Korean J Transplant.  2022 Nov;36(Supple 1):S204. 10.4285/ATW2022.F-3396.

Evolution of simultaneous pancreas and kidney transplant program in PGIMER Chandigarh

• Subramani VN
• Singh S
• Sharma A
• Kenwar DB
• Kumar S
• Bhadada S
• Ramachandran R

• KMID: 2535269
• DOI: http://doi.org/10.4285/ATW2022.F-3396

Abstract

Background
Simultaneous pancreas kidney (SPK) transplant is an effective treatment in patients with end-stage renal disease (ESRD) due to type 1 diabetes mellitus. SPK transplant is associated with significant mortality and morbidity. In India, pancreas transplant program is in its infancy. Less than 200 SPK transplants have been performed so far. We started SPK at our institute in 2014 and we review the experience comparing the initial years with the recent years.
Methods
Retrospective analysis of data of all patients who underwent SPK transplant at our center was done dividing them into two groups; initial years (2014–2018, group 1; n=17) and recent years (2019–2022, group 2; n=17) and outcomes were com-pared.
Results
The rate of re-exploration was 53% in group 1 and 43% in group 2. Biopsy proven rejections were equal in both groups (23%). There was one case of duodenal leak in each group and one anastomotic leak in group 1. There were four cases of vas-cular thrombosis in group 1 and two in group 2. Three cases in group 1 had delayed graft function whereas one patient had DGF in group 2. No renal graft loss was seen in either group. Five (29%) patients in group 1 lost their pancreas and two (12%) patients in group 2 had pancreatic graft loss. The 30-day mortality was 6% in group 1 and zero in group 2. The 1-year patient survival and death-censored pancreatic graft survival were was 76% and 64% in group 1 and 94% and 94% in group 2 respec-tively. The hospital stays, infection rate, creatinine and HbA1C at various time intervals were similar. The learning curve over the years reflected in the results.
Conclusions
Improved surgical techniques and peri-operative protocols have improved outcomes. Keys to success include teamwork, decision making, surgical skills, experience and close follow-up.