title: [Simultaneous kidney and pancreas transplantation (SKPT) in patients with type 1 diabetes and chronic renal failure: experience in 12 patients in Chile].
abstract: BACKGROUND
  Simultaneous kidney and pancreas transplantation (SKPT) is the best alternative for end stage renal disease among patients with insulin dependent diabetes mellitus.
  
  
  OBJECTIVE
  To report our experience with SKPT.
  
  
  METHODS
  Retrospective analysis of 12 recipients of SKPT transplanted in one center starting in 1994, with a mean follow-up period of 6.8 years (2-15).
  
  
  RESULTS
  Eleven of 12 recipients were in chronic hemodialysis before SKPT. Mean A, B, DR and HLA mismatch was 4.3. Mean preformed anti HLA antibodies was 3.3 %. Mean cold ischemia times for pancreas and kidney were 6 and 10 hours, respectively. In the first eight cases, the pancreas was drained to the bladder, and in the last four, an enteric drainage was performed. Eleven recipients were induced with antibodies, and maintenance immunosuppression consisted of cyclosporin or tacrolimus plus an antiproliferative agent. Ten year patient survival was 70%. Pancreas and kidney survival, defined by insulin and dialysis independence, were 72 and 73% respectively. Fifty percent of recipients experienced acute graft rejection (cellular or humoral), with good response to treatment except in one case.
  
  
  CONCLUSIONS
  This experience shows that SKPT is associated with an excellent patient survival associated to insulin and dialysis independence in 70% of patients at 10 years.
authors.affiliation: Centro de Trasplantes Clínica Las Condes, Lo Fontecilla 441, Santiago, Chile.
authors.forename: Andrea
authors.initials: A
authors.lastname: Alba
authors.forename: Jorge
authors.initials: J
authors.lastname: Morales
authors.forename: Mario
authors.initials: M
authors.lastname: Ferrario
authors.forename: Carlos
authors.initials: C
authors.lastname: Zehnder
authors.forename: Jorge
authors.initials: J
authors.lastname: Aguiló
authors.forename: Carlos
authors.initials: C
authors.lastname: Zavala
authors.forename: Cristina
authors.initials: C
authors.lastname: Herzog
authors.forename: Lorena
authors.initials: L
authors.lastname: Calabran
authors.forename: Luis
authors.initials: L
authors.lastname: Contreras
authors.forename: Ricardo
authors.initials: R
authors.lastname: Espinoza
authors.forename: Erwin
authors.initials: E
authors.lastname: Buckel
authors.forename: Juan Alberto
authors.initials: JA
authors.lastname: Fierro
mesh_terms: D000328:Adult; D002677:Chile; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology / Q000601:surgery*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000401:mortality*; D016896:Treatment Outcome