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Article ; Online: Successful Pregnancy in a Kidney-Pancreas Transplanted Patient on LifeCycle Pharma Tacrolimus (LCPT)-Based Immunosuppression.

Bösmüller, Claudia / Demmelbauer, Nikolaus / Antlanger, Marlies / Oppelt, Peter / Rudnicki, Michael / Krendl, Felix Julius / Messner, Franka / Öfner, Dietmar / Schneeberger, Stefan / Margreiter, Christian

The American journal of case reports

2022 Volume 23, Page(s) e937386

Abstract: BACKGROUND There has been, to our knowledge, no reports on LifeCycle Pharma tacrolimus (LCPT) taken during pregnancy after simultaneous pancreas-kidney transplantation (SPK). Here, we report a 25-year-old female SPK recipient who gave birth to a healthy ... ...

Abstract	BACKGROUND There has been, to our knowledge, no reports on LifeCycle Pharma tacrolimus (LCPT) taken during pregnancy after simultaneous pancreas-kidney transplantation (SPK). Here, we report a 25-year-old female SPK recipient who gave birth to a healthy infant in posttransplant month 32. We analyzed the long-term graft function, obstetric/neonatal course, LCPT dosage, tacrolimus (TAC) levels, concomitant medication, and complications. CASE REPORT Her medical history consisted of type 1 diabetes with chronic nephropathy, arterial hypertension, and atypical haemolytic uremic syndrome with critical deterioration of her general condition requiring clinically indicated early termination of her first pregnancy prior to SPK. SPK was performed according to surgical standards. The immunosuppressive prophylaxis consisted of thymoglobulin, mycophenolate mofetil, standard TAC formulation, and steroids. Due to rapid TAC metabolism, the patient was converted from a standard TAC formulation to LCPT in the first month posttransplant. Her long-term immunosuppression, including the obstetric and peripartal course, consisted of LCPT, prednisolone, and azathioprine. She was normotensive without antihypertensive medication and maintained excellent function of both grafts during the observation period of 48 months posttransplant. All (mostly infectious) complications were reversible, especially temporary polyoma viremia within normal renal function, and 2 episodes of urosepsis. No relapse of her pretransplant episode of atypical haemolytic uremic syndrome occurred posttransplant. Her child is in good health at the age of 12 months without any malformations. CONCLUSIONS This case suggests that pregnancy after SPK under LCPT is feasible. Further studies are needed to expand the empirical knowledge surrounding tacrolimus.
MeSH term(s)	Adult ; Female ; Humans ; Infant ; Infant, Newborn ; Pregnancy ; Graft Survival ; Immunosuppression Therapy ; Kidney/physiology ; Kidney Transplantation ; Pancreas ; Pancreas Transplantation ; Tacrolimus/therapeutic use
Chemical Substances	Tacrolimus (WM0HAQ4WNM)
Language	English
Publishing date	2022-11-26
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2517183-5
ISSN	1941-5923 ; 1941-5923
ISSN (online)	1941-5923
ISSN	1941-5923
DOI	10.12659/AJCR.937386
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Transplanting Marginal Organs in the Era of Modern Machine Perfusion and Advanced Organ Monitoring.

Resch, Thomas / Cardini, Benno / Oberhuber, Rupert / Weissenbacher, Annemarie / Dumfarth, Julia / Krapf, Christoph / Boesmueller, Claudia / Oefner, Dietmar / Grimm, Michael / Schneeberger, Sefan

Frontiers in immunology

2020 Volume 11, Page(s) 631

Abstract: Organ transplantation is undergoing profound changes. Contraindications for donation have been revised in order to better meet the organ demand. The use of lower-quality organs and organs with greater preoperative damage, including those from donation ... ...

Abstract	Organ transplantation is undergoing profound changes. Contraindications for donation have been revised in order to better meet the organ demand. The use of lower-quality organs and organs with greater preoperative damage, including those from donation after cardiac death (DCD), has become an established routine but increases the risk of graft malfunction. This risk is further aggravated by ischemia and reperfusion injury (IRI) in the process of transplantation. These circumstances demand a preservation technology that ameliorates IRI and allows for assessment of viability and function prior to transplantation. Oxygenated hypothermic and normothermic machine perfusion (MP) have emerged as valid novel modalities for advanced organ preservation and conditioning.
MeSH term(s)	Anti-Inflammatory Agents ; Humans ; Immunomodulation ; Organ Preservation/methods ; Organ Transplantation/methods ; Perfusion/methods ; Reperfusion Injury/prevention & control ; Stem Cells/immunology ; Tissue Donors ; Transduction, Genetic/methods ; Transplants/immunology
Chemical Substances	Anti-Inflammatory Agents
Language	English
Publishing date	2020-05-12
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2020.00631
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Article: Arterial Hypertension as a Risk Factor for Reduced Glomerular Filtration Rate after Living Kidney Donation.

