Abstract:

BACKGROUND: Simultaneous pancreas-kidney transplantation (SPKT) is a valid therapeutic option for the diabetic end stage nephropathy patients. However, there are few centers carry out SPKT due to transplantation complex and various complications.
OBJECTIVE: To summarize our clinical experience of long-term surviving in SPKT, and to discuss the long-term outcome and its impact factors of SPKT with bladder drainage of pancreatic secretion.
METHODS: The study population included 15 patients who underwent SPKT. The mean human leukocyte antigen match was 2.13. SPKT was always performed using bladder drainage and vascular anastomoses to the systemic circulation. Immunosuppressive treatment consisted of anti-lymphocyte globulin induction followed by tacrolimus, mycophenolate mofetil, and prednisone. The renal function, blood sugar, amylzyme and complications were observed after transplantation.
RESULTS AND CONCLUSION: The mean hospital stay was 37.7 (13-82) days. After surgery, pancreas functions of 13 patients recovered well, while 2 cases’ pancreas was removed immediately. Except for one case’s renal delayed graft function, all the other renal function recovered immediately. After a mean follow-up of 48.2 (8.5-105.5) months, because of chronic rejection, 2 cases lost their pancreas and kidney functions. Major complications included rejection, reflux pancreatitis and thrombosis. SPKT is a safe but valid therapeutic option for the diabetic end stage nephropathy patients. A perfect perioperative management, prevention and in time manipulation of complications, and suitable utilization of immunosuppressant are key factors affect long-term survivals of transplantation.