title: Simultaneous cadaver pancreas-living donor kidney transplantation.
abstract: BACKGROUND
  The expansion of the donor pool achieved with living kidney donation (LKD) is particularly beneficial for diabetic patients, who have a worse prognosis during dialysis when compared to other kidney recipients. Simultaneous cadaver pancreas-living kidney transplantation (SPLKTx) merges the advantages of LKD with those of cadaver donation, and may be an attractive alternative to simultaneous pancreas kidney transplantation (SPKTx).
  
  
  METHODS
  The outcomes of 18 SPLKTx were compared with those of 33 SPKTx.
  
  
  RESULTS
  LKD expanded the donor pool from 33 to 51 (P =.004). Median wait time was shorter for SPLKTx (14 days) than for SPKTx (95 days) (P =.006). The risk for surgical complications was not increased by SPLKTx, as witnessed by relaparotomy rates (SPLKTx: 2/18, 11.1%; SPKTx: 2/33, 6.1%; P >.05). Hospital stay averaged 26.1 +/- 11.2 days for SPLKTx and 27.1 +/- 16.3 for SPKTx (P >.05) with equivalent 30-day readmission rates (SPLKTx: 5.5%; SPKTx: 6.1%); (P >.05). One acute kidney rejection occurred in SPLKTx (5.5%) as compared with four in SPKTx (12.1%); (P >.05). Equivalent rates for the pancreas were 5.5% (1/18) for SPLKTx and 3.0% (1/33) for SPKTx (P >.05). Two-year recipient survival rates were 100% for SPLKTx as compared with 96.9% for SPKTx. Equivalent figures for kidney and pancreas were 80.0% and 84.0% for SPLKTx and 96.9% and 96.9% for SPKTx.
  
  
  CONCLUSIONS
  SPLKTx is a valuable alternative to SPKTx. Further development of SPLKTX relies on increased rates of living kidney donation.
authors.affiliation: Divisione di Chirurgia Generale e Trapianti, Università di Pisa, Pisa, Italy.
authors.forename: U
authors.initials: U
authors.lastname: Boggi
authors.forename: F
authors.initials: F
authors.lastname: Vistoli
authors.forename: M
authors.initials: M
authors.lastname: Del Chiaro
authors.forename: S
authors.initials: S
authors.lastname: Signori
authors.forename: L
authors.initials: L
authors.lastname: Coletti
authors.forename: L
authors.initials: L
authors.lastname: Morelli
authors.forename: A
authors.initials: A
authors.lastname: Pietrabissa
authors.forename: C
authors.initials: C
authors.lastname: Moretto
authors.forename: M
authors.initials: M
authors.lastname: Barsotti
authors.forename: P
authors.initials: P
authors.lastname: Marchetti
authors.forename: G
authors.initials: G
authors.lastname: Rizzo
authors.forename: F
authors.initials: F
authors.lastname: Mosca
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002102:Cadaver; D002423:Cause of Death; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology; D007902:Length of Stay; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000502:physiology; D012086:Reoperation; D012189:Retrospective Studies; D014019:Tissue Donors / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D003404:Creatinine