Kerschbaum, Julia / Bitter, Stefanie / Weitlaner, Maria / Kienzl-Wagner, Katrin / Neuwirt, Hannes / Bösmüller, Claudia / Mayer, Gert / Schneeberger, Stefan / Rudnicki, Michael

Journal of clinical medicine

2020 Volume 9, Issue 2

Abstract: Living kidney donation represents the optimal renal replacement therapy, but recent data suggest an increased long-term renal risk for the donor. Here, we evaluated the risk for reduced estimated glomerular filtration rate (eGFR), death, and major ... ...

Abstract	Living kidney donation represents the optimal renal replacement therapy, but recent data suggest an increased long-term renal risk for the donor. Here, we evaluated the risk for reduced estimated glomerular filtration rate (eGFR), death, and major cardiovascular events such as nonfatal myocardial infarction or cerebrovascular event including TIA (transient ischemic attack) and stroke in 225 donors, who underwent pre-donation examinations and live donor nephrectomy between 1985 and 2014 at our center. The median follow-up time was 8.7 years (1.0-29.1). In multivariate analysis, age and arterial hypertension at baseline were significantly associated with a higher risk of adverse renal outcomes, such as (1) eGFR <60 mL/min/1.73 m
Language	English
Publishing date	2020-01-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm9020338
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Article ; Online: Successful management of six pregnancies resulting in live births after simultaneous pancreas kidney transplantation: a single-center experience.

Bösmüller, Claudia / Pratschke, Johann / Ollinger, Robert

Transplant international : official journal of the European Society for Organ Transplantation

2014 Volume 27, Issue 12, Page(s) e129–31

MeSH term(s)	Adult ; Cesarean Section ; Drug Substitution ; Female ; Graft Survival ; Humans ; Immunosuppressive Agents/adverse effects ; Immunosuppressive Agents/therapeutic use ; Infant, Newborn ; Kidney Transplantation ; Live Birth ; Middle Aged ; Pancreas Transplantation ; Postoperative Period ; Pregnancy ; Pregnancy Outcome
Chemical Substances	Immunosuppressive Agents
Language	English
Publishing date	2014-12
Publishing country	England
Document type	Letter
ZDB-ID	639435-8
ISSN	1432-2277 ; 0934-0874
ISSN (online)	1432-2277
ISSN	0934-0874
DOI	10.1111/tri.12402
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Article: Post-Transplant Malignancies following Pancreas Transplantation: Incidence and Implications on Long-Term Outcome from a Single-Center Perspective.

Krendl, Felix J / Messner, Franka / Bösmüller, Claudia / Scheidl, Stefan / Cardini, Benno / Resch, Thomas / Weissenbacher, Annemarie / Oberhuber, Rupert / Maglione, Manuel / Schneeberger, Stefan / Öfner, Dietmar / Margreiter, Christian

Journal of clinical medicine

2021 Volume 10, Issue 21

Abstract: Chronic immunosuppression is associated with an increased risk of malignancy. The main objective of this study is to evaluate the incidence and effect of post-transplant malignancies (PTMs) following pancreas transplantation. The 348 first pancreas ... ...

Abstract	Chronic immunosuppression is associated with an increased risk of malignancy. The main objective of this study is to evaluate the incidence and effect of post-transplant malignancies (PTMs) following pancreas transplantation. The 348 first pancreas transplants performed between 1985 and 2015 were retrospectively analyzed in this study. Incidences of PTMs, as well as patient and graft survival, were evaluated. Out of 348 patients, 71 (20.4%) developed a PTM. Median time to diagnosis was 130 months. Thirty-six patients (50.7%) developed skin cancers (four patients with melanoma, 32 with NMSCs). Solid organ malignancy occurred in 25 (35.2%), hematologic malignancy in ten patients (14.1%). Affected patients were transplanted earlier [2000 (IQR 1993-2004) vs. 2003 (IQR 1999-2008);
Language	English
Publishing date	2021-10-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10214810
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Article: Good Long-term Results Following Simultaneous Pancreas-kidney Transplantation in a 69-y-old Recipient: A Case Report.

