[Organ donation by living donors in isolated pancreas and simultaneous pancreas-kidney transplantation].
We studied retrospectively 106 pancreas transplants from living donors. Of these, 83 were solitary pancreas transplants, done between June 1979 and December 1997 (51 pancreas transplants alone for non-uremic recipients as well as 32 pancreas-after-kidney transplants for previously uremic recipients with a functioning kidney graft), and 23 were simultaneous pancreas-kidney transplants (SPK), done between March 1994 and December 1997. In all, 105 (99%) donors were genetically related to the recipients. Perioperative donor mortality was 0%. Donor complications included 9 splenectomies as well as 4 operatively drained and 7 percutaneously managed peripancreatic fluid collections. We noted hyperglycemia in 3 (3%) donors (all among the initial cases in this series). The 1-year survival rate was 50% for solitary pancreas recipients and 78% (pancreas) and 100% (kidney) for SPK recipients. Of the 5 pancreas graft losses which occurred after SPK, 3 were due to thrombosis, 1 to pancreatitis and infection, and 1 to chronic rejection. Currently, all kidney grafts and 18 pancreas grafts are functioning in these 23 dual organ recipients (with 0% recipient mortality). Living donor pancreas and SPK grafting is associated with low donor morbidity and good graft outcome. With stringent donor criteria and appropriate counseling of the prospective donor/recipient pairs, living donor pancreas transplants may become a more widely applied therapeutic alternative for selected non-uremic and uremic patients with Type I diabetes.
Troppmann
C
C
Klinik für Viszeralchirurgie, Departement Chirurgie, Universitätsspital Zürich.
Grüssner
A C
AC
Sutherland
D E
DE
Grüssner
R W
RW
D003924:Diabetes Mellitus, Type 2 / Q000401:mortality / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000401:mortality / Q000601:surgery*; D006084:Graft Rejection / Q000209:etiology / Q000401:mortality; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D009392:Nephrectomy; D016035:Pancreas Transplantation; D010180:Pancreatectomy; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014511:Uremia / Q000401:mortality / Q000601:surgery*