Ann Surg Treat Res.  2015 Jan;88(1):41-47. 10.4174/astr.2015.88.1.41.

Simultaneous pancreas-kidney transplantation: lessons learned from the initial experience of a single center in Korea

• Kim SM
• Youn WY
• Kim DJ
• Kim JS
• Lee S

• KMID: 2167058
• DOI: http://doi.org/10.4174/astr.2015.88.1.41

Abstract

PURPOSE
The purpose of this study is to report the results of simultaneous pancreas-kidney (SPK) transplantations and describe the lessons learned from the early experiences of a single center.
METHODS
Between January 2002 and June 2013, a total of 8 patients underwent SPK transplantation. Clinical and radiologic data were reviewed retrospectively.
RESULTS
Seven patients were diagnosed with type I diabetes mellitus and one patient became insulin-dependent after undergoing a total pancreatectomy because of trauma. Pancreas exocrine drainage was performed by enteric drainage in 4 patients and bladder drainage in 4 patients. Three patients required conversion from initial bladder drainage to enteric drainage due to urinary symptoms and duodenal leakage. Four patients required a relaparotomy due to hemorrhage, ureteral stricture, duodenal leakage, and venous thrombosis. There was no kidney graft loss, and 2 patients had pancreas graft loss because of venous thrombosis and new onset of type II diabetes mellitus. With a median follow-up of 76 months (range, 2-147 months), the death-censored graft survival rates for the pancreas were 85.7% at 1, 3, and 5 years and 42.9% at 10 years. The patient survival rate was 87.5% at 1, 3, 5, and 10 years.
CONCLUSION
The long-term grafts and patient survival in the current series are comparable to previous studies. A successful pancreas transplant program can be established in a single small-volume institute. A meticulous surgical technique and early anticoagulation therapy are required for further improvement in the outcomes.

Keyword

Pancreas transplantation; Complications

MeSH Terms

Constriction, Pathologic
Diabetes Mellitus
Drainage
Follow-Up Studies
Graft Survival
Hemorrhage
Humans
Kidney
Korea
Pancreas
Pancreas Transplantation
Pancreatectomy
Retrospective Studies
Survival Rate
Transplants
Ureter
Urinary Bladder
Venous Thrombosis

Figure

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  Fig. 1 The death-censored graft survival rates of the pancreas.

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  Fig. 2 The patient survival rates.

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