third of islet grafted patients developed DSA DSA had no significant negative impact on pancreatic islet graft Pouliquen, Am J Transplant, 2017
39 Solid organ transplant Vascular chimerism Islet graft Donor heart Donor vessel Donor islet Recipient vessel DSA Allogeneic MHC Syngeneic MHC Vascular sequestration of DSA Chen C et al, JCI 2018
40 Pancreas versus islet Simultaneous with kidney After Kidney Pancreas Tx Islet Tx Alone 73% 61% Procedural risk Major procedural risk Minor procedural risk Immunosuppression Life-long Immunosuppression Life-long immunosuppression ESRD Fonctional renal transplant Consider SPK PAK : glycemic lability Severe hypoglycemia Avoid IAK : glycemic lability Severe hypoglycemia
41 Outline Procedure: Pancreas transplantation Islet graft Outcome and beneficial impact: Pancreas transplantation Islet graft Transplantation strategy
42 Transplantation strategy in Type 1 diabetic patients Type 1 diabetic patient and normal renal function (GFR> 50 ml/mn/1.73m2) Pancreas or Islet Transplantation? Type 1 diabetic patient and chronic kidney disease (DFG < 50 ml/mn/1.73m2) Simultaneous pancreas and kidney transplantation? Simultaneous islet and kidney transplantation? Kidney transplantation followed by pancreas after kidney transplantation? Kidney transplantation followed by islet after kidney transplantation?
43 Pre-emptive kidney transplantation in Type 1 diabetic patients Pruijm et al, Transplantation 2006, 81:1119
44 SPK : simultaneous pancreas and kidney transplantation PALK: pancreas transplantation after living donor kidney transplantation LDK/no P : living donor kidney transplantation, no pancreas TR DDK : Deceased donor kidney transplantation, no pancreas TR Edmund Huang, Transplantation 2011
45 Patients Survival Similar patients survival in all groups but DDK versus PALK (p=0.03) Edmund Huang, Transplantation 2011
46 Kidney Graft Survival Lower kidney survival for : Preemptive DDK vs preemptive PALK (DDK: 73.0%; log-rank P<0.003) SPK vs preemptive PALK (SPK: 80.2%; log-rank P<0.03) Edmund Huang, Transplantation 2011
47 Pancreas Graft Survival Better pancreas graft survival SPK versus PALK Edmund Huang, Transplantation 2011
48 Key parameters to define transplant strategy in type 1 diabetic patients Age (priority < 55 years) Sensitization (priority PRA<20%) Number of transplantation (priority first transplantation) Renal function GFR > 50 ml/mn : Islet or pancreas GFR <30 ml/m : kidney graft mandatory Diabetic control: Hb A1c, severe hypoglycemia, microvascular complications Surgical risk: coronary disease, iliac arterial calcifications, BMI <27 kg/m2
49 TREPID group, submitted
50 Greffe Donneur vivant Immunisation Cardiovasculair e Diabète Fonction rénale edfg > > edfg > 30 > edfg > 20 > edfg diabète instable non oui diabète instable oui non état cardiovasculaire compatible avec TP état cardiovasculaire compatible avec TP état cardiovasculaire compatible avec TP état cardiovasculaire compatible avec TP oui non oui non oui non oui non immunisation importante non oui donneur vivant non oui 0T durée d attente TPS GIS TRP TRP TRP TR trop longue (TPAR (GIAR) TREPID group, submitted S )
51 TREPID group, submitted
52 Case report 1 Female 42 years old Type 1 diabetes Diabetes duration: 24 years Hb A1C 8.5% Insulin therapy: Implantable pump Hypoglycemia: once a day, no severe hypoglycemia Diabetes complication: neuropathy, retinopathy, nephropathy GFR : 44 ml/mn/1.73m 2 (CKD EPI) Blood Group: AB No evidence for macroangiopathy
53 Greffe Donneur vivant Immunisation Cardiovasculair e Diabète Fonction rénale edfg > > edfg > 30 > edfg > 20 > edfg diabète instable non oui diabète instable oui non état cardiovasculaire compatible avec TP état cardiovasculaire compatible avec TP état cardiovasculaire compatible avec TP état cardiovasculaire compatible avec TP oui non oui non oui non oui non immunisation importante non oui donneur vivant non oui 0T durée d attente TPS GIS TRP TRP TRP TR trop longue (TPAR (GIAR) TREPID group, submitted S )
54
55
56 Case report 2 Female 27 years old Type 1 diabetes BMI 22 kg/m2 Diabetes duration: 18 years Hb A1C 10.5% Insulin therapy: Lantus 24 UI/day Hypoglycemia: 3/weeks, no severe hypoglycemia Diabetes complication: neuropathy, retinopathy, nephropathy Hemodialysis for 4 years Blood Group: AB No evidence for macroangiopathy Anti HLA antibodies: PRA class I: 70%
