R H J Bandsma1, M A Bozic2, J A Fridell3, M H Crull4, J Molleston2, Y Avitzur1, Y Mozer-Glassberg5, R P Gonzalez-Peralta6, M Hodik6, A Fecteau7, M de Angelis1, P Durie8, V L Ng9. 1. 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. 2. Pediatric Gastroenterology/Hepatology/Nutrition, Indiana University School of Medicine, Riley Hospital for Children, 705 Riley Hospital Drive, Indianapolis, IN 46202, USA. 3. Department of Surgery, University of Indiana, School of Medicine, 550N University Blvd., Indianapolis, IN 46202, USA. 4. Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. 5. Institute of Gastroenterology, Nutrition, and Liver Disease, Schneider Children's Medical Center of Israel, 14 Kaplan Street, Petach Tikvah 49202, Israel. 6. 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. 7. Division of Surgery, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada. 8. 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; Physiology and Experimental Medicine, Research Institute, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G1X8, Canada. 9. 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. Electronic address: vicky.ng@sickkids.ca.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: Patients with CFLD undergoing initial assessment for liver transplantation may benefit from consideration of simultaneous liver-pancreas transplantation.
BACKGROUND: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. METHODS: 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. RESULTS: 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). CONCLUSIONS:Patients with CFLD undergoing initial assessment for liver transplantation may benefit from consideration of simultaneous liver-pancreas transplantation.
Authors: Sylvester M Black; Frederick W Woodley; Dmitry Tumin; Khalid Mumtaz; Bryan A Whitson; Joseph D Tobias; Don Hayes Journal: Dig Dis Sci Date: 2015-11-24 Impact factor: 3.199