A retrospective monocenter review of simultaneous pancreas-kidney transplantation.
OBJECTIVE
Herein we have reviewed a consecutive series of simultaneous pancreas-kidney (SPK) transplantations performed at our institution over a 6-year period.


METHODS
The study population included 22 patients (15 males and 7 females) who underwent SPK transplantation between 2001 and 2007. The mean recipient age was 47 years (range, 26-63 years). Eighteen patients suffered type 1 and 4 type 2 diabetes mellitus. The mean donor age was 33 years (range, 14-56 years). The mean HLA match was 2.1 (range, 1-5). Immunosuppressive treatment consisted of basiliximab induction followed by tacrolimus, mycophenolate mofetil, and prednisone.


RESULTS
The mean hospital stay was 20 days (range, 11-52 days). After a mean follow-up of 44 months (range, 17-88 months), patient, kidney, and pancreas graft survivals were 86%, 82%, and 73%, respectively. Two patients died in the immediate postoperative period due to, respectively, disseminated intravascular coagulation and pulmonary embolism. A kidney graft was lost due to early hyperacute rejection. Other early complications associated with the pancreas graft included 2 cases of immediate reperfusion defects that led to early vascular thrombosis in 1 patient and a duodenal graft fistula in the other patient; a third patient developed type 2 diabetes mellitus. Beyond the postoperative period, graft loss was limited to 1 case of noncompliance to the immunosuppressive medications and 1 death secondary to pulmonary infection with a functional allograft after 4 years.


CONCLUSIONS
SPK transplantation is a valid therapeutic option for patients with insulin-dependent diabetes mellitus and renal failure due to diabetic nephropathy. The main complications of SPK transplantation occur in the immediate postoperative period consequent to vascular or rejection processes.
Department of Abdominal Surgery and Transplantation, CHU de Liège, University of Liège, B4000 Liège, Belgium.
E
E
Decker
C
C
Coimbra
L
L
Weekers
O
O
Detry
P
P
Honoré
J-P
JP
Squifflet
M
M
Meurisse
A
A
De Roover
D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000077552:Basiliximab; D001786:Blood Glucose / Q000378:metabolism; D002102:Cadaver; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000601:surgery; D003928:Diabetic Nephropathies / Q000601:surgery*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000276:immunology / Q000706:statistics & numerical data*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D014019:Tissue Donors / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult
D000911:Antibodies, Monoclonal; D001786:Blood Glucose; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab