The Prevalence of Prostate Cancer in Organ Donors With Increased Prostate-Specific Antigen.

Elevated prostate-specific antigen (PSA) levels were found in 139 of 472 kidney donors from our transplant center tested between 2009 and 2022, representing 29%. The mean age of these donors was 47.3 years. PSA values ranged from 2.8 to 160.4 ng/mL (mean 13.9 ng/mL). The recommended range is <2.5 ng/mL. Prostate histopathologic examination was performed in 38 of the 139 (27%). We found 14 cases of prostate cancer (PCa), with Gleason 3+3 in 8 cases, 3+4 in 4 cases (one donor disqualification), 1 case Gleason 4+3 (donor disqualification), and 1 case Gleason 4+5 (donor disqualification). Thirty-three patients met the criteria, were aged ≥50 years, and had a PSA level >10 mg/mL. Of these, prostate histopathologic examination was performed in 24 cases. PCa was found in 10 cases (42%). There was no difference between donors ≥50 years of age, with PSA>10 ng/mL with and without pathomorphologic diagnosis of PCa regarding age (mean 60.4 vs 60.6 years), creatinine clearance according to the Cockroft-Gaulta formula (mean 101.6 vs 94.8 mL/min) and PSA levels (mean 34.1 vs 29.3 ng/mL). Among other donors with PCa, 3 were <50 years with PSA >10 ng/mL, and 1 was ≥50 years with PSA<8 ng/mL. Kidneys from donors with PCa were transplanted into 10 men and 9 women. Follow-up time was 1 to 10 years. No cases of PCa transmission were reported. One of the recipients died of neoplasm-breast cancer. Donors ≥50 years of age with PSA>10 ng/mL have a higher risk for Pca. Accepting donors with Pca (Gleason 3+3 and 3+4) possesses minimal risk for transmission. All donors ≥50 years with increased PSA require further diagnostic procedures (eg, digital rectal examination, ultrasound, and eventually histologic examination).

Results of pancreaticogastrostomy after pancreaticoduodenectomy in 159 consecutive cases.

BACKGROUND: Pancreaticogastrostomy has been known as a method of reconstruction after pancreaticoduodenectomy for almost 60 years. According to some published reports, the pancreatic fistula rate for pancreaticogastrostomy is low. The purpose of this study is to present the results of pancreaticogastrostomy after pancreaticoduodenectomy at one department of our university hospital. METHODS: From 1994 to 2004, 159 patients underwent pancreaticoduodenectomy. Whipple procedures were performed in 125 cases and 34 underwent pylorus-preserving modification. In all of them, pancreaticogastrostomy was the method of choice for pancreatic-enteric anastomosis. The main outcome measures were postoperative morbidity and mortality. RESULTS: There were 56 patients (35%) who developed postoperative complications. 20 of them were reoperated due to pancreatic fistula (4), pancreatic fistula and biliary stenosis (1), biliary leak (2), enteric anastomosis leak (1), hemorrhage from the pancreaticogastric anastomosis (6), intra-abdominal bleeding (2), abdominal abscess (2) and evisceration (2). The other 36 patients were managed conservatively. The appearance of pancreatic fistulas had a statistically significant influence on the duration of hospitalization only. Six patients (3.7%) died. Two of them had pancreatic fistula. CONCLUSION: We recommend pancreaticogastrostomy as a simple and safe method of reconstruction after pancreatico- duodenectomy with low mortality and morbidity rates. and IAP.