57
58 PRA > 70% No priority
59 Kidney Transplantation Living donor > Dcd donor
60 TREPID group, submitted
61 Acknowledgments Transplantation, nephrology and clinical immunology : M Brunet F Buron C Levi S Daoud O Thaunat R Cahen, C Pouteil-Noble, Antoine Sicard, A Koenig, C Fournie Diabetology : C Thivolet - M Laville- S Reffet Anesthesiology/Intensive care unit : T Rimmelle- A Bertin- C Jadaud- G Marcotte Surgical team L Badet X Martin R Codas H Fassi Fehri M Colombel S Crouzet Gragil network : T Berney, PY Benhamou, L Kessler. TREPID group Esposito AL, Badet L, Gragil, Paris, Lille s groups
62 Thank you
Eilandjes transplantatie. Eelco de Koning, LUMC 14 februari 2008
Eilandjes transplantatie Eelco de Koning, LUMC 14 februari 2008 Pancreas or islets? What tissue do we wish to transplant? Is there competition for donor pancreas? How does the islet isolation and transplantation
Pancreas After Islet Transplantation: A First Report of the International Pancreas Transplant Registry
American Journal of Transplantation 2016; 16: 688 693 Wiley Periodicals Inc. Brief Communication Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons doi:
Islet and Pancreas Transplantation
Islet and Pancreas Transplantation Julie Wardle Specialist Nurse Coordinator Indication for Transplant Treatment option for a select groups of patients with type 1 diabetes Aged 18 years or over Recurrent
Simultaneous Pancreas Kidney Transplantation:
Simultaneous Pancreas Kidney Transplantation: What is the added advantage, and for whom? Alexander Wiseman, M.D. Associate Professor, Division of Renal Diseases and Hypertension Medical Director, Kidney
Pancreas Transplantation. Sonia Clarke-Swaby Recipient Kidney/pancreas Transplant Co-ordinator Guy s Hospital
Pancreas Transplantation Sonia Clarke-Swaby Recipient Kidney/pancreas Transplant Co-ordinator Guy s Hospital Introduction Selection criteria, New innovation Complications, Success rates, Life expectancy
Clinical Policy: Pancreas Transplantation Reference Number: PA.CP.MP.102
Clinical Policy: Reference Number: PA.CP.MP.102 Effective Date: 01/18 Last Review Date: 03/17 Revision Log Coding Implications Description This policy describes the medical necessity requirements for pancreas
NHS BLOOD AND TRANSPLANT ORGAN DONATION AND TRANSPLANTATION DIRECTORATE PANCREAS ADVISORY GROUP AUDIT OF STANDARD CRITERIA FOR LISTING SUMMARY
INTRODUCTION NHS BLOOD AND TRANSPLANT ORGAN DONATION AND TRANSPLANTATION DIRECTORATE PANCREAS ADVISORY GROUP AUDIT OF STANDARD CRITERIA FOR LISTING SUMMARY 1 Selection criteria for patients onto the national
Allogeneic Pancreas Transplant
Protocol Allogeneic Pancreas Transplant (70302) Medical Benefit Effective Date: 07/01/14 Next Review Date: 05/15 Preauthorization Yes Review Dates: 09/09, 09/10, 09/11, 07/12, 05/13, 05/14 The following
For more information about how to cite these materials visit
Author(s): Silas P. Norman, M.D., 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Noncommercial Share Alike 3.0 License: http://creativecommons.org/licenses/by-nc-sa/3.0/
Allogeneic Pancreas Transplant
Protocol Allogeneic Pancreas Transplant (70302) Medical Benefit Effective Date: 07/01/14 Next Review Date: 05/18 Preauthorization Yes Review Dates: 09/09, 09/10, 09/11, 07/12, 05/13, 05/14, 05/15, 05/16,
Kidney Transplantation
Kidney Tran nsplantation Historical per rspective and current practice Piyanut Poo otracool, M.D. Departmen nt of Surgery, Ramathibo odi Hospital, Mahidol University Kidney Transplantation DDKT Adult deceased
UEMS & EBS: DIVISION OF TRANSPLANT SURGERY
CURRICULUM AND SYLLABUS TRANSPLANTATION Module 1: Multi-organ retrieval Ability to evaluate donor suitability Ability to retrieve abdominal organs for transplantation Evaluation of donor/ organs suitability
Transplantation in 2012:
Transplantation in 2012: Optimizing Outcomes through Seamless Communication Kidney, Pancreas and Islet Breakout Session Kidney Transplantation as a Treatment of Choice for ESRD Uday S. Nori, MD Assistant
Records. Adult Kidney Pancreas Transplant Recipient Registration Worksheet. Recipient Information. Provider Information.
