Simultaneous liver–pancreas transplantation for cystic fibrosis-related liver disease: A multicenter experience
Diabetes is associated with increased morbidity and mortality in patients with cystic fibrosis (CF). While liver transplantation is well established for CF-related liver disease (CFLD), the role of simultaneous liver–pancreas transplantation is less understood. We polled 81 pediatric transplantation...
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| Published in | Journal of cystic fibrosis Vol. 13; no. 4; pp. 471 - 477 |
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| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Netherlands
Elsevier B.V
01.07.2014
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1569-1993 1873-5010 1873-5010 |
| DOI | 10.1016/j.jcf.2013.12.010 |
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| Abstract | Diabetes is associated with increased morbidity and mortality in patients with cystic fibrosis (CF). While liver transplantation is well established for CF-related liver disease (CFLD), the role of simultaneous liver–pancreas transplantation is less understood.
We polled 81 pediatric transplantation centers to identify and characterize subjects who had undergone simultaneous liver–pancreas transplantation and obtain opinions about this procedure in CFLD.
Fifty (61.7%) polled transplant centers responded and 94% reported that they would consider simultaneous liver–pancreas transplantation for CFLD and diabetes. A total of 8 patients with simultaneous liver–pancreas transplantation were identified with median follow up of 38months. All patients had pre-existing diabetes. Exocrine and endocrine pancreatic function was initially restored in all patients with later functional loss in one patient. Body mass index Z-score increased between one year pre-transplantation and one year post-transplantation (P=0.029).
Patients with CFLD undergoing initial assessment for liver transplantation may benefit from consideration of simultaneous liver–pancreas transplantation. |
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| AbstractList | Diabetes is associated with increased morbidity and mortality in patients with cystic fibrosis (CF). While liver transplantation is well established for CF-related liver disease (CFLD), the role of simultaneous liver-pancreas transplantation is less understood.
We polled 81 pediatric transplantation centers to identify and characterize subjects who had undergone simultaneous liver-pancreas transplantation and obtain opinions about this procedure in CFLD.
Fifty (61.7%) polled transplant centers responded and 94% reported that they would consider simultaneous liver-pancreas transplantation for CFLD and diabetes. A total of 8 patients with simultaneous liver-pancreas transplantation were identified with median follow up of 38 months. All patients had pre-existing diabetes. Exocrine and endocrine pancreatic function was initially restored in all patients with later functional loss in one patient. Body mass index Z-score increased between one year pre-transplantation and one year post-transplantation (P=0.029).
Patients with CFLD undergoing initial assessment for liver transplantation may benefit from consideration of simultaneous liver-pancreas transplantation. Diabetes is associated with increased morbidity and mortality in patients with cystic fibrosis (CF). While liver transplantation is well established for CF-related liver disease (CFLD), the role of simultaneous liver-pancreas transplantation is less understood.BACKGROUNDDiabetes is associated with increased morbidity and mortality in patients with cystic fibrosis (CF). While liver transplantation is well established for CF-related liver disease (CFLD), the role of simultaneous liver-pancreas transplantation is less understood.We polled 81 pediatric transplantation centers to identify and characterize subjects who had undergone simultaneous liver-pancreas transplantation and obtain opinions about this procedure in CFLD.METHODSWe polled 81 pediatric transplantation centers to identify and characterize subjects who had undergone simultaneous liver-pancreas transplantation and obtain opinions about this procedure in CFLD.Fifty (61.7%) polled transplant centers responded and 94% reported that they would consider simultaneous liver-pancreas transplantation for CFLD and diabetes. A total of 8 patients with simultaneous liver-pancreas transplantation were identified with median follow up of 38 months. All patients had pre-existing diabetes. Exocrine and endocrine pancreatic function was initially restored in all patients with later functional loss in one patient. Body mass index Z-score increased between one year pre-transplantation and one year post-transplantation (P=0.029).RESULTSFifty (61.7%) polled transplant centers responded and 94% reported that they would consider simultaneous liver-pancreas transplantation for CFLD and diabetes. A total of 8 patients with simultaneous liver-pancreas transplantation were identified with median follow up of 38 months. All patients had pre-existing diabetes. Exocrine and endocrine pancreatic function was initially restored in all patients with later functional loss in one patient. Body mass index Z-score increased between one year pre-transplantation and one year post-transplantation (P=0.029).Patients with CFLD undergoing initial assessment for liver transplantation may benefit from consideration of simultaneous liver-pancreas transplantation.CONCLUSIONSPatients with CFLD undergoing initial assessment for liver transplantation may benefit from consideration of simultaneous liver-pancreas transplantation. Diabetes is associated with increased morbidity and mortality in patients with cystic fibrosis (CF). While liver transplantation is well established for CF-related liver disease (CFLD), the role of simultaneous liver–pancreas transplantation is less understood. We polled 81 pediatric transplantation centers to identify and characterize subjects