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  • 101.
    Ullsten, Sara
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology.
    Lau, Joey
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology.
    Welsh, Nils
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology.
    Carlsson, Per-Ola
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Vascular Heterogeneity Between Native Pancreatic Islets Determines Their Fate of Survival and Revascularization Posttransplantation2013In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 96, no 6, p. S21-S21Article in journal (Other academic)
  • 102.
    von Zur-Mühlen, Bengt
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Lundgren, Torbjorn
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Karolinska, Sweden;Karolinska Univ Hosp, Dept Transplantat Surg, Karolinska, Sweden.
    Bayman, Levent
    Univ Iowa, Clin Trials Stat & Data Management Ctr, Iowa City, IA USA.
    Berne, Christian
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Bridges, Nancy
    NIAID, NIH, 9000 Rockville Pike, Bethesda, MD 20892 USA.
    Eggerman, Thomas
    NIDDK, Bethesda, MD 20892 USA.
    Foss, Aksel
    Uppsala Univ, Dept Surg Sci, Uppsala, Sweden;Natl Hosp Norway, Dept Transplantat Med, Univ Hosp Oslo, Oslo, Norway.
    Goldstein, Julia
    NIAID, NIH, 9000 Rockville Pike, Bethesda, MD 20892 USA.
    Jenssen, Trond
    Natl Hosp Norway, Dept Transplantat Med, Univ Hosp Oslo, Oslo, Norway.
    Jorns, Carl
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Karolinska, Sweden;Karolinska Univ Hosp, Dept Transplantat Surg, Karolinska, Sweden.
    Morrison, Yvonne
    NIAID, NIH, 9000 Rockville Pike, Bethesda, MD 20892 USA.
    Ryden, Mikael
    Karolinska Inst, Dept Med H7, Solna, Sweden.
    Schwieger, Traci
    Univ Iowa, Clin Trials Stat & Data Management Ctr, Iowa City, IA USA.
    Tufveson, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Nilsson, Bo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology. Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala Univ, Rudbeck Lab, Dept Immunol Genet & Pathol, Uppsala, Sweden.
    Korsgren, Olle
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology. Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology. Uppsala Univ, Rudbeck Lab, Dept Immunol Genet & Pathol, Uppsala, Sweden.
    Open Randomized Multicenter Study to Evaluate Safety and Efficacy of Low Molecular Weight Sulfated Dextran in Islet Transplantation2019In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 103, no 3, p. 630-637Article in journal (Refereed)
    Abstract [en]

    Background. When transplanted human pancreatic islets are exposed to blood during intraportal infusion, an innate immune response is triggered. This instant blood-mediated inflammatory reaction (IBMIR) activates the coagulation and complement cascades and leads to the destruction of 25% of all transplanted islets within minutes, contributing to the need, in most patients, for islets from more than 1 donor. Low molecular dextran sulfate (LMW-DS) has been shown in experimental settings to inhibit IBMIR. Methods. The Clinical Islet Transplantation consortium 01 study was a phase II, multicenter, open label, active control, randomized study. Twenty-four subjects were randomized to peritransplant intraportal and systemic treatment with either LMW-DS or heparin, targeting an activated partial thromboplastin time of 150 +/- 10 seconds and 50 +/- 5 seconds, respectively. C-peptide response was measured with a mixed meal tolerance test at 75 and 365 days after transplant. Results. Low molecular dextran sulfate was safe and well tolerated with similar observed adverse events (mostly attributed to immunosuppression) as in the heparin arm. There was no difference in the primary endpoint (stimulated C-peptide 75 +/- 5 days after the first transplant) between the 2 arms (1.33 +/- 1.10 versus 1.56 +/- 1.36 ng/mL, P = 0.66). Insulin requirement, metabolic parameters, Clarke and HYPO score, quality of life, and safety were similar between the 2 treatments groups. Conclusions. Even with low dosing, LMW-DS showed similar efficacy in preventing IBMIR to promote islet engraftment when compared to "state-of-the art" treatment with heparin. Furthermore, no substantial differences in the efficacy and safety endpoints were detected, providing important information for future studies with more optimal dosing of LMW-DS for the prevention of IBMIR in islet transplantation.

