Short-term follow-up of 12 simultaneous pancreas-kidney transplantation / 中华器官移植杂志

ABSTRACT

Objective To summarize the short-term results of simultaneous pancreas-kidney transplantation (SPK) at a single center in China.Methods SPK was performed on 12 consecutive patients from Jan.2010 to July 2014.All patients had long-standing insulin-dependent diabetes mellitus (IDDM) and subsequent renal failure.Bladder drainage (BD) of exocrine secretion was used in the 10 cases and enteric drainage (ED) in 2 patients.The patients were treated with quadruple therapy,which included ATG or anti-CD25 monoclonal antibody induction therapy,prednisone,tacrolimus and mycophenolat-mofetil (MMF).Results The SPK was performed successfully in 10 cases.One patient accepted re-pancreas transplantation due to necrotizing pancreatitis.One patient suffered hemorrhage of bladder,accepted 3 times of embolization therapy and died due to lung infection.Ten patients achieved excellent renal function and euglycemia,and no further insulin treatment was given in 9.5 ± 4.2 days posttransplant.Fasting plasma glucose returned to normal in 14.2 ± 5.1 days.Serum creatinine returned to normal in 10.4 ± 6.5 days.The mean hospital stay was 21.4 ± 7.3 days.One biopsy-proven renal rejection episodes occurred in 14 days postoperation.Main complications included wound infections on the side of pancreatic graft,lymphorrhagia,tacrolimus toxicity and urinary tract infection.Conclusion SPK is an effective therapy of ESRD.Donated graft protection system foundation,refinement and individualized treatment posttransplantion may be the key factors for successful SPK.