Eurotransplant Annual Meeting 2015
Prof. Gottlieb (GHO) and Dr. Nossent (NGR) presented results from a survey on 9
clinical lung cases. The purpose was to compare the ET LAS to the new UNOS LAS
which was implemented on February 19, 2015.
In the new UNOS LAS model, the effect of PHT for COPD is much stronger, the
effect is reversed and the effect of supplemental oxygen is less strong. 40% of
the differences between UNOS and ET LAS are covered by the current business
rules.
Mr. Zanen (Eurotransplant) showed the results of the tests of the new LAS audit system. All comments from the clinicians
have been addressed and solved. If the tests in the upcoming week show good results, the new system will be implemented
on October 26, 2015.
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Pancreas meeting
Chair: W. Schareck
Speakers: D. Lam, T. Biester, R. Lehmann, R. Ploeg
Report by: J. de Boer
This year, the pancreas meeting was dedicated to external aspects of what we are doing. Can we improve our procurement
results by certification of procurement surgeons? What is going on in the external insulin therapy of type I diabetics with
new technologies and concepts? What would be considered success or failure of a transplant?
Dr. Lam presented the Dutch experience with certification of procurement surgeons. The Leiden University Medical Center
(LUMC) started with an in house course in 1997. This was followed by a national master class in 1999 and finally in 2004, in
close collaboration with ESOT, an international course was initiated. This course is held yearly and consists of lectures, a
hands-on training and an e-learning facility. Quality forms of 264 pancreases procured between Jan 2010 and Sept. 2015
were investigated. In 21% of the pancreases procured by certified surgeons surgical problems were detected as compared to
33% of the pancreases procured by non-certified surgeons. This however had no effect on the discard rate.
Dr. Biester presented the concept of an artificial pancreas. In pediatric diabetology, 45% patients are treated with an
insulin pump. The concept of the artificial pancreas is an insulin pump connected to a (subcutaneous) Glucose sensor. The
most advanced model (PLGM) can predict and prevent a hypoglycemia. The drawback of the conventional therapy,
hyperinsulinemia, can be prevented with the artificial pancreas. The artificial pancreas also prevents extreme metabolic
situations, stabilizes the nocturnal glucose levels, but does not solve the basic problems of external insulin application.
Finally, a panel discussion on the definition of pancreas graft failure was introduced by Prof. R. Lehmann and Prof. R. Ploeg.
In case of full organ transplant, one therapeutic goal is to achieve insulin independence, but in case of islet transplant
which is also a successful therapeutic intervention, there is also the goal of achieving an HbA1c < 7ng/ml. The basic goal of
Islet cell transplantation is to protect the kidney against diabetic nephropathy. This can be established with an HbA1c of <
7%. The goal should not be Insuline independence, but a good diabetes control. Indication for retransplant should be a
HbA1c >7.0% with a C-peptide < 100pmol/l (0.3ng/ml) For the pancreas a functioning graft should be defined as
independence of insulin or oral anti diabetic medication.
Report Annual Meeting 2015 | Eurotransplant
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