who had undergone simultaneous liver–pancreas transplantation and obtain opinions about this procedure in CFLD. Fifty (61.7%) polled transplant centers responded and 94% reported that they would consider simultaneous liver–pancreas transplantation for CFLD and diabetes. A total of 8 patients with simultaneous liver–pancreas transplantation were identified with median follow up of 38months. All patients had pre-existing diabetes. Exocrine and endocrine pancreatic function was initially restored in all patients with later functional loss in one patient. Body mass index Z-score increased between one year pre-transplantation and one year post-transplantation (P=0.029). Patients with CFLD undergoing initial assessment for liver transplantation may benefit from consideration of simultaneous liver–pancreas transplantation. AbstractBackgroundDiabetes is associated with increased morbidity and mortality in patients with cystic fibrosis (CF). While liver transplantation is well established for CF-related liver disease (CFLD), the role of simultaneous liver–pancreas transplantation is less understood. MethodsWe polled 81 pediatric transplantation centers to identify and characterize subjects who had undergone simultaneous liver–pancreas transplantation and obtain opinions about this procedure in CFLD. ResultsFifty (61.7%) polled transplant centers responded and 94% reported that they would consider simultaneous liver–pancreas transplantation for CFLD and diabetes. A total of 8 patients with simultaneous liver–pancreas transplantation were identified with median follow up of 38 months. All patients had pre-existing diabetes. Exocrine and endocrine pancreatic function was initially restored in all patients with later functional loss in one patient. Body mass index Z-score increased between one year pre-transplantation and one year post-transplantation (P = 0.029). ConclusionsPatients with CFLD undergoing initial assessment for liver transplantation may benefit from consideration of simultaneous liver–pancreas transplantation. |
| Author | Bandsma, R.H.J. Durie, P. Bozic, M.A. Hodik, M. Fridell, J.A. Fecteau, A. Gonzalez-Peralta, R.P. Crull, M.H. Molleston, J. Mozer-Glassberg, Y. Ng, V.L. de Angelis, M. Avitzur, Y. |
| Author_xml | – sequence: 1 givenname: R.H.J. surname: Bandsma fullname: Bandsma, R.H.J. organization: Division of Pediatric Gastroenterology, Hepatology and Nutrition, SickKids Transplant Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada – sequence: 2 givenname: M.A. surname: Bozic fullname: Bozic, M.A. organization: Pediatric Gastroenterology/Hepatology/Nutrition, Indiana University School of Medicine, Riley Hospital for Children, 705 Riley Hospital Drive, Indianapolis, IN 46202, USA – sequence: 3 givenname: J.A. surname: Fridell fullname: Fridell, J.A. organization: Department of Surgery, University of Indiana, School of Medicine, 550N University Blvd., Indianapolis, IN 46202, USA – sequence: 4 givenname: M.H. surname: Crull fullname: Crull, M.H. organization: Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands – sequence: 5 givenname: J. surname: Molleston fullname: Molleston, J. organization: Pediatric Gastroenterology/Hepatology/Nutrition, Indiana University School of Medicine, Riley Hospital for Children, 705 Riley Hospital Drive, Indianapolis, IN 46202, USA – sequence: 6 givenname: Y. surname: Avitzur fullname: Avitzur, Y. organization: Division of Pediatric Gastroenterology, Hepatology and Nutrition, SickKids Transplant Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada – sequence: 7 givenname: Y. surname: Mozer-Glassberg fullname: Mozer-Glassberg, Y. organization: Institute of Gastroenterology, Nutrition, and Liver Disease, Schneider Children's Medical Center of Israel, 14 Kaplan Street, Petach Tikvah 49202, Israel – sequence: 8 givenname: R.P. surname: Gonzalez-Peralta fullname: Gonzalez-Peralta, R.P. organization: Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Florida College of Medicine, UF Health-Shands Children's Hospital, 1600 SW Archer Road, Gainesville, FL 32608, USA – sequence: 9 givenname: M. surname: Hodik fullname: Hodik, M. organization: Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Florida College of Medicine, UF Health-Shands Children's Hospital, 1600 SW Archer Road, Gainesville, FL 32608, USA – sequence: 10 givenname: A. surname: Fecteau fullname: Fecteau, A. organization: Division of Surgery, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada – sequence: 11 givenname: M. surname: de Angelis fullname: de Angelis, M. organization: Division of Pediatric Gastroenterology, Hepatology and Nutrition, SickKids Transplant Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada – sequence: 12 givenname: P. surname: Durie fullname: Durie, P. organization: Division of Pediatric Gastroenterology, Hepatology and Nutrition, SickKids Transplant Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada – sequence: 13 givenname: V.L. surname: Ng fullname: Ng, V.L. email: vicky.ng@sickkids.ca organization: Division of Pediatric Gastroenterology, Hepatology and Nutrition, SickKids Transplant Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada |
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| Copyright | 2014 European Cystic Fibrosis Society. European Cystic Fibrosis Society. Copyright © 2014 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved. |
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| SubjectTerms | Adolescent Child Clinical Cohort Cystic fibrosis Cystic Fibrosis - complications Cystic Fibrosis - surgery Diabetes Female Follow-Up Studies Humans Liver Diseases - etiology Liver Diseases - surgery Liver Transplantation - methods Male Pancreas Transplantation - methods Pulmonary/Respiratory Retrospective Simultaneous liver pancreas transplantation Treatment Outcome Young Adult |
| Title | Simultaneous liver–pancreas transplantation for cystic fibrosis-related liver disease: A multicenter experience |
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