Simultaneous pancreas-kidney (SPK) transplantation from controlled non-heart-beating donors (NHBDs).
From January 1993 through June 1999, 18 simultaneous pancreas-kidney transplants (SPKs) were performed from controlled non-heart-beating donors (NHBDs) and 339 SPKs were performed from heart-beating donors (HBDs). No difference in donor characteristics was noted except for warm ischemic time, which was 14.8 min (range 4-46 min) for NHBDs. Following transplantation, no difference in pancreatic function was noted; however, a higher rate of enteric conversions was seen in pancreas transplants from NHBDs (32% vs. 13%; p < 0.01). Hemodialysis for acute tubular necrosis (ATN) was higher in kidney transplants from NHBDs (22.2% vs. 4.1%; p = 0.009) as was discharge serum creatinine (1.7 mg/dl vs. 1.5 mg/dl; p < 0.05). Also, the number of patients remaining rejection free was lower for NHBDs and approached significance (33.3% vs. 50.1%; p = 0.07). However, no difference in patient survival (100% vs. 95.4%) or pancreatic (87.4% vs. 86.5%) and renal (86.3% vs. 86.3%) allograft survival was noted during the study period. Our results indicate that SPK transplantation from controlled NHBDs is a viable method for increasing the number of pancreas and kidney transplants available for transplantation.
D'Alessandro
A M
AM
Division of Organ Transplantation, University of Wisconsin Medical School, Madison 53792, USA. tony@tx.surgery.wisc.edu
Odorico
J S
JS
Knechtle
S J
SJ
Becker
Y T
YT
Hoffmann
R M
RM
Kalayoglu
M
M
Sollinger
H W
HW
D000328:Adult; D000681:Amylases / Q000097:blood; D001786:Blood Glucose; D002102:Cadaver; D005260:Female; D006084:Graft Rejection / Q000401:mortality; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D009200:Myocardial Contraction; D016035:Pancreas Transplantation / Q000401:mortality*; D014019:Tissue Donors; D014184:Transplantation, Homologous
D001786:Blood Glucose; D000681:Amylases