Pancreas-kidney transplantation for intensivists: perioperative care and complications.
Simultaneous pancreas-kidney transplantation is a therapeutic option for type I diabetics with end-stage renal disease. It aims to correct the uremic state, to normalize glucose hemeostasis, and to ameliorate diabetic complications. Careful donor-recipient selection and meticulous intra-operative and postoperative care will substantially impact recipient morbidity. An understanding of the technical aspects of the surgical procedure and its metabolic and immunological consequences is necessary to successfully manage a pancreas-kidney transplant recipient, many of whom are nursed in intensive care units. A successful outcome is predicted in early recognition of technical complications and aggressive management of rejection to achieve the current 1-year graft survival rates of 75% for pancreas transplants and 84% for kidney transplants.
Fabrega
A J
AJ
Department of Surgery, University of Illinois at Chicago 60680, USA.
Rivas
P A
PA
Pollak
R
R
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000601:surgery*; D006801:Humans; D007430:Intraoperative Care; D016030:Kidney Transplantation / Q000379:methods*; D008875:Middle Aged; D009926:Organ Preservation; D016035:Pancreas Transplantation / Q000379:methods*; D018579:Patient Selection; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D014019:Tissue Donors