Records Adult Kidney Pancreas Transplant Recipient Registration Worksheet FORM APPROVED: O.M.B. NO. 0915 0157 Expiration Date: 07/31/2020 Note: These worksheets are provided to function as a guide to what
Allogeneic Pancreas Transplant. Description
Subject: Allogeneic Pancreas Transplant Page: 1 of 12 Last Review Status/Date: June 2015 Allogeneic Pancreas Transplant Description Transplantation of a normal pancreas is a treatment method for patients
Pancreas and Pancreas-Kidney Transplantation By: Kay R. Brown, CLCP
Pancreas and Pancreas-Kidney Transplantation By: Kay R. Brown, CLCP Pancreas transplant recipients are usually under age 50. The majority of pancreas transplants are performed on diabetics, who are generally
Corporate Medical Policy
Corporate Medical Policy Pancreas Transplant File Name: Origination: Last CAP Review: Next CAP Review: Last Review: pancreas_transplant 1/2000 5/2017 5/2018 8/2017 Description of Procedure or Service Transplantation
FEP Medical Policy Manual
FEP Medical Policy Manual Effective Date: January 15, 2019 Related Policies: 1.01.30 Artificial Pancreas Device Systems 7.03.12 Autologous Islet transplantation Allogeneic Pancreas Transplant Description
Vascular Remodelling in Pancreas Transplantation
Vascular Remodelling in Pancreas Transplantation Prof Steve White Consultant HPB/Transplant Surgeon The Freeman Hospital Newcastle President Elect EPITA European Pancreas Transplants Pancreas Transplants
Allogeneic Pancreas Transplant. Populations Interventions Comparators Outcomes Individuals: With insulin-dependent diabetes
Protocol Allogeneic Pancreas Transplant (70302) Medical Benefit Effective Date: 07/01/14 Next Review Date: 05/19 Preauthorization Yes Review Dates: 09/09, 09/10, 09/11, 07/12, 05/13, 05/14, 05/15, 05/16,
Pancreas Transplantation: A Daring Concept 17 December 1966
Pancreas Transplantation Pancreas Transplantation: A Daring Concept 17 December 1966 Rutger J. Ploeg, MD PhD Abdominal & Transplant Surgery University Medical Centre Groningen The Netherlands Diabetes
THE MEDICAL BENEFITS OF PANCREATIC TRANSPLANTATION
THE MEDICAL BENEFITS OF PANCREATIC TRANSPLANTATION Carlos E. Marroquin, M.D., F.A.C.S. Chief, Transplant and Hepatobiliary Surgery Department of Surgery Learning Objectives Describe historic events in
Topic: Pancreas Transplant Date of Origin: January Section: Transplant Last Reviewed Date: August 2013
Medical Policy Manual Topic: Pancreas Transplant Date of Origin: January 1996 Section: Transplant Last Reviewed Date: August 2013 Policy No: 6 Effective Date: November 1, 2013 IMPORTANT REMINDER Medical
Islet Transplantation
Islet Transplantation Policy Number: Original Effective Date: MM.07.027 07/01/2014 Line(s) of Business: Current Effective Date: HMO; PPO 12/16/2016 Section: Transplants Place(s) of Service: Inpatient I.
