Background: Pancreas transplantation is the only curative treatment option for patients with juvenile diabetes. Organ shortage and restrictive allocation criteria are the main reasons for increasing waitlists, leading to severe morbidity and mortality. We designed a study to increase the donor pool with extended donor criteria (EDC) organs (donor age, 50-60 years; body mass index, 30-34 kg/m).
Methods: Utilization of EDC organs required the implementation of a new allocation system within Eurotransplant. The study was a prospective, multicenter, 2-armed trial. The primary endpoint was pancreas function after 3 months. Rejection episodes, kidney function, and waitlist time were secondary endpoints. Patients receiving an EDC organ were study group patients; recipients of standard organs were control group patients. Follow-up was 1 year.
Results: Seventy-nine patients were included in 12 German centers, 18 received EDC organs and 61 received standard organs. Recipient demographics were similar. Mean EDC donor age was 51.4 ± 5 years versus 31.7 ± 12 in the control group. Insulin-free graft survival was 83.3% for EDC and 67.2% for standard organs (P = 0.245) after 3 months. One-year pancreas survival was 83.3% and 83.5% in the EDC versus standard group. One-year kidney allograft survival was approximately 94% in both groups. Rejection episodes and morbidity were similar.
Conclusions: The Extended Pancreas Donor Program (EXPAND) shows in a prospective trial that selected EDC organs of donors older than 50 years can be used with outcomes similar to standard-criteria organs, therefore showing potential to reduce organ shortage and waiting times. This study substantiates the full implementation of EDC organs in a pancreas allocation system.
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http://dx.doi.org/10.1097/TP.0000000000002122 | DOI Listing |
ACS Appl Mater Interfaces
January 2025
University Clinic of Navarra Centre for Applied Medical Research, 31008 Pamplona, Spain.
Experimental reproducibility in organ-on-chip (OOC) devices is a challenging issue, mainly caused by cell adhesion problems, as OOC devices are made of bioinert materials not suitable for natural cellularization of their surfaces. To improve cell adhesion, several surface functionalization techniques have been proposed, among which the simple use of an intermediate layer of adsorbed proteins has become the preferred one by OOC users. This way, the cells use surface receptors to adhere to the adsorbed proteins, which are in turn attached to the surface.
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Department of Ocean Integrated Science, Chonnam National University, Yeosu 59626, Republic of Korea.
Endocrine-disrupting chemicals (EDCs) significantly damage biological systems related to reproductive, neurological, and metabolic functions. Approximately 1000 chemicals are known to possess endocrine-acting properties, including bisphenol A (BPA) and di(2-ethylhexyl) phthalate (DEHP). This study primarily focuses on the potential effects of EDCs on the transcriptional levels of innate immune prophenoloxidase (proPO) system-related genes under oxidative stress in the gonads and stomach of the mud crab , an indicator species for assessing coastal benthic environments, when exposed to 1 µg L, 10 µg L, and 30 µg L BPA or DEHP.
View Article and Find Full Text PDFSe Pu
January 2025
State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China.
17-Estradiol (E2) is a natural steroidal estrogen essential for a variety of physiological functions in organisms. However, external E2, which is renowned for its potent biological effects, is also considered to be an endocrine-disrupting compound (EDC) capable of disturbing the normal operation of the endocrine system, even at nanogram-per-liter (ng/L) concentrations. Studies have revealed that medical and livestock wastewater can be contaminated with E2, which poses potential risks to human health.
View Article and Find Full Text PDFEnviron Pollut
December 2024
Department of Food Science and Biotechnology, Gachon University, Seongnam, Gyeonggi-do, 13120, Republic of Korea. Electronic address:
Endocrine-disrupting compounds (EDCs), such as butylparaben (BP), which are used as preservatives in food and cosmetics, have been shown to negatively affect male reproductive health. Organs under the control of hormones such as androgens and estrogens, such as the prostate, are vulnerable to EDC stimulation. It is well known that BP can cause hormonal imbalances in the prostate and lead to various prostate diseases.
View Article and Find Full Text PDFReproduction
December 2024
V Padmanabhan, Pediatrics, University of Michigan, Ann Arbor, 48109-5718, United States.
Environmental exposures to endocrine disrupting chemicals (EDCs), air pollution, biosolids, fracking materials, some pharmaceutical agents, and heat stress adversely affect reproductive health and exert long-ranging effects on maternal, paternal, and child health (Gore et al. 2015; Brehm & Flaws 2019; Gonsioroski et al. 2020; Peretz et al.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!