ABSTRACT
Since the introduction of pancreas transplantation more than 40 years ago, surgical techniques and immunosuppressive regiments have improved and both have contributed to increase the number and success rate of this procedure. However, graft survival corresponds to early diagnosis of organ-related complications. Thus, knowledge of the transplantation procedure and postoperative image anatomy are basic requirements for radiologists. In this article, we demonstrate the imaging spectrum of pancreas transplantation with enteric exocrine drainage.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Anastomosis, Surgical/methods , Diagnostic Imaging/methods , Drainage/methods , Graft Rejection/pathology , Graft Survival , Iliac Artery/diagnostic imaging , Immunosuppressive Agents , Kidney Transplantation , Medical Illustration , Mesenteric Artery, Superior/diagnostic imaging , Pancreas/blood supply , Pancreas Transplantation/adverse effects , Pancreatitis, Graft/etiology , Portal Vein/diagnostic imaging , Postoperative Complications/diagnostic imaging , Postoperative Hemorrhage/etiology , Survival RateABSTRACT
Purpose: Aim of this study is to review the simultaneous pancreas and kidney transplantation (SPK) cases performed in Seoul National University Hospital for DM nephropathy patients. Methods: Medical records of the SPK recipients from April 2002 to February 2006 were reviewed and analyzed retrospectively. Results: There were 10 cases of SPK transplantation in SNUH from April 2002 to February 2006, which were composed of 8 type II DM patients and 2 type I DM patients. We experienced 1 operative mortality case and 3 acute rejection cases. All the acute rejection cases were recovered by steroid pulse therapy. We performed two graft pancreatectomy operations due to CMV infection followed by duodenal perforation and severe graft pancreatitis with pancreatic leakage. With the exception of 1 mortality case and 2 graft loss cases, all 7 patients stopped insulin and oral hypoglycemic agent and are keeping blood glucose level within normal range. Conclusion: Although patient follow-up is limited up to four years, SPK recipients are free from insulin use and show good graft functions. SPK could be a good treatment modality for insulin dependent type II DM nephropathy patients.