title: En bloc pancreas and kidney transplantation in a patient with limited vascular access.
abstract: We report a successful en bloc pancreas and kidney transplantation on a type I diabetic patient with advanced peripheral arterial calcific disease, who had frequent life-threatening episodes of hypoglycemia. The en bloc double organ, created by joining the graft renal artery to the arterial Y graft of the pancreas, was implanted to the proximal left common iliac artery, which was the only site available for an arterial anastomosis. Under appropriate circumstances, this procedure would be an option for potential combined pancreas-kidney transplant recipients with severe calcific arterial disease.
authors.affiliation: Department of Surgery, Transplantation Institute, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
authors.forename: A
authors.initials: A
authors.lastname: Sugitani
authors.forename: H A
authors.initials: HA
authors.lastname: Gritsch
authors.forename: F
authors.initials: F
authors.lastname: Egidi
authors.forename: R
authors.initials: R
authors.lastname: Shapiro
authors.forename: R J
authors.initials: RJ
authors.lastname: Corry
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D001163:Arteriovenous Anastomosis; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D003925:Diabetic Angiopathies / Q000601:surgery; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D007084:Iliac Vein / Q000601:surgery*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000000981:diagnostic imaging / Q000276:immunology; D008775:Methylprednisolone / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D016035:Pancreas Transplantation / Q000000981:diagnostic imaging / Q000276:immunology; D011184:Postoperative Period; D011877:Radionuclide Imaging; D012039:Regional Blood Flow / Q000528:radiation effects; D016559:Tacrolimus / Q000627:therapeutic use; D016284:Technetium Tc 99m Pentetate
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D016284:Technetium Tc 99m Pentetate; D016559:Tacrolimus; D008775:Methylprednisolone