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A retrospective monocenter review of simultaneous pancreas-kidney transplantation with bladder drainage in China Bi H; Hou XF; Ma LL; Luo KP; Wang GL; Zhao L; Liu YLChin Med J (Engl) 2011[Jan]; 124 (2): 205-9BACKGROUND: Simultaneous pancreas-kidney transplantation (SPKT) frees the diabetic patient with end-stage nephropathy from dialysis and daily insulin injections. Herein, we review consecutive cases of SPKT with bladder drainage performed at our institution over an 8-year period. METHODS: The study population included 21 patients (16 males and 5 females) who underwent SPKT between September 2001 and September 2009. Seven patients had type-1 diabetes and 14 had type-2 diabetes. Nineteen patients were on dialysis at the time of transplantation. Donation after cardiac death donors were selected for SPKT. The mean human leukocyte antigen match was 2 (range 0 - 4). SPKT was always performed using bladder drainage and vascular anastomoses to the systemic circulation. Immunosuppressive treatment consisted of anti-lymphocyte globulin induction followed by tacrolimus, mycophenolate mofetil, and prednisone. RESULTS: The mean hospital stay was 45.43 days. After a mean follow-up of 39.4 months, survival rates for patient, kidney, and pancreas were 76.2%, 76.2%, and 66.7% at 1 year; 76.2%, 59.3%, and 55.6% at 5 years; and 57.1%, 39.5%, and 41.7% at 8 years, respectively. Major complications included anastomotic leaks, reflux pancreatitis, and rejection. Six patients died from septic shock (n = 3), duodenal stump leak (1), cardiac arrest (1), or renal failure (1). Eight kidney grafts were lost due to acute rejection (n = 2), chronic rejection (3), and death with a functioning graft (3). Pancreatic graft failure (9) was caused by thrombosis (n = 1), rejection (2), duodenal stump leak (1), and death with a functioning graft (5). CONCLUSIONS: SPKT is a valid therapeutic option for uremic diabetics although few hospitals in China can undertake SPKT.|*Urinary Catheterization[MESH]|Adult[MESH]|Diabetes Mellitus, Type 1/surgery[MESH]|Diabetes Mellitus, Type 2/surgery[MESH]|Female[MESH]|Graft Rejection[MESH]|Humans[MESH]|Immunosuppressive Agents/therapeutic use[MESH]|Kidney Transplantation/adverse effects/mortality/*statistics & numerical data[MESH]|Male[MESH]|Middle Aged[MESH]|Pancreas Transplantation/adverse effects/mortality/*statistics & numerical data[MESH]|Postoperative Complications[MESH]|Retrospective Studies[MESH]|Treatment Outcome[MESH] |
