ABSTRACT
Background: Simultaneous kidney and páncreas transplantation (SKPT) is the best alternative for end stage renal disease among patients with insulin dependent diabetes mellitus. Aim: To report our experience with SKPT. Material andMethods: Retrospective analysis ofl2 recipients of SKPT transplanted in one center starting in 1994, with a meanfollow-upperiod of6.8years (2-15). Results: Eleven ofl2 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 percent. Mean cold ischemia times for páncreas and kidney were 6 and 10 hours, respectively. In the first eight cases, the páncreas 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 ofCyclosporine or Tacrolimusplus an antiproliferative agent. Ten year patient survival was 70 percent. Páncreas and kidney survival, defined by insulin and dialysis independence, were 72 and 73 percent 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 percent of patients at 10 years.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Diabetes Mellitus, Type 1/surgery , Kidney Failure, Chronic/surgery , Kidney Transplantation/mortality , Pancreas Transplantation/mortality , Chile , Diabetes Mellitus, Type 1/physiopathology , Epidemiologic Methods , Kidney Failure, Chronic/physiopathology , Kidney Transplantation/adverse effects , Pancreas Transplantation/adverse effects , Treatment OutcomeABSTRACT
Los ANCA son anticuerpos detectados frecuentemente en enfermedades autoinmunes, especialmente vasculitis. Su actividad se dirige contra diferentes estructuras citoplasmáticas de los neutrófilos. El presente artículo es una revisión de sus especificidades antigénicas, sus métodos de detección, sus correlaciones clínicas y su posible rol etiopatogénico en estas enfermedades