Preliminary clinical experience of ipsilateral simultaneous pancreas and kidney transplantation

Abstract

Objective To preliminarily explore the clinical efficacy of ipsilateral simultaneous pancreas and kidney transplantation (SPK). Methods Ipsilateral SPK was performed in 40 patients from September 2016 to August 2018. During a follow-up period of 6 to 29 months, we summarized the efficacy and complications of the technique. Results Up to now, 38 patients achieved an exceelent clinical efficacy with no major surgical complications. However, two patients died of severe pneumonia. The postoperative serum levels of creatinine at 3, 6, 12, 24 months were 107, 102, 107, 110 umol/L; creatinine clearance rate 64, 67, 64, 63 ml/min; fasting glucose 4.6, 5.1, 4.6, 5.2 mmol/L; glycated hemoglobin 4.8%, 5.4%, 4.9%, 5.2% respectively. And 1/2-year pancrea and kidney graft survival rates both were 92%. Complications included kidney graft rejection (n=11), pancreas graft rejection (n=12), simultaneous renal & pancreas graft rejection (n=6), renal graft DGF (n=1), pulmonary infection (n=14), urinary tract infections (n=18), gastrointestinal bleeding (n=10) diarrhea (n=6), splenic venous thrombosis (n=2), incomplete ureteric obstruction of renal allograft (n=3), urine leakage (n=1) and pancreas allograft dysfunction (n=2). There were no severe surgical complications. After aggressive interventions, all postoperative complications were cured and none required excision of kidney or pancreas. Conclusions Ipsilateral SPK has definite therapeutic efficacy and it is worth wider popularization. Key words: Simultaneous pancreas and kidney transplantation; Ipsilateral; Renal graft function; Pancreas graft function; Operation complications