Simultaneous pancreas-kidney transplantation. Experience of the Doce de Octubre Hospital

Cir Esp (Engl Ed). 2018 Jan;96(1):25-34. doi: 10.1016/j.ciresp.2017.09.016. Epub 2017 Oct 28.
[Article in English, Spanish]

Abstract

Introduction: Simultaneous pancreas-kidney transplantation (SPKT) constitutes the therapy of choice for diabetes type1 or type2 associated with end-stage renal disease, because is the only proven method to restore normo-glicemic control in the diabetic patient.

Methods: Retrospective and descriptive study of a series of 175 patients who underwent SPKT from March 1995 to April 2016. We analyze donor and recipient characteristics, perioperative variables and immunosuppression, post-transplant morbi-mortality, patient and graft survival, and risk factors related with patient and graft survival.

Results: Median age of the donors was 28years and mean age of recipients was 38.8±7.3years, being 103 males and 72 females. Enteric drainage of the exocrine pancreas was performed in 113 patients and bladder drainage in 62. Regarding post-transplant complications, the overall rate of infections was 70.3%; graft pancreatitis 26.3%; intraabdominal bleeding 17.7%; graft thrombosis 12.6%; and overall pancreas graft rejection 10.9%. The causes of mortality were mainly cardiovascular and infectious complications. Patient survival at 1, 3 and 5-year were 95.4%, 93% and 92.4%, respectively, and pancreas graft survival at 1, 3 and 5-year were 81.6%, 77.9% y 72.3%, respectively.

Conclusions: In our 20-year experience of simultaneous pancreas-kidney transplantation, the morbidity rate, and 5-year patient and pancreas graft survivals were similar to those previously reported from the international pancreas transplant registries.

Keywords: Diabetes tipo 1; Diabetes tipo 2; Diabetic nephropathy; Nefropatía diabética; Pancreas transplantation; Pancreas-kidney transplantation; Trasplante de páncreas; Trasplante de páncreas-riñón; Type 1 diabetes; Type 2 diabetes.

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / surgery*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / surgery*
  • Diabetic Nephropathies / complications
  • Diabetic Nephropathies / surgery*
  • Female
  • Hospitals
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation*
  • Male
  • Pancreas Transplantation*
  • Retrospective Studies
  • Treatment Outcome