Bösmüller, Claudia / Krendl, Felix / Messner, Franka / Berchtold, Valeria / Kienzl-Wagner, Katrin / Scheidl, Stefan / Oberhuber, Rupert / Öfner, Dietmar / Schneeberger, Stefan / Margreiter, Christian

Transplantation direct

2021 Volume 7, Issue 11, Page(s) e773

Language	English
Publishing date	2021-10-06
Publishing country	United States
Document type	Journal Article
ISSN	2373-8731
ISSN	2373-8731
DOI	10.1097/TXD.0000000000001204
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Article ; Online: Recipient age and outcome after pancreas transplantation: a retrospective dual-center analysis.

Messner, Franka / Leemkuil, Marjolein / Yu, Yifan / Massie, Allan B / Krendl, Felix J / Benjamens, Stan / Bösmüller, Claudia / Weissenbacher, Annemarie / Schneeberger, Stefan / Pol, Robert A / Margreiter, Christian

Transplant international : official journal of the European Society for Organ Transplantation

2021 Volume 34, Issue 4, Page(s) 657–668

Abstract: With a later onset of diabetes complications and thus increasing age of transplant candidates, many centers have extended upper age limits for pancreas transplantation. This study investigates the effect of recipient and donor age on outcomes after ... ...

Abstract	With a later onset of diabetes complications and thus increasing age of transplant candidates, many centers have extended upper age limits for pancreas transplantation. This study investigates the effect of recipient and donor age on outcomes after pancreas transplantation.We retrospectively analyzed 565 pancreas transplants performed at two Eurotransplant centers. The cohort was split at a recipient and donor age of 50 and 40 years, respectively. Median recipient age in old patients (≥50 years; 27.2%) was 54 years and 40 years in young patients (<50 years). Compared to young recipients, old recipients had an inferior patient survival rate (≥50: 5yr, 82.8%; 10yr, 65.6%; <50: 5yr, 93.3%; 10yr, 82.0%; P < 0.0001). Old recipients demonstrated comparable death-censored pancreas (≥50: 1yr, 80.6%; 5yr, 70.2%; <50: 1yr, 87.3%; 5yr, 77.8%; P = 0.35) and kidney graft survival (≥50: 1yr, 97.4%; 5yr, 90.6%; <50: 1yr, 97.8%; 5yr, 90.2%; P = 0.53) compared to young recipients. Besides a lower rate of kidney rejection, similar relative risks for postoperative complications were detected in old and young patients. This study shows that despite an increased mortality in old recipients, excellent graft survival can be achieved similar to that of young patients. Age alone should not exclude patients from receiving a pancreas transplant.
MeSH term(s)	Graft Rejection/epidemiology ; Graft Survival ; Humans ; Kidney Transplantation ; Middle Aged ; Pancreas Transplantation ; Retrospective Studies ; Tissue Donors ; Treatment Outcome
Language	English
Publishing date	2021-03-01
Publishing country	England
Document type	Journal Article
ZDB-ID	639435-8
ISSN	1432-2277 ; 0934-0874
ISSN (online)	1432-2277
ISSN	0934-0874
DOI	10.1111/tri.13845
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Article ; Online: Validation of systems biology derived molecular markers of renal donor organ status associated with long term allograft function.

Perco, Paul / Heinzel, Andreas / Leierer, Johannes / Schneeberger, Stefan / Bösmüller, Claudia / Oberhuber, Rupert / Wagner, Silvia / Engler, Franziska / Mayer, Gert

Scientific reports

2018 Volume 8, Issue 1, Page(s) 6974

Abstract: Donor organ quality affects long term outcome after renal transplantation. A variety of prognostic molecular markers is available, yet their validity often remains undetermined. A network-based molecular model reflecting donor kidney status based on ... ...

Abstract	Donor organ quality affects long term outcome after renal transplantation. A variety of prognostic molecular markers is available, yet their validity often remains undetermined. A network-based molecular model reflecting donor kidney status based on transcriptomics data and molecular features reported in scientific literature to be associated with chronic allograft nephropathy was created. Significantly enriched biological processes were identified and representative markers were selected. An independent kidney pre-implantation transcriptomics dataset of 76 organs was used to predict estimated glomerular filtration rate (eGFR) values twelve months after transplantation using available clinical data and marker expression values. The best-performing regression model solely based on the clinical parameters donor age, donor gender, and recipient gender explained 17% of variance in post-transplant eGFR values. The five molecular markers EGF, CD2BP2, RALBP1, SF3B1, and DDX19B representing key molecular processes of the constructed renal donor organ status molecular model in addition to the clinical parameters significantly improved model performance (p-value = 0.0007) explaining around 33% of the variability of eGFR values twelve months after transplantation. Collectively, molecular markers reflecting donor organ status significantly add to prediction of post-transplant renal function when added to the clinical parameters donor age and gender.
MeSH term(s)	Age Factors ; Biomarkers/analysis ; Female ; Glomerular Filtration Rate ; Graft Rejection/etiology ; Graft Survival ; Humans ; Kidney/physiology ; Kidney Transplantation ; Linear Models ; Male ; Models, Biological ; Risk Assessment ; Risk Factors ; Sex Factors ; Systems Biology/methods ; Tissue Donors ; Transcriptome
Chemical Substances	Biomarkers
Language	English
Publishing date	2018-05-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-018-25163-8
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Article ; Online: Late recurrent bleeding episodes from duodenojejunostomy after pancreas transplantation.

