The current state of pancreas-kidney transplantation in China: the indications, surgical techniques and outcome.
It is currently estimated that 50 million Chinese have diabetic mellitus (DM) with more than 90% of these being afflicted with type 2 DM. Concomitantly, the socio-economic improvements in China are supporting the adoption of pancreas-kidney transplantations as a treatment option for these patients. Recipient candidate pool has yet to be expanded and the final effect to be improved in clinical practice. To date, more than 250 pancreas-kidney transplants have been performed on patients with type 1 and type 2 DM. To improve the outcome, a new surgical technique that involves anastomosis of the graft duodenum to recipient jejunum side-to-side but not Roux-en-Y, has been devised for enteric drainage. Furthermore, the systemic venous drainage (SVD) has been used as the method of choice for endocrine secretions. Graft and recipient long-term survival in China was similar to that in America and Europe. Three-year survival rate of pancreas and kidney grafts was 92.2% and 90.2%, respectively, in our center. No difference in survival and graft function between type 1 and type 2 DM recipients was noted. It is concluded that pancreas-kidney transplantation is an effective way for the treatment of type 1 DM and some type 2 DM complicated with uremia.
Ming
Changsheng
C
Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430003, China. chshming@tom.com
Gong
Nianqiao
N
Chen
Xiaoping
X
D000714:Anastomosis, Surgical; D002681:China; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000150:complications / Q000601:surgery; D004322:Drainage / Q000379:methods; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D016035:Pancreas Transplantation / Q000379:methods*; D016896:Treatment Outcome; D014511:Uremia / Q000209:etiology / Q000601:surgery