Surgical Morbidity of Simultaneous Kidney and Pancreas Transplantation: A Single-Centre Experience in the Tacrolimus Era. (28th August 2012)

• Record Type: Journal Article
• Authors: Thwaites, Stephen E.; Lam, Vincent W. T.; Yao, Jinna; Kable, Kathy; Jenkins, Lillian; Chen, Cheng; Robertson, Paul; Hawthorne, Wayne J.; Ryan, Brendan J.; Pleass, Henry C.; Allen, Richard D. M.
• Other Names: Hess A. D. Academic Editor.; Rydzewski A. Academic Editor.
• Is Part Of: ISRN transplantation. Volume 2013(2013)
• Publication Date: 2012-08-28
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation of organs, tissues, etc; Transplantation -- Periodicals; Periodicals; 617.954
• DOI: 10.5402/2013/685850
• Languages: English
• ISSNs: 2314-4092

Abstract

Abstract : Introduction . Simultaneous pancreas and kidney (SPK) transplantation is performed to restore normoglycaemia and renal function in patients with Type I diabetes mellitus and end-stage renal failure. We aimed to evaluate the impact of major postoperative complications to patient and graft survival outcomes. Method . Using a prospectively collected database over a 10-year period, major postoperative complications requiring return to operating theatre as well as patient and graft survival outcomes were analysed retrospectively. Results . Between January 2001 and May 2010, 165 patients underwent first-time SPK transplantation. Median age of recipients was 39.8 years (range, 16.9–53.2). Enteric drainage was used in 149 patients, and bladder drainage was used in 16. Median follow-up time was 5.2 years (range 1.1–10.3). Fifty-six patients (34%) returned to operating theatre at least once. Pancreatic allograft loss secondary to vascular thrombosis occurred in 12 patients (7%), and 2 patients (1.2%) required transplant pancreatectomy due to debilitating pancreatic enzyme leaks. At 1 and 5 years, patient survival was 98% and 94%; pancreas graft survival, 86% and 77%; kidney graft survival 96% and 89%, respectively. Conclusion . SPK is a safe and effective treatment for Type I diabetes mellitus and end-stage renal failure although surgical reintervention is required in approximately one-third of patients. Preventing vascular thrombosis remains a major challenge.