Simultaneous pancreas-kidney transplantation: lessons learned from the initial experience of a single center in Korea.
10.4174/astr.2015.88.1.41
- Author:
Suh Min KIM
1
;
Woo Young YOUN
;
Doo Jin KIM
;
Joo Seop KIM
;
Samuel LEE
Author Information
1. Department of Surgery, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. slee@hallym.or.kr
- Publication Type:Original Article
- Keywords:
Pancreas transplantation;
Complications
- MeSH:
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
- From:Annals of Surgical Treatment and Research
2015;88(1):41-47
- CountryRepublic of Korea
- Language:English
-
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.