PANCREAS TRANSPLANTATION WAS first described
0163-769X/04/$20.00/0 Endocrine Reviews 25(6):919 946 Printed in U.S.A. Copyright 2004 by The Endocrine Society doi: 10.1210/er.2002-0036 Pancreas Transplantation: Indications and Consequences JENNIFER
MEDICAL POLICY. POLICY NUMBER: CATEGORY: Transplants
MEDICAL POLICY SUBJECT: PANCREAS TRANSPLANT: (PANCREAS TRANSPLANT ALONE, PANCREAS AFTER KIDNEY TRANSPLANT, SIMULTANEOUS PANCREAS KIDNEY TRANSPLANT); ISLET CELL TRANSPLANT CATEGORY: Transplants EFFECTIVE
Islet Transplantation. Description
Subject: Islet Transplantation Page: 1 of 7 Last Review Status/Date: September 2015 Islet Transplantation Description Autologous islet transplantation, performed in conjunction with pancreatectomy, is
Allogeneic Pancreas Transplant
Allogeneic Pancreas Transplant Policy Number: 7.03.02 Last Review: 8/2014 Origination: 8/2001 Next Review: 8/2015 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage for allogeneic
The New Kidney Allocation System: What You Need to Know. Anup Patel, MD Clinical Director Renal and Pancreas Transplant Division Barnabas Health
The New Kidney Allocation System: What You Need to Know Anup Patel, MD Clinical Director Renal and Pancreas Transplant Division Barnabas Health ~6% of patients die each year on the deceased donor waiting
José Oberholzer, MD. Director Charles O. Strickler Transplant Center. Chief, Division of Transplantation
José Oberholzer, MD Director Charles O. Strickler Transplant Center Chief, Division of Transplantation Professor of Surgery and Biomedical Engineering DISCLOSURES No consulting for, no payments, no stocks
Original Policy Date
MP 7.03.10 Islet Transplantation Medical Policy Section Surgery Issue 12/2013 Original Policy Date 12/2013 Last Review Status/Date Reviewed with literature search/12/2013 Return to Medical Policy Index
Transplant International. Impact of graft implantation order on graft survival in simultaneous pancreas-kidney transplantation.
Draft Manuscript for Review Impact of graft implantation order on graft survival in simultaneous pancreas-kidney transplantation. Journal: Manuscript ID TRI-OA--0.R Manuscript Type: Original Article Date
Impact of graft implantation order on graft survival in simultaneous pancreas kidney transplantation
Transplant International ORIGINAL ARTICLE Impact of graft implantation order on graft survival in simultaneous pancreas kidney transplantation Nadja Niclauss, Beno^ıt Bedat, Philippe Morel, Axel Andres,
Chairs : D. Cantarovich A. Magnan
SYMPOSIUM : Perfusion hépatique et rénale : Carlo Ceresa Perfusion pulmonaire : Edouard Sage Phillipe Lacoste Perfusion Pancreas : J Branchereau Chairs : D. Cantarovich A. Magnan SYMPOSIUM : Background
Diabetes mellitus afflicts about 6% of. Review. Current Status of Pancreas and Islet Cell Transplantation
Review Current Status of Pancreas and Islet Cell Transplantation R. F. Saidi Assistant Professor of Surgery, Division of Organ Transplantation, Department of Surgery, University of Massachusetts Medical
Original Policy Date
MP 7.03.03 Allogeneic Pancreas Transplant Medical Policy Section Surgery Issue 12/2013 Original Policy Date 12/2013 Last Review Status/Date Reviewed with literature search/12/2013 Return to Medical Policy
SUPPLEMENTARY DATA. Telediab Study Group :
Telediab Study Group : Guillaume Charpentier, MD, Department of Diabetes, Sud-Francilien Hospital, Corbeil-Essonnes, France Centre d Études et de Recherches pour l Intensification du Traitement du Diabète
TRANSPLANTATION IN DIABETIC PATIENTS. A.Tarik Kizilisik, MD, MSc, FACS, FICS Director & Primary Transplant Surgeon Lutheran Transplant Center
TRANSPLANTATION IN DIABETIC PATIENTS A.Tarik Kizilisik, MD, MSc, FACS, FICS Director & Primary Transplant Surgeon Lutheran Transplant Center Diabetes is the pandemic of the new millennium 24 million diabetics
Dix ans de transplantation rénale Fonds Boussard
Dix ans de transplantation rénale Fonds Boussard Groupe Spiesser A.T.N. Christophe Legendre, Hôpital Necker & Université Paris Descartes, Paris Fondation Day-Solvay Actualités Néphrologiques Jean Hamburger
Beta-Cell Replacement by Transplantation in Diabetes Mellitus: When Pancreas, When Islets, and How To Allocate the Pancreas?
