[Simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantation in a diabetic patient with end-stage liver disease].
OBJECTIVE
To study the effect of combined transplantation of the liver and the pancreas in diabetic patients with end-stage liver disease, and explore the optimal surgical procedure.


METHODS
Simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantations were performed in a patient diagnosed as having chronic hepatitis B, hepatocirrhosis, hepatic cellular cancer, and insulin-dependent diabetes. Immunosuppression therapy utilized prednisone, tacrolimus (FK506), mycophenolate mofetil (MMF), and simulect. The function of the liver graft, serum amylase and lipase, blood glucose, and C-peptide were monitored after transplantation.


RESULTS
Insulin was withdrawn at the 6th day after operation, good liver allograft functional recovery was achieved, without such complications as pancreatitis, thrombosis, and localized infections.


CONCLUSIONS
End-stage liver disease with concomitant insulin-dependent diabetes is the indication for combined liver-pancreas transplantations, for which simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantations may constitute the optimal surgical approaches as the primary choice.
Yu
Li-xin
LX
Department of Kidney Transplantation, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.
Ye
Jun-sheng
JS
Xu
Jian
J
Deng
Wen-feng
WF
Han
Cong-xiang
CX
Ye
Gui-rong
GR
Fu
Shao-jie
SJ
Du
Chuan-fu
CF
Ma
Jun-jie
JJ
Wang
Yi-bin
YB
Liu
Xiao-you
XY
Li
Chuan-jiang
CJ
D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D004386:Duodenum / Q000637:transplantation*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000628:therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000628:therapy*; D008113:Liver Neoplasms / Q000150:complications / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D016042:Transplantation, Heterotopic