  • 103. Wadstrom, J.
    et al.
    Berglund, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Yamamoto, S.
    von Zur-Muhlen, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Single Centre Long-Term Follow-Up of Live Kidney Donors Demonstrates Preserved Kidney Function But the Necessity of a Structured Life-Long Follow-Up2014In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 98, p. 494-494Article in journal (Other academic)
  • 104.
    Wadström, Jonas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Hand-assisted retroperitoneoscopic live donor nephrectomy: experience from the first 75 consecutive cases2005In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 80, no 8, p. 1060-6Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The two major life-threatening complications associated with laparoscopic live donor nephrectomy are sudden severe bleeding and intestinal injury. A combined technique-hand-assisted and retroperitoneoscopic (HARS)-reduces the risk of these life-threatening complications. In this study, we report on our experience from the first 75 consecutive HARS operations. METHODS: The data has been collected prospectively according to intention to treat and includes all consecutive donors operated with the HARS technique. Warm ischemia time, operating time, and blood loss were recorded. Complications, convalescence, and allograft outcome were followed postoperatively with a mean follow-up of 701 (range 60-1438) days. RESULTS: The mean operating time was 138 (range 85-260) minutes and the mean warm ischemia time 175 (85-510) seconds. The operative time was significantly longer in male donors. The mean bleeding was 176 (50-700) ml. There were no conversions to open surgery. Major complications comprised one pulmonary embolus and one donor required 2 units of blood transfusion. One donor was reoperated due to suspicion of trocar hernia. Nine patients experienced minor complications (fever, n=4; urinary tract infection, n=2; chylous ascites, n=1; orchialgia, n=1; subcostal pain, n=1). All except two kidneys had immediate onset of function. Neither of these could, however, be attributed to the donor operation. One recipient experienced urinary leakage and one a stenosis. Recipient and graft survival were 99% and 96%, respectively. CONCLUSIONS: We conclude that HARS facilitates the procedure by enabling short operating times and at the same time significantly reducing the risks associated with endoscopic live donor nephrectomy.

  • 105.
    Wadström, Jonas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Laparoscopic donor nephrectomy: is it cost effective? Perspective from a transplant surgeon2007In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 83, no 12, p. 1538-1539Article in journal (Refereed)
  • 106.
    Wadström, Jonas
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Biglarnia, Ali-Reza
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Gjertsen, Henrik
    Sugitani, Atsushi
    Fronek, Jiri
    Introducing hand-assisted retroperitoneoscopic live donor nephrectomy: Learning curves and development based on 413 consecutive cases in four centers2011In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 91, no 4, p. 462-469Article in journal (Refereed)
    Abstract [en]

    Background: Hand-assisted and retroperitoneoscopic techniques reduce the risk of bleeding and intra-abdominal complications in live donor nephrectomy (LDN). This study reports on our four-centre experience, development and learning curves from the first 413 LDN using a hand-assisted retroperitoneoscopic technique (HARS).

    Methods: The first 413 consecutive donors operated on using HARS were included in the study. Donor demographics, peri- and postoperative data, complications, and recipient outcomes have been compiled. The data was analysed as a whole and separately for each centre, looking at centre differences and learning curves over time.

    Results: Significant differences were found in donor demographics between centres for the variables: age, BMI, number of arteries, and side of operation. Mean operating time was 170.2 minutes, with significant differences between centres. Operating time was also significantly influenced by learning curves, Sex/BMI, and side of operation. Warm ischemia time differed significantly between centres and was influenced by centre-wise learning and number of arteries. Overall conversion rate was 2.4% and differed significantly between centres. There was no mortality and no intra-abdominal complications. Apart from the conversions and one pulmonary embolism, there were no major intra- or postoperative complications. Overall 3-month graft survival was 99%, with 96% immediate onset of function and 1% ureteral complications.

    Conclusions: The HARS technique reduces the risk of intra-abdominal complications. It can be implemented with excellent donor and recipient outcomes despite different population demographics and centre/surgeon-related tradition and experience. Based on our experience, we recommend the technique in order to increase the safety margin of LDN.