Trends David E.R. in Transplant. Sutherland 2010;4:99-107 and Dixon B. Kaufmann: Beta-Cell Replacement by Transplantation in Diabetes Mellitus Beta-Cell Replacement by Transplantation in Diabetes Mellitus:
Chapter 4 Section Simultaneous Pancreas-Kidney (SPK), Pancreas-After-Kidney (PAK), And Pancreas-Transplant-Alone (PTA)
Surgery Chapter 4 Section 24.7 Simultaneous Pancreas-Kidney (SPK), Pancreas-After-Kidney (PAK), And Pancreas-Transplant-Alone Issue Date: February 5, 1996 Authority: 32 CFR 199.4(e)(5) 1.0 CPT 1 PROCEDURE
Allogeneic Pancreas Transplant
Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc.(collectively referred to as the Company ), unless otherwise provided
Chapter 4 Section 24.7
Surgery Chapter 4 Section 24.7 Simultaneous Pancreas-Kidney (SPK), Pancreas-After-Kidney (PAK), And Pancreas-Transplant-Alone (PTA), And Pancreatic Islet Cell Transplantation Issue Date: February 5, 1996
Single Center Analysis of Mortality in 202 Consecutive Pancreas Transplants
Single Center Analysis of Mortality in 202 Consecutive Pancreas Transplants Robert J. Stratta, MD 1, Alan C. Farney, MD, PhD 1, Giuseppe Orlando, MD, PhD 1, Umar Farooq, MD 1, Yousef Al-Shraideh, MBBCh
Transplant Options for Patients: Choices and Consequences. Olwyn Johnston Medical Director Kidney Transplantation Vancouver General Hospital
Transplant Options for Patients: Choices and Consequences Olwyn Johnston Medical Director Kidney Transplantation Vancouver General Hospital BC Kidney Days October 6 th 2017 Non contributory Conflict of
Highly Sensitized Patient Registry: Update and Successes
Highly Sensitized Patient Registry: Update and Successes Dr. Olwyn Johnston Medical Director Kidney and Pancreas Transplant Program Vancouver General Hospital Conflict of Interest Transplant Nephrologist
Clinical impact of de-novo HLA antibodies in pancreas and islet transplantation
Clinical impact of de-novo HLA antibodies in pancreas and islet transplantation David Turner, PhD, FRCPath Lead for H&I Services, Scottish National Blood Transfusion Service Treatment of Type I DM Insulin
Current strategies to kidney allocation
Current strategies to kidney allocation Dr Marie Alice Macher Dr Christian Jacquelinet Emilie Savoye Dr Corinne Antoine Direction Prélèvement Greffe organes - tissus From organ sharing to organ allocation
Allogeneic Pancreas Transplant
Allogeneic Pancreas Transplant Policy Number: Original Effective Date: MM.07.002 03/23/2001 Line(s) of Business: Current Effective Date: HMO; PPO 09/01/2013 Section: Transplants Place(s) of Service: Inpatient
Islet Transplantation
Islet Transplantation Policy Number: Original Effective Date: MM.07.027 07/01/2014 Line(s) of Business: Current Effective Date: HMO; PPO 3/24/2017 Section: Transplants Place(s) of Service: Inpatient I.
LIVE KIDNEY DONOR RISK PREDICTION ; NEW PARADIGM, NEW CALCULATORS PEDRAM AHMADPOOR MD
LIVE KIDNEY DONOR RISK PREDICTION ; NEW PARADIGM, NEW CALCULATORS PEDRAM AHMADPOOR MD Outline: PART 1 : Update on safety of nephrectomy for living donor candidate PART 2 : Latest guideline recommendation
Pediatric Kidney Transplantation
Pediatric Kidney Transplantation Vikas Dharnidharka, MD, MPH Associate Professor Division of Pediatric Nephrology Conflict of Interest Disclosure Vikas Dharnidharka, MD, MPH Employer: University of Florida
Surgical Aspects of Kidney and Pancreas Transplant. Hannah Choate, MD
Surgical Aspects of Kidney and Pancreas Transplant Hannah Choate, MD I have no financial disclosures or conflicts of interest Kidney transplantation Indications ESRD or advancing CKD with GFR less than
Pancreas Transplantation From Living Donors: A Single Center Experience of 20 Cases
American Journal of Transplantation 2016; 16: 2413 2420 Wiley Periodicals Inc. Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons doi: 10.1111/ajt.13738
Chronic Kidney Disease (CKD) Stages. CHRONIC KIDNEY DISEASE Treatment Options. Incident counts & adjusted rates, by primary diagnosis Figure 2.
