title: [Simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantation in a diabetic patient with end-stage liver disease].
abstract: 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  Insulin was withdrawn at the 6th day after operation, good liver allograft functional recovery was achieved, without such complications as pancreatitis, thrombosis, and localized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.
authors.affiliation: Department of Kidney Transplantation, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.
authors.forename: Li-xin
authors.initials: LX
authors.lastname: Yu
authors.forename: Jun-sheng
authors.initials: JS
authors.lastname: Ye
authors.forename: Jian
authors.initials: J
authors.lastname: Xu
authors.forename: Wen-feng
authors.initials: WF
authors.lastname: Deng
authors.forename: Cong-xiang
authors.initials: CX
authors.lastname: Han
authors.forename: Gui-rong
authors.initials: GR
authors.lastname: Ye
authors.forename: Shao-jie
authors.initials: SJ
authors.lastname: Fu
authors.forename: Chuan-fu
authors.initials: CF
authors.lastname: Du
authors.forename: Jun-jie
authors.initials: JJ
authors.lastname: Ma
authors.forename: Yi-bin
authors.initials: YB
authors.lastname: Wang
authors.forename: Xiao-you
authors.initials: XY
authors.lastname: Liu
authors.forename: Chuan-jiang
authors.initials: CJ
authors.lastname: Li
mesh_terms: 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