title: [Simultaneous en-bloc allotransplantation of pancreas and kidney in the animal model. Comparison of separate organ and en-bloc pancreas/kidney transplantation in swine].
abstract: The high technical complication rate of pancreas transplantation requires large animal models to improve clinical transplant survival rates. The pig is a very suitable animal due to its anatomy, physiology and immunology which are similar to humans. In this study a model of en-bloc simultaneous pancreas and kidney transplantation was established which--in contrast to separate transplantation of both organs--decreases preservation time, operation time, and clamp time. Furthermore, the rates of intra- and postoperative complications were reduced compared with separate transplantation. The donor aorta (encompassing celiac axis, superior mesenteric artery, and left renal artery) is anastomosed en-bloc to the recipients aorta in a an oblique-to-side fashion. The portal vein is anastomosed end-to-side to the left common iliac vein. The exocrine pancreatic secretions are drained via duodenocystostomy to allow for monitoring of urinary amylase for rejection. The en-bloc technique is an alternative for pediatric donor organs since the risk of vascular complications is lower compared with separate implantation of the donor vessels. Based on our results in a large animal model the en-bloc technique could be used in adult uremic diabetic patients who receive a combined pancreas-kidney transplant from a pediatric cadaver donor.
mesh_terms: D000681:Amylases / Q000652:urine; D000818:Animals; D001158:Arteries / Q000601:surgery; D001706:Biopsy; D003559:Cystostomy; D004386:Duodenum / Q000601:surgery; D004724:Endoscopy; D006084:Graft Rejection / Q000473:pathology; D007431:Intraoperative Complications / Q000473:pathology / Q000601:surgery; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000379:methods* / Q000473:pathology; D010179:Pancreas / Q000473:pathology; D016035:Pancreas Transplantation / Q000379:methods* / Q000473:pathology; D011183:Postoperative Complications / Q000473:pathology / Q000601:surgery; D013536:Suture Techniques; D013552:Swine
chemical_list: D000681:Amylases
vernacular_title: Die simultane En-bloc-Allotransplantation von Pankreas und Niere im Tiermodell. Vergleich von organgetrennter und En-bloc-Pankreas-/Nierentransplantation beim Schwein.