Chronic Kidney Disease (CKD) Stages Stage 1 GFR > 90 (evidence of renal disease) Stage 2 GFR 60-89 Stage 3 GFR 30-59 Stage 4 GFR 15-29 Stage 5 GFR
Access and Outcomes Among Minority Transplant Patients, , with a Focus on Determinants of Kidney Graft Survival
American Journal of Transplantation 2010; 10 (Part 2): 1090 1107 Wiley Periodicals Inc. Special Feature No claim to original US government works Journal compilation C 2010 The American Society of Transplantation
Long-Term Post Transplantation Care. Pathogenesis and Management of Long Term Cardiovascular and Metabolic Complications in Renal Transplantation
3 rd ERA-EDTA CME COURSE Long-Term Post Transplantation Care Pathogenesis and Management of Long Term Cardiovascular and Metabolic Complications in Renal Transplantation What the Non Transplant-Nephrologists
Allogeneic Pancreas Transplant
Allogeneic Pancreas Transplant Policy Number: 7.03.02 Last Review: 8/2018 Origination: 8/2001 Next Review: 8/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage for allogeneic
Objectives. Kidney Complications With Diabetes. Case 10/21/2015
Objectives Kidney Complications With Diabetes Brian Boerner, MD Diabetes, Endocrinology, and Metabolism University of Nebraska Medical Center Review screening for, and management of, albuminuria Review
POLICY GUIDELINES GENERAL CRITERIA
Medical Policy MP 7.03.02 BCBSA Ref. Policy: 7.03.02 Last Review: 08/30/2017 Effective Date: 08/30/2017 Section: Surgery End Date: 08/19/2018 Related Policies 1.01.30 Artificial Pancreas Device Systems
Quinze ans de greffe de tissus composites: quels enseignements? Fifteen years of composite grafts: what lessons?
Quinze ans de greffe de tissus composites: quels enseignements? Fifteen years of composite grafts: what lessons? Emmanuel Morelon Service de Transplantation, Néphrologie et Immunologie Clinique INSERM
Angelika C. Gruessner and Rainer W.G. Gruessner
Reprint from The Review of DIABETIC STUDIES Vol 13 1 2016 The Review of DIABETIC STUDIES ORIGINAL DATA Pancreas Transplantation of US and nus Cases from 2005 to 2014 as Reported to the United Network for
Name of Policy: Islet Transplantation
Name of Policy: Islet Transplantation Policy #: 300 Latest Review Date: June 2014 Category: Surgery Policy Grade: B Background/Definitions: As a general rule, benefits are payable under Blue Cross and
Diabetic nephropathy and -cell replacement therapy
REVIEW Diabetic nephropathy and -cell replacement therapy J.W. de Fijter Department of Nephrology (C3-P22), Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, the Netherlands, tel.: +31 (0)71-526
EVATEL Study. Remote follow-up of patients implanted with an ICD The prospective randomized EVATEL study
EVATEL Study Remote follow-up of patients implanted with an ICD The prospective randomized EVATEL study Philippe Mabo, Pascal Defaye, Nicolas Sadoul, Jean Marc Davy, Jean-Claude Deharo, Salem Kacet, Eric
General Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons
General Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons MODULE TITLE: TRANSPLANTATION 7-Nov-2016 DEVELOPED BY: Daryl
Current Updates & Challenges In Managing Diabetes in CVD
Current Updates & Challenges In Managing Diabetes in CVD Preventive Cardiovascular Conference 2016 Instituit Jantung Negara 12 th November 2016 Nor Azmi Kamaruddin Diabetes Clinic Department of Medicine
ANNEX FORM TO EXAMINE THE CAUSES OF ESRD I IDENTIFICATION. 1 Record number (patient chart) Name. 1.1 Date of birth / / 1.2 Sex:
Supplementary Material from Prevalence of clinically validated primary causes of end-stage renal disease (ESRD) in a State Capital in Northeastern Brazil ANNEX FORM TO EXAMINE THE CAUSES OF ESRD I IDENTIFICATION
The Role of Kidney-Pancreas Transplantation in Diabetic Kidney Disease
Curr Diab Rep (2010) 10:385 391 DOI 10.1007/s11892-010-0136-0 The Role of Kidney-Pancreas Transplantation in Diabetic Kidney Disease Alexander C. Wiseman Published online: 27 July 2010 # The Author(s)
New-onset diabetes after transplantation. Christophe Legendre Université Paris Descartes & Hôpital Necker, Paris.
