title: [Simultaneous pancreas-kidney transplantation: a single center experience on 148 cases].
abstract: OBJECTIVE
  To evaluate the outcome of simultaneous pancreas transplantation (SKPT) focusing on the surgical technique applied.
  
  
  METHODS
  One hundred forty-eight patients were submitted to SKPT 33 with segmental pancreas with duct occlusion (from 1985 to 1990), 77 with whole pancreas with bladder diversion (from 1990 to 1998) and 38 whole pancreas with enteric diversion (29 with systemic and 9 with portal drainage) (from 1998 to December 2001).
  
  
  RESULTS
  Patient survival was 92%, 82%, 63% at 1, 5, and 10 years respectively. Kidney survival was 87%, 75%, and 48% at 1, 5, 10 years. Pancreas graft survival was 71%, 58%, and 46% at 1, 5, 10 years. In the enteric diversion group patient, kidney, pancreas survival at one year was 93%, 92%, and 75%. A positive effect on patient survival was evident in enteric diversion versus duct occlusion group (p = 0.03), but not versus bladder diversion group and on pancreas graft survival in enteric diversion versus duct occlusion group (p < 0.01).
  
  
  CONCLUSIONS
  These data suggest that SKPT has become a successful intervention for patients with type I diabetes and end stage renal disease. Reasons for these improvements include improved donor and patient selection criteria, refinements in surgical technique and better immunosuppression.
authors.affiliation: Università Vita - Salute - IRCCS San Raffaele, Dipartimento Assistenziale di Scienze Chirurgiche, Milano, Italia. elenaors@libero.it
authors.forename: E
authors.initials: E
authors.lastname: Orsenigo
authors.forename: M
authors.initials: M
authors.lastname: Cristallo
authors.forename: C
authors.initials: C
authors.lastname: Socci
authors.forename: R
authors.initials: R
authors.lastname: Castoldi
authors.forename: E
authors.initials: E
authors.lastname: La Rocca
authors.forename: D
authors.initials: D
authors.lastname: Invernizzi
authors.forename: P
authors.initials: P
authors.lastname: Fiorina
authors.forename: A
authors.initials: A
authors.lastname: Beneduce
authors.forename: A
authors.initials: A
authors.lastname: Secchi
authors.forename: C
authors.initials: C
authors.lastname: Staudacher
authors.forename: V
authors.initials: V
authors.lastname: Di Carlo
mesh_terms: D000328:Adult; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D016035:Pancreas Transplantation / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D013997:Time Factors