  • 107.
    Wadström, Jonas
    et al.
    Karolinska Univ Hosp, Stockholm, Sweden..
    Ericzon, Bo-Goran
    Karolinska Inst, Stockholm, Sweden..
    Halloran, Philip F.
    Alberta Transplant Appl Genom Ctr, Edmonton, AB, Canada..
    Bechstein, Wolf O.
    Frankfurt Univ Hosp & Clin, Frankfurt, Germany..
    Opelz, Gerhard
    Heidelberg Univ, Heidelberg, Germany..
    Seron, Daniel
    Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Barcelona, Spain.;Inst Carlos III, Red Invest Renal REDinREN, Madrid, Spain..
    Grinyo, Josep
    Univ Barcelona, Hosp Univ Bellvitge, Barcelona, Spain..
    Loupy, Alexandre
    Hop Necker Enfants Malad, Serv Nephrol Transplantat, Paris, France..
    Kuypers, Dirk
    Univ Hosp Leuven, Leuven, Belgium..
    Mariat, Christophe
    Univ Jean Monnet, Univ Hosp St Etienne, St Etienne, France..
    Clancy, Marc
    Western Infirm & Associated Hosp, Glasgow, Lanark, Scotland..
    Jardine, Alan G.
    Western Infirm & Associated Hosp, Glasgow, Lanark, Scotland..
    Guirado, Lluis
    Fundacio Puigvert, Barcelona, Spain..
    Fellström, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    O'Grady, John
    Kings Coll Hosp London, London, England..
    Pirenne, Jacques
    Univ Hosp Leuven, Leuven, Belgium..
    O'Leary, Jacqueline G.
    Baylor Univ, Med Ctr Dallas, Dallas, TX USA..
    Aluvihare, Varuna
    Kings Coll Hosp London, London, England..
    Trunecka, Pavel
    Inst Clin & Expt Med IKEM, Transplantctr, Prague, Czech Republic..
    Baccarani, Umberto
    Univ Hosp Udine, Dept Med & Biol Sci, Udine, Italy..
    Neuberger, James
    Queen Elizabeth Hosp, Liver Unit, Birmingham, W Midlands, England.;NHS Blood & Transplant, Directorate Organ Donat & Transplantat, Bristol, Avon, England..
    Soto-Gutierrez, Alejandro
    Univ Pittsburgh, Dept Pathol, Pittsburgh, PA USA..
    Geissler, Edward K.
    Univ Regensburg, Univ Hosp Regensburg, Expt Surg, Regensburg, Germany..
    Metzger, Monty
    Ahead Time GmbH, Starnberg, Germany..
    Gray, Muir
    Better Value Healthcare, Oxford, England..
    Advancing Transplantation: New Questions, New Possibilities in Kidney and Liver Transplantation2017In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 101Article in journal (Refereed)
  • 108.
    Wadström, Jonas
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery. Hamad Med Corp, Dept Surg Transplantat, Doha, Qatar.
    von Zur-Mühlen, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Yamamoto, Shinji
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Few Gender Differences in Attitudes and Experiences after Live Kidney Donation, with Minor Changes over Time2018In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 102, p. S336-S336Article in journal (Other academic)
  • 109.
    Watanabe, Masaaki
    et al.
    Karolinska Inst, CLINTEC, Div Transplantat Surg, Stockholm, Sweden..
    Kumagai-Braesch, Makiko
    Karolinska Inst, CLINTEC, Div Transplantat Surg, Stockholm, Sweden..
    Yao, Ming
    Karolinska Inst, CLINTEC, Div Transplantat Surg, Stockholm, Sweden..
    Berglund, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.
    Jorns, Carl
    Karolinska Inst, CLINTEC, Div Transplantat Surg, Stockholm, Sweden..
    Thunberg, Sara
    Karolinska Inst, Dept Clin Immunol, S-10401 Stockholm, Sweden..
    Lind-Enoksson, Sara
    Karolinska Inst, Dept Clin Immunol, S-10401 Stockholm, Sweden..
    Henrikson, Jarmo
    Karolinska Inst, CLINTEC, Div Transplantat Surg, Stockholm, Sweden..
    Lundgren, Torbjorn
    Karolinska Inst, CLINTEC, Div Transplantat Surg, Stockholm, Sweden..
    Sellberg, Felix
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.
    Berglund, Erik
    Karolinska Inst, CLINTEC, Div Transplantat Surg, Stockholm, Sweden..
    Ericzon, Bo-Goran
    Karolinska Inst, CLINTEC, Div Transplantat Surg, Stockholm, Sweden..
    Ex Vivo Generation of Alloantigen-Specific T Regulatory Cells using Selective T-Cell Co-Stimulation Blockade2015In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 99, no 11, p. S47-S47Article in journal (Other academic)
  • 110. Wennberg, Ann-Marie
    et al.
    Stenquist, Bo
    Stockfleth, Eggert
    Keohane, Stephen
    Lear, John T.
    Jemec, Gregor
    Mork, Cato
    Christensen, Eidi
    Kapp, Alexander
    Solvsten, Henrik
    Talme, Toomas
    Berne, Berit
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Dermatology and Venereology.
    Forschner, Tobias
    Photodynamic therapy with methyl aminolevulinate for prevention of new skin lesions in transplant recipients: a randomized study2008In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 86, no 3, p. 423-9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Organ transplant recipients on long-term immunosuppressive therapy are at increased risk of non-melanoma skin lesions. Repeated field photodynamic therapy using topical methyl aminolevulinate (MAL) may have potential as a preventive treatment. METHODS: This open randomized, intrapatient, comparative, multicenter study included 81 transplant recipients with 889 lesions (90% actinic keratoses (AK)]. In each patient, the study treatment was initially administered to one 50 cm area on the face, scalp, neck, trunk, or extremities (n=476 lesions) twice (1 week apart), with additional single treatments at 3, 9, and 15 months. On each occasion, the area was debrided gently and MAL cream (160 mg/g) applied for 3 hr, before illumination with noncoherent red light (630 nm, 37 J/cm2). The control, 50 cm2 area (n=413 lesions) received lesion-specific treatment (83% cryotherapy) at baseline and 3, 9, and 15 months. Additionally, all visible lesions were given lesion-specific treatment 21 and 27 months in both treatment and control areas. RESULTS: At 3 months, MAL photodynamic therapy significantly reduced the occurrence of new lesions (65 vs. 103 lesions in the control area; P=0.01), mainly AK (46% reduction; 43 vs. 80; P=0.006). This effect was not significant at 27 months (253 vs. 312; P=0.06). Hypopigmentation, as assessed by the investigator, was less evident in the treatment than control areas (16% vs. 51% of patients; P<0.001) at 27 months. CONCLUSION: Our results suggest that repeated field photodynamic therapy using topical MAL may prevent new AK in transplant recipients although further studies are needed.