Messner, Franka / Bösmüller, Claudia / Oberhuber, Rupert / Maglione, Manuel / Cardini, Benno / Resch, Thomas / Scheidl, Stefan / Öfner, Dietmar / Schneeberger, Stefan / Margreiter, Christian

Clinical transplantation

2018 Volume 32, Issue 9, Page(s) e13350

Abstract: In response to a number of late, repetitive bleeding episodes from the site of the enteric anastomosis, we herein analyze the clinical courses and etiologies of 379 consecutively performed pancreas transplants between January 2000 and December 2016. ... ...

Abstract	In response to a number of late, repetitive bleeding episodes from the site of the enteric anastomosis, we herein analyze the clinical courses and etiologies of 379 consecutively performed pancreas transplants between January 2000 and December 2016. Duodenojejunostomies for enteric drainage were performed at the upper jejunum in a side to side, double layer fashion. Five patients (1.3%) developed recurrent late hemorrhagic episodes originating from the graft duodenal anastomosis. Bleeding from the anastomotic site was associated with hematochezia, hemodynamic instability and decrease in serum hemoglobin. Mean onset was 6.4(±2.8) years after transplantation. Bleeding was recurrent (mean 5.2 ± 2.6) and required 9(±2.5) interventions. Hypervascularization, mucosal vulnerability, and bleeding at the site of the enteric anastomosis could be identified in all cases. In four patients, the enteric pancreas anastomosis was resected and a new duodenojejunostomy was performed. No pancreas graft loss occurred due to bleeding. In two patients, hepatic cirrhosis and portal hypertension were identified, one patient had a liver fibrosis as putative cause for the repetitive bleeding episodes. Late anastomotic hemorrhage is a rare but severe complication following pancreas transplantation. The treatment is challenging and includes endoscopy, interventional radiology, and surgery. Hepatic conditions with an increased portal pressure may be the underlying cause.
MeSH term(s)	Adult ; Duodenostomy/adverse effects ; Female ; Follow-Up Studies ; Graft Rejection/etiology ; Graft Rejection/pathology ; Graft Survival ; Hemorrhage/etiology ; Hemorrhage/pathology ; Humans ; Jejunostomy/adverse effects ; Male ; Middle Aged ; Pancreas Transplantation/adverse effects ; Pancreatic Diseases/surgery ; Pancreaticoduodenectomy/adverse effects ; Postoperative Complications ; Prognosis ; Recurrence ; Retrospective Studies ; Risk Factors
Language	English
Publishing date	2018-08-09
Publishing country	Denmark
Document type	Clinical Trial ; Journal Article
ZDB-ID	639001-8
ISSN	1399-0012 ; 0902-0063
ISSN (online)	1399-0012
ISSN	0902-0063
DOI	10.1111/ctr.13350
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Article: A Retrospective Propensity Score Matched Analysis Reveals Superiority of Hypothermic Machine Perfusion over Static Cold Storage in Deceased Donor Kidney Transplantation.

Gasteiger, Silvia / Berchtold, Valeria / Bösmüller, Claudia / Dostal, Lucie / Ulmer, Hanno / Bogensperger, Christina / Resch, Thomas / Rudnicki, Michael / Neuwirt, Hannes / Oberhuber, Rupert / Cardini, Benno / Scheidl, Stefan / Mayer, Gert / Öfner, Dietmar / Weissenbacher, Annemarie / Schneeberger, Stefan

Journal of clinical medicine

2020 Volume 9, Issue 7

Abstract: Hypothermic machine perfusion (HMP) has been introduced as an alternative to static cold storage (SCS) in kidney transplantation, but its true benefit in the clinical routine remains incompletely understood. The aim of this study was to assess the effect ...

Abstract	Hypothermic machine perfusion (HMP) has been introduced as an alternative to static cold storage (SCS) in kidney transplantation, but its true benefit in the clinical routine remains incompletely understood. The aim of this study was to assess the effect of HMP vs. SCS in kidney transplantation. All kidney transplants performed between 08/2015 and 12/2019 (
Language	English
Publishing date	2020-07-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm9072311
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