Outcome of simultaneous kidney pancreas transplantation: a single center analysis.

The aim of this study was to evaluate the outcome of simultaneous kidney pancreas transplantation (SKPT) by various surgical techniques. The 161 patients submitted to SKPT underwent the following: 36 pancreas with duct occlusion (from 1985 to 1989), 75 with whole pancreas with bladder diversion (from 1990 to 1998), and 50 whole pancreas with enteric diversion (40 with systemic and 10 with portal drainage) (from 1999 to September 2002). A positive effect on patient survival was evident using enteric diversion versus the duct occlusion group (P = .005), and versus the bladder diversion group (.035), and on pancreas graft survival in the enteric diversion versus the duct occlusion group (P < .028). These improvements may be due to refined donor and patient selection criteria, surgical technique, and immunosuppression.

[Diagnosis of pulmonary thromboembolism by transesophageal echocardiography. Report of a case]. / Diagnosi di tromboembolia polmonare mediante ecocardiografia transesofagea. Descrizione di un caso.

We describe the case of a 73-year-old man, admitted after several days of moderate dyspnea, followed by sincopal episode. Transesophageal echocardiography clearly demonstrated a high resolution image indicating thromboembolus of the proximal right main pulmonary artery. The patient's clinical conditions were moderately impaired; a treatment with heparin followed by warfarin was started. At 15 and 30 days interval, TEE controls were performed, showing an incomplete but evident resolution of pulmonary thromboembolism, associated to an improvement of clinical ECG and scintigraphic parameters. Our TEE observation, in accordance with the small number of similar observations reported in literature, showed a clear direct visualization with high resolutive diagnostic possibilities for pulmonary thromboembolism; successful resolution was confirmed by repeated TEE studies.