  • 111.
    Westermark, Gunilla T.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology.
    Davalli, Alberto M.
    Secchi, Antonio
    Folli, Franco
    Kin, Tatsuya
    Toso, Christian
    Shapiro, A. M. James
    Korsgren, Olle
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.
    Tufveson, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Andersson, Arne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology.
    Westermark, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Molecular and Morphological Pathology.
    Further Evidence for Amyloid Deposition in Clinical Pancreatic Islet Grafts2012In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 93, no 2, p. 219-223Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The reasons for the long-term complete or partial loss of islet graft function are unknown, but there are obviously other reasons than just pure allogeneic graft rejection. Earlier studies have shown that deposition of islet amyloid polypeptide amyloid in transplanted islets may indicate a mechanism for loss of β cells.

    MATERIALS AND METHODS: Sections from liver material from four deceased islet-bearing recipients have been scrutinized for the presence of amyloid. Clinical data and certain aspects of the islet graft pathology of these patients have been published previously.

    RESULT: With this extended histological analysis, we demonstrate the occurrence of amyloid deposits in islets transplanted into the liver in three of four patients with type 1 diabetes.

    CONCLUSION: The finding adds evidence to the assumption that aggregation of islet amyloid polypeptide might be an important cause of progressing β-cell dysfunction in clinically transplanted islets.

  • 112. Winstedt, L.
    et al.
    Malmqvist, U.
    Bjorck, L.
    Tufveson, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Bengtsson, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.
    Kjellman, C.
    The IgG Specific Cysteine Protease IdeS: A Novel Candidate Drug for Pre-Transplantation Desensitization.2014In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 98, p. 666-666Article in journal (Other academic)
123 101 - 112 of 112
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