Simultaneous pancreas and kidney transplantation for 5 patients with diabetesplus end-stage renal disease

Abstract

Objective To reduce the perioperative complications of simultaneous pancreas and kidney transplantation (SPK) and boost the clinical efficacy by exploring its perioperative management in diabetics with end-stage renal disease. Methods Retrospective analysis was performed for the clinical data of 5 diabetics with end-stage renal disease undergoing SPK since 2017. Results The cold ischemic time of all allografts was under 8 hours. No surgical complications occurred in recipients post-transplantation. Two patients were complicated with hyperkalemia and their serum potassium levels normalized after treatment. One case of bleeding in abdominal cavity was cured conservatively. Renal functions of two patients with delayed renal function post-transplantation gradually recovered after hematodialysis. One case of peritransplant fluid collection recovered after debridement and drainage. Another case of acute left heart failure and cardiac arrest at 45 days post-transplantation resumed normal heart rhythm after rescue. However, his consciousness could not be restored and his families gave up subsequent treatments. Transplanted kidneys and pancreases of these 4 patients normalized. Follow-up was conducted until March 20, 2019. They became insulin and dialysis independent and serum creatinine and blood glucose normalized. Diabetic complications were relieved and their quality-of-life also improved significantly. Conclusions SPK is an effective treatment for diabetics with end-stage renal disease. While maintaining normal serum creatinine and blood glucose, it may liberate patients from insulin dosing and dialytic maintenance, lower diabetic complications and improve quality-of-life. Key words: Simultaneous pancreas and kidney transplantation (SPK); Diabetes; End-stage renal disease; Perioperative management.