Research - Transplantation Surgery
Research related to liver transplantation
Bo-Göran Erizon, professor, senior physician
The aims of the research programs are:
- to create evaluation guidelines, monitor short-term and long-term outcome in order to reduce rejection episodes, and prolong graft and patient survival;
- to increase the number of donor organs and improve preservation before transplantation surgery; -to increase access to transplantation treatment by means of hepatocyte transplantation and a living donor program;
- to study and treat liver disorders to prevent the need for LT;
Evaluation of Liver Transplantation transfusion policy at Karolinska Institutet:
reviewing the Past to improve the Future.
Paola Violi, MD
Perioperative blood loss and transfusions of blood products are associated with increased rates of morbidity and mortality, both in non-cirrhotic and cirrhotic patients. The main cause of blood loss during surgery is due to surgical factors , but in liver transplantation there are additional factors, like severity of liver disease, length of cold ischemia time, type of surgical technique. It is also known that perioperative blood products transfusions are associated to an higher rate of morbidity and mortality.The aim of this study is to retrospectively analyse the factors that contribute to massive blood loss in Liver Transplant. In order to achieve this objective, we will review all the adult Liver Transplants performed at the Department of Transplantation Surgery - Karolinska University Hospital, Huddinge during the last five years to investigate different variables associated with major blood loss, rate of transfusions and outcomes of the liver transplants.
Experimental studies to improve the results of islet transplantation
Makiko Kumagai, senior researcher
Aim of our research is to improve islet graft function and survival. We use rodent islet transplantation models and evaluate different strategies to prolong islet graft survival. Our research group also joined the strategic research program (SRP) in diabetes in Karolinska Institutet. Immunological analysis of graft survival and metabolic studies for evaluation of graft function are also an important part of our studies.
Iset transplantation in the treatment of diabetes.
Experimental and clinical studies to improve the access to and results of islet transplantation.
Annika Tibell, MD, Associate professor
Aim. To make transplantation of insulin producing cells a successful treatment for patients with type-1 diabetes complicated by management problems.
Transplantation of islets can normalize metabolic control in patients with type-1 diabetes. Poor engraftment, shortage of cells and risks for side effects of immunosuppressive drugs, limit the use of islet transplantation. When islets are injected into the blood, an inflammatory reaction (IBMIR) is triggered that injures a large part of the graft. Transplantations from 2-4 donors are required to achieve insulin independence. In a Nordic project, new drugs that hamper the IBMIR-reaction will be evaluated in randomised clinical studies. Our group will also evaluate drugs that improve the resistance of islets to hypoxia and inflammation. To reduce the need for immunosuppressive drugs, methods for transplantation of encapsulated islets are developed using rat to mouse model. Induction therapy with antibodies blocking co-stimulatory pathways is evaluated in a new model for autoimmune diabetes. For studies of IBMIR and the rejection response to islets a humanised mouse model is established. Projects to promote donor identification and management are ongoing to increase the access of islets for transplantation.
If the survival of islet grafts can be improved and the access to tissue increased, islet transplantation can become a valuable alternative for patients with complicated type-1 diabetes where traditional treatment fails.