New-onset diabetes after transplantation Christophe Legendre Université Paris Descartes & Hôpital Necker, Paris. Actualités Jean Hamburger Paris, 23-24 avril 2012 NODAT IFG IGT CJ Yates et al, Am J Transplant
Hépatite E & transplantation d organes Pr Nassim KAMAR
Hépatite E & transplantation d organes Pr Nassim KAMAR Service de Néphrologie, Dialyse et Transplantation d Organes CHU Rangueil- Toulouse Genotype 3 HEV infection is an emerging disease in developing
Living Donor Paired Exchange (LDPE)
Living Donor Paired Exchange (LDPE) Why do we need Living Donation? 3,796 patients waiting for an organ transplant 2,679 (71%) waiting for a kidney transplant 249 people died while waiting for an organ
Australia & New Zealand Pancreas. Transplant Registry Report Inquiries or comments should be directed to the secretariat at:
Australia & New Zealand Pancreas Transplant Registry Report 1984-2013 This report is a compilation of data provided by the four current Pancreas transplant units in Australia and New Zealand: Auckland
Summary of Significant Changes. Policy
This Policy replaces POL185/3 Copy Number Effective 02/08/2016 Summary of Significant Changes Inclusion of Simultaneous Islet and Kidney transplants Policy This policy has been created by the Pancreas
United States Renal Data System (USRDS) International Data Collection Form
United States Renal Data System (USRDS) International Data Collection Form This form is designed to solicit information on the population of End-Stage Renal Disease (ESRD) patients in your country who
Overview. Evaluation of Potential Kidney Transplant Recipients. Projected Years of Life in Patients with ESRD
Evaluation of Potential Kidney Transplant Recipients Donald E. Hricik MD Professor of Medicine and Chief, Division of Nephrology and Hypertension University Hospitals Case Medical Center Conflict of Interest
U.S. changes in Kidney Allocation
U.S. changes in Kidney Allocation Match kidneys with longest survival to patients with longest survival No parallel matching for kidneys with lower survival potential Decrease discard of kidneys with lower
Who Should Be Considered for Islet Transplantation Alone?
Curr Diab Rep (2017) 17: 23 DOI 10.1007/s11892-017-0847-6 IMMUNOLOGY, TRANSPLANTATION, AND REGENERATIVE MEDICINE (L PIEMONTI AND V SORDI, SECTION EDITORS) Who Should Be Considered for Islet Transplantation
The New Kidney Allocation System: What You Need to Know. Quality Insights Renal Network 3 Annual Meeting October 2, 2014
The New Kidney Allocation System: What You Need to Know Quality Insights Renal Network 3 Annual Meeting October 2, 2014 Pre Dialysis Era Dialysis Status in USA 500,000 patients on dialysis in 2013 100,000
H. Le Dinh, A. DeRoover, C. Coimbra, L. Weekers, J. Léonet, M. Meurisse, and J.P. Squifflet
Evolution of Native Kidney Function After Pancreas Transplantation Alone H. Le Dinh, A. DeRoover, C. Coimbra, L. Weekers, J. Léonet, M. Meurisse, and J.P. Squifflet ABSTRACT Introduction. This study investigated
Why is Earlier and More Aggressive Treatment of T2 Diabetes Better?
Blood glucose (mmol/l) Why is Earlier and More Aggressive Treatment of T2 Diabetes Better? Disclosures Dr Kennedy has provided CME, been on advisory boards or received travel or conference support from:
Jadranka Buturović-Ponikvar Department of Nephrology, University Medical Center, Ljubljana, Slovenia
Jadranka Buturović-Ponikvar Department of Nephrology, University Medical Center, Ljubljana, Slovenia Hemodialysis or kidney transplantation what is better? Jadranka Buturović-Ponikvar Department of Nephrology,
Home Hemodialysis or Transplantation of the Treatment of Choice for Elderly?
