Reviewer ’s report  
Title: Pancreas grafts for transplantation from donors with h ypertension: An analysis of the 
Scientific Registry of Transplant Recipients database  
 
Version: 1 Date: 21 May 2018  
 
Revie wer: Gabriele Spoletini  
 
Reviewer's report:  
Overall, there has been substantial improvement in the quality of the manuscript.  
 
Unresolved issues are:  
 
1- English language is still not fluent enough for pubblication in the targeted journal and should 
be opti mized by a mother tongue editor.  
Few examples follow:  
- Page 3, lines 2 -4: "Pancreas transplantation is the main method used to reestablish insulin 
secretion, which is reliable and repeatable for type 1 diabetes and less commonly for type 2 
diabetes". Are the Authors saying that PTx is more commonly indicated in T1DM?, If so, 
please re -formulate more clearly.  
- Page 3, lines 20, 21:  "With the significant improvements of life expectancy and the need for 
the quality of life, the demands for organs have been increasing steadily". Are the Authors 
saying that because PTx has become a safer procedure with improved results over time, there 
has been a rise in demand for it? Please re -formulate.  
- Page 3, lines 23, 24: "Many factors have been discussing". Change to "have been discussed".  
- Page 4, lines 1, 2: "However, few study referred the role of hypertension in pancreas 
transplantation". Few studieS. Change "Referred" to a more appropriate verb if you meant 
"Assessed" or "Analyzed"  
These are just few examples but  the same issue goes on through the whole paper.  
Even the "Funding" section (page 12) contains a grammatical error (i.e. supposed).  
 
2- The discussion section needs optimization in relation to content:  
- Page 8, lines 14 -19: Although these are known mechanisms of action, you need to provide a 
reference for this.  
- Page 9, lines 12 -24: the dissertation about type of transplants is too long and in particular this 
part. Pancreas graft loss in SPKs is mainly  for technical reasons because the immunologic 
losses are avoided thanks to the presence of the kidney graft (for various reasons: rejection is 
easier to detect; immunologic protection is exerted by the kidney; biopsying the kidney is 
easier than biopsying  the pancreas)  
- Page 10, lines 3 -5: "SPK is performed mostly in patients with insulin -dependent DM and 
chronic renal failure because of immune or renal failure requiring dialysis". Please explain 
better / eliminate duplication.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supported  by the data shown?  
If not, please explain in your comments to the authors.  
Yes 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please spec ify what aspects require further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Not suitable for publicati on unless extensively edited  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or  lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future ? 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer r eview policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included a s confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
Title: Pancreas grafts for transplantation from donors with h ypertension: An analysis of the 
Scientific Registry of Transplant Recipients database  
 
Version: 1 Date: 21 May 2018  
 
Revie wer: Gabriele Spoletini  
 
Reviewer's report:  
Overall, there has been substantial improvement in the quality of the manuscript.  
 
Unresolved issues are:  
 
1- English language is still not fluent enough for pubblication in the targeted journal and should 
be opti mized by a mother tongue editor.  
Few examples follow:  
- Page 3, lines 2 -4: "Pancreas transplantation is the main method used to reestablish insulin 
secretion, which is reliable and repeatable for type 1 diabetes and less commonly for type 2 
diabetes". Are the Authors saying that PTx is more commonly indicated in T1DM?, If so, 
please re -formulate more clearly.  
- Page 3, lines 20, 21:  "With the significant improvements of life expectancy and the need for 
the quality of life, the demands for organs have been increasing steadily". Are the Authors 
saying that because PTx has become a safer procedure with improved results over time, there 
has been a rise in demand for it? Please re -formulate.  
- Page 3, lines 23, 24: "Many factors have been discussing". Change to "have been discussed".  
- Page 4, lines 1, 2: "However, few study referred the role of hypertension in pancreas 
transplantation". Few studieS. Change "Referred" to a more appropriate verb if you meant 
"Assessed" or "Analyzed"  
These are just few examples but  the same issue goes on through the whole paper.  
Even the "Funding" section (page 12) contains a grammatical error (i.e. supposed).  
 
2- The discussion section needs optimization in relation to content:  
- Page 8, lines 14 -19: Although these are known mechanisms of action, you need to provide a 
reference for this.  
- Page 9, lines 12 -24: the dissertation about type of transplants is too long and in particular this 
part. Pancreas graft loss in SPKs is mainly  for technical reasons because the immunologic 
losses are avoided thanks to the presence of the kidney graft (for various reasons: rejection is 
easier to detect; immunologic protection is exerted by the kidney; biopsying the kidney is 
easier than biopsying  the pancreas)  
- Page 10, lines 3 -5: "SPK is performed mostly in patients with insulin -dependent DM and 
chronic renal failure because of immune or renal failure requiring dialysis". Please explain 
better / eliminate duplication.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supported  by the data shown?  
If not, please explain in your comments to the authors.  
Yes 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please spec ify what aspects require further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Not suitable for publicati on unless extensively edited  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or  lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future ? 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer r eview policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included a s confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
Title: Pancreas grafts for transplantation from donors with h ypertension: An analysis of the 
Scientific Registry of Transplant Recipients database  
 
Version: 1 Date: 21 May 2018  
 
Revie wer: Gabriele Spoletini  
 
Reviewer's report:  
Overall, there has been substantial improvement in the quality of the manuscript.  
 
Unresolved issues are:  
 
1- English language is still not fluent enough for pubblication in the targeted journal and should 
be opti mized by a mother tongue editor.  
Few examples follow:  
- Page 3, lines 2 -4: "Pancreas transplantation is the main method used to reestablish insulin 
secretion, which is reliable and repeatable for type 1 diabetes and less commonly for type 2 
diabetes". Are the Authors saying that PTx is more commonly indicated in T1DM?, If so, 
please re -formulate more clearly.  
- Page 3, lines 20, 21:  "With the significant improvements of life expectancy and the need for 
the quality of life, the demands for organs have been increasing steadily". Are the Authors 
saying that because PTx has become a safer procedure with improved results over time, there 
has been a rise in demand for it? Please re -formulate.  
- Page 3, lines 23, 24: "Many factors have been discussing". Change to "have been discussed".  
- Page 4, lines 1, 2: "However, few study referred the role of hypertension in pancreas 
transplantation". Few studieS. Change "Referred" to a more appropriate verb if you meant 
"Assessed" or "Analyzed"  
These are just few examples but  the same issue goes on through the whole paper.  
Even the "Funding" section (page 12) contains a grammatical error (i.e. supposed).  
 
2- The discussion section needs optimization in relation to content:  
- Page 8, lines 14 -19: Although these are known mechanisms of action, you need to provide a 
reference for this.  
- Page 9, lines 12 -24: the dissertation about type of transplants is too long and in particular this 
part. Pancreas graft loss in SPKs is mainly  for technical reasons because the immunologic 
losses are avoided thanks to the presence of the kidney graft (for various reasons: rejection is 
easier to detect; immunologic protection is exerted by the kidney; biopsying the kidney is 
easier than biopsying  the pancreas)  
- Page 10, lines 3 -5: "SPK is performed mostly in patients with insulin -dependent DM and 
chronic renal failure because of immune or renal failure requiring dialysis". Please explain 
better / eliminate duplication.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supported  by the data shown?  
If not, please explain in your comments to the authors.  
Yes 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please spec ify what aspects require further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Not suitable for publicati on unless extensively edited  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or  lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future ? 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer r eview policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included a s confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant