[Portal venous and enteric drainage in simultaneous pancreas kidney transplantation].
OBJECTIVE
To summarize the initial experience of simultaneous pancreas kidney transplantation (SPK) with portal venous and enteric drainage.


METHODS
Between Jane 2001 and Jane 2003, SPK were performed in 5 patients. Systemic venous-enteric drainage (SED) was used in the first 2 patients and portal venous-enteric drainage (PED) in the last 3 cases. All patient were immunosuppressed with quadruple therapy, which included anti-CD25 mAb (Zenapax/Simulect) induction therapy, FK506, mycophenolate mofetil (MMF), and prednisone baseline therapy. The complications were analyzed.


RESULTS
Serum glucose and renal function of the 5 cases were normal and no further insulin was needed within 7 days post-operation. No technique complications such as duodenal fistula and thrombosis were observed, One episode of acute rejection of kidney allograft occurred in one patient with SED, and resolved with a bolus corticosteroids. One case with SED and one with PED were died of sepsis and FK506 toxicity 4 weeks after transplantation. The death occurred with functioning pancreas graft. No latter complications were observed in the 3 survived patients with excellent graft functions.


CONCLUSIONS
Both methods of SED and PED can be performed successfully and with no latter complications. But with its potential physiologic and immunologic advantages, PED might be a standard procedure for SPK.
Peng
Zhi-Hai
ZH
Department of General Surgery, First People's Hospital, Shanghai Jiaotong University, Shanghai 200080, China.
Xu
Jun-Ming
JM
Fan
Yu
Y
Xia
Qiang
Q
Chen
Guo-Qing
GQ
Zhu
Zhe-Cheng
ZC
Li
Ke
K
Qiu
Zheng-Jun
ZJ
Dai
Xue-Ming
XM
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007422:Intestines / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D016035:Pancreas Transplantation / Q000379:methods*; D011169:Portal Vein / Q000601:surgery; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014511:Uremia / Q000601:surgery