Home Hemodialysis or Transplantation of the Treatment of Choice for Elderly? Miklos Z Molnar, MD, PhD, FEBTM, FERA, FASN Associate Professor of Medicine Division of Nephrology, Department of Medicine University
Future Therapies in the Treatment of Diabetes: Islet Transplantation
Future Therapies in the Treatment of Diabetes: Islet Transplantation Michael R. Rickels, MD, MS Associate Professor of Medicine University of Pennsylvania Perelman School of Medicine Medical Director,
J Am Soc Nephrol 14: , 2003
J Am Soc Nephrol 14: 208 213, 2003 Kidney Allograft and Patient Survival in Type I Diabetic Recipients of Cadaveric Kidney Alone Versus Simultaneous Pancreas/Kidney Transplants: A Multivariate Analysis
Microvascular Disease in Type 1 Diabetes
Microvascular Disease in Type 1 Diabetes Jay S. Skyler, MD, MACP Division of Endocrinology, Diabetes, and Metabolism and Diabetes Research Institute University of Miami Miller School of Medicine The Course
Introduction and Overview of the Current Landscape on Organ Donation and Transplantation in Canada Jag Gill, MD
2017 CST-Astellas Canadian Transplant Fellows Symposium Introduction and Overview of the Current Landscape on Organ Donation and Transplantation in Canada Jag Gill, MD Dr. Gill graduated from Medicine
Faiez Zannad, MD, PhD, Nancy
1 Biotargets, drug discovery and therapeutic innovation. How French clinical networks can accelerate the discovery of new treatments in the field of cardiovascular and metabolic diseases? Faiez Zannad,
Pancreas and Kidney Transplantation in Patients with Type 1 Diabetes and End-Stage Renal Disease: Long-Term Outcomes
Pancreas and Kidney Transplantation in Patients with Type 1 Diabetes and End-Stage Renal Disease: Long-Term Outcomes PhD Thesis Jørn Petter Hanto Lindahl 2016 Oslo University Hospital, Rikshospitalet Department
Islet Cell Allo-Transplantation. Disclosure. Objectives
Islet Cell Allo-Transplantation Gregory P. Forlenza, MD MCR Assistant Professor Barbara Davis Center University of Colorado Denver Special thanks to Melena Bellin, MD at The University of Minnesota who
Manchester Royal Infirmary Renal & Pancreas Transplant Unit / 2012 Activity Annual Report
Manchester Royal Infirmary Renal & Pancreas Transplant Unit 211 / 212 Activity Annual Report Vicki Bowman Renal Transplant Audit & Data Manager Dr Susan Martin Consultant Clinical Scientist / Transplantation
Pancreas/kidney transplant outcome functioning renal transplants (4). A small number of centers in the United States have also embarked upon living re
Hong Kong Journal Nephrol of 1999;1(1):11-17. Nephrology 1999;1(1):11-17. R E V I E W A T R I C L E Simultaneous pancreas and kidney transplantation: a review of outcome from a single center Jeremy R CHAPMAN,
Diabetes mellitus is a complex of syndromes characterized metabolically by hyperglycemia and altered glucose metabolism, and associated
Diabetes mellitus is a complex of syndromes characterized metabolically by hyperglycemia and altered glucose metabolism, and associated pathologically with specific microvascular and macrovascular complications.
SURGERY, TRANSPLANTATION AND POLYCYSTIC DISEASE. Mr Nick Inston PhD FRCS Consultant Transplant Surgeon Queen Elizabeth Hospital Birmingham
SURGERY, TRANSPLANTATION AND POLYCYSTIC DISEASE Mr Nick Inston PhD FRCS Consultant Transplant Surgeon Queen Elizabeth Hospital Birmingham What are polycystic kidneys and livers?! Cystic degenerative condition!
ICD-10-AM/ACHI/ACS Eighth Edition. HIMAA/NCCH Conference Renal workshop October 2014
ICD-10-AM/ACHI/ACS Eighth Edition HIMAA/NCCH Conference Renal workshop October 2014 Record 1 N18.5 Chronic kidney disease, stage 5 E11.22 Type 2 diabetes mellitus with established diabetic nephropathy
New Zealand Kidney Allocation Scheme
New Zealand Kidney Allocation Scheme The New Zealand Kidney Allocation Scheme (NZKAS) has been developed to ensure that kidney allocation in NZ is performed on an equitable, accountable and transparent
Geographic Optimization of Liver Allocation in Transplantation
1 1 Geographic Optimization of Liver Allocation in Transplantation Esri Health GIS Conference Florian Bayer, Dr. Christian Jacquelinet, Benoit Audry, Dr. Corinne Antoine 2 2 a - Introduction Study Objectives
Literature Review Transplantation
Literature Review 2010- Transplantation Alexander Wiseman, M.D. Associate Professor, Division of Renal Diseases and Hypertension Medical Director, Kidney and Pancreas Transplant Programs University of
IMPORTANT REMINDER DESCRIPTION. Transplantation of a normal pancreas is a treatment method for patients with diabetes. MEDICAL POLICY CRITERIA
Medical Policy Manual Transplant, Policy No. 06 Pancreas Transplant Next Review: August 2018 Last Review: August 2017 Effective: October 1, 2017 IMPORTANT REMINDER Medical Policies are developed to provide
Pancreas Transplantation
REVIEW ARTICLE Pancreas Transplantation Yi-Ming Shyr* Divisions of General and Transplantation Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University, Taipei,