Korean J Transplant.  2022 Nov;36(Supple 1):S86. 10.4285/ATW2022.F-2021.

Simultaneous pancreas kidney transplant: a tertiary care center experience in India

• Subramani VN
• Kumar S
• Sharma A
• Kenwar DB
• Singh S
• Ramachandran 2 R
• Bhadada 3 S

• KMID: 2535602
• DOI: http://doi.org/10.4285/ATW2022.F-2021

Abstract

Background
Simultaneous pancreas kidney transplant (SPK) gives a physiological replacement of pancreas and kidney function in patients with end-stage renal disease (ESRD) due to type 1 diabetes mellitus (DM) after which the patients can be free from di-alysis and insulin therapy. The aim of our study was to report the experience with SPK transplant at a tertiary care center in India.
Methods
Outcomes were reported by retrospective review of data of patients who underwent SPK transplant at our center from January 2019 through December 2021.
Results
Eleven patients underwent SPK transplant during the study period. Median age of recipients was 36. Ten patients had type 1 DM and one patient had type 2 DM. Median age of donors was 32 years. Median serum creatinine in the donors was 3.54 and amylase was 87. Kidneys were placed in left iliac fossa and pancreas in right iliac fossa. Median cold ischemia time was 561 minutes for pancreas and 417 minutes for kidneys. Median graft weight of kidneys was 142 g. Pancreatic drainage was enteric in all cases. Five patients needed re-laparotomy. Two patients needed graft pancreatectomy in view of duodenal necrosis. One patient had SMV thrombosis but graft was salvaged after re-exploration. One year graft survival was 100% for kidneys and 81% for pancreas. Median creatinine at end of 1 year was 1.01 mg/dL. All patients were independent of dialysis and insulin at end of 1 year.
Conclusions
SPK transplant is an effective treatment for type 1 DM with ESRD with favorable outcomes. Though SPK transplant patients had early period complications, timely diagnosis and intervention can prevent graft loss and provide better outcomes.