The optimized technique of excision, and finishing on donative pancreas / 中华器官移植杂志

ABSTRACT

Objective To explore the technology of excision,and finishing on donative pancreas during combined pancreas-kidney transplantation.Methods We successfully harvested multiple abdominal organs together on 40 cases.Wide surgical exposure was obtained.Cannulas were placed for in situ cooling in portal vein and abdominal aorta,and flushed with HC-A (2000 ml) and UW (1000 ml) with the pressure being 10 cm H2O.The intestine was flushed with 0～4 ( normal saline (1000 ml) and metronidazole (200 ml),the liver,kidney,pancreas,spleen and duodenum were en bloc excised and isolated,and the pancreas and kidney were pruned.Results Excision of donative abdominal organ was successfully performed on all 40 cases.The en bloc warm ischemic time was 3.2 min (2～5 min).The cold ischemic time of pancreas was 10.6 h (8～15 h).The cold ischemic time of kidney was 8.5 h (4～16 h).Post-operation mean withdrawal-insulin time was 9.5 days (4～17 d),FFG 6.7 μmol/L (4.4～10.7 μmol/L),GHbA1c 4.4 ％ (4.1 ％～4.7 ％).Creatine was 87.2 (56～121) μmol/L one month after operation.There were 2 cases of DGF after operation,and the creatine level was returned to the normal within one month after operation.Conclusion Technology of excision,preservation and finishing on donative pancreas for combined pancreas-kidney transplantation was one of the key points for successful transplantation.