Simultaneous pancreas kidney transplantation: initial experience of the Emory University transplant service.
The successful replacement of islet tissue by pancreas transplantation appears to be beneficial in the early course of those uremic diabetic recipients who receive a simultaneous renal transplant. The long-term advantages of SKP transplantation remain to be determined, however, current improvement in patient and graft survival following SPK and the difficulties thus far reported in islet cell transplantation have renewed clinical interests in SPK, PAK and PA transplantation. In our experience, pancreas transplantation has been a challenging technical, immunological and physiological endeavor which was well received by our patients despite the initial problems and complications we and they encountered. Notwithstanding extensive preparation, our team experienced a "learning curve" and we present many of the lessons we learned. This knowledge has aided our transplant team in the successful management and avoidance of these complications and other inherent problems associated with SKP transplantation in subsequent patients.
Whelchel
J D
JD
Emory University School of Medicine, Emory University Hospital, Renal and Pancreatic Transplantation Service, Atlanta, Georgia.
Larse
C
C
Olsen
R
R
Pearson
T
T
Risaliti
A
A
Petri
R
R
Uzzau
A
A
Anania
G
G
Bresadola
F
F
D000714:Anastomosis, Surgical / Q000009:adverse effects; D003586:Cytomegalovirus Infections / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D004386:Duodenum / Q000601:surgery; D005122:Exudates and Transudates; D005500:Follow-Up Studies; D005845:Georgia; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016381:Islets of Langerhans Transplantation; D016030:Kidney Transplantation; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000379:methods; D011169:Portal Vein / Q000601:surgery; D011182:Postoperative Care; D013530:Surgical Wound Infection / Q000209:etiology; D013927:Thrombosis / Q000209:etiology; D014021:Tissue Preservation
D007166:Immunosuppressive Agents