title: Simultaneous pancreas-kidney transplantation: a single-center experience and prospective analysis.
abstract: In patients with end-stage chronic kidney disease (CKD) and type 1 diabetes mellitus (DM 1), simultaneous pancreas-kidney (SPK) transplantation is currently considered the gold standard therapy. The aim of this study was to analyze and report the long-term clinical outcomes of the 23 SPK transplantations performed at our institution over an 84-month period (January 1, 2000 to December 31, 2006). A prospective analysis of these patients included donor, recipient, and transplantation characteristics. The only requirements for transplantation were blood group compatibility and a negative cross-match. Bladder drainage via pancreaticoduodenocystostomy was performed in all of the patients. Due to a pulmonary embolus 1 patient (4.3%) died at 2 months. The actuarial patient survival rates at 3 months and 1, 3, and 5 years were 95.6%. Causes for the renal graft loss were chronic allograft nephropathy in 3 cases (13%) and death of the patient in 1 case (4.3%). The actuarial censored renal allograft survival rates at 3 months and at 1 year were 100%, and at 3 and 5 years were 91.3%. Causes for the renal graft loss were chronic rejection in 1 case (4.3%) and patient death in 1 case (4.3%). The actuarial censored pancreatic allograft survival rates at 3 months and at 1 and 3 years were 100%, and at 5 years was 95.6%. The results of this work add further evidence that SPK is the gold standard therapy for selected patients with end-stage CKD due to DM 1.
authors.affiliation: Chirurgia Generale e Trapianti d'Organo, La Sapienza Università di Roma, Umberto I Policlinico di Roma, Rome, Italy. m.rossi@uniroma1.it
authors.forename: M
authors.initials: M
authors.lastname: Rossi
authors.forename: Q
authors.initials: Q
authors.lastname: Lai
authors.forename: G
authors.initials: G
authors.lastname: Spoletini
authors.forename: L
authors.initials: L
authors.lastname: Poli
authors.forename: F
authors.initials: F
authors.lastname: Nudo
authors.forename: S
authors.initials: S
authors.lastname: Ferretti
authors.forename: F
authors.initials: F
authors.lastname: Della Pietra
authors.forename: F
authors.initials: F
authors.lastname: Pugliese
authors.forename: G
authors.initials: G
authors.lastname: Ferretti
authors.forename: G
authors.initials: G
authors.lastname: Novelli
authors.forename: R
authors.initials: R
authors.lastname: Pretagostini
authors.forename: P B
authors.initials: PB
authors.lastname: Berloco
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D001786:Blood Glucose