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Experience with simultaneous pancreas-kidney transplantation.
H W Sollinger1, R J Stratta, A M D'Alessandro
1Department of Surgery, University of Wisconsin School of Medicine, Madison.
Annals of Surgery
|October 1, 1988
Summary
Simultaneous pancreas-kidney transplants offer excellent outcomes for Type I diabetes patients, achieving high graft survival rates and insulin independence. This combined approach enhances pancreas allograft survival without compromising kidney function.
Area of Science:
- Transplantation immunology
- Endocrinology
- Surgical innovation
Background:
- Vascularized pancreas transplantation is gaining renewed interest due to surgical advancements.
- Type I diabetes mellitus (IDDM) necessitates long-term management and can lead to complications.
Purpose of the Study:
- To evaluate the outcomes of simultaneous pancreas-kidney transplantation.
- To assess the impact of combined transplantation on allograft survival and patient recovery.
Main Methods:
- 30 whole-organ vascularized pancreas transplants were performed with kidney transplants between December 1986 and April 1988.
- Patients received immunosuppression including cyclosporine, prednisone, azathioprine, and Minnesota antilymphoblast globulin (MALG).
Main Results:
- All 30 patients achieved immediate insulin independence.
- Two-year actuarial patient survival was 96.3%, with kidney and pancreas graft survival rates of 94.0% and 84.0%, respectively.
- Mean serum creatinine was 1.75 mg/dl, indicating preserved renal function.
Conclusions:
- Simultaneous pancreas-kidney transplantation significantly improves pancreas allograft survival.
- Combined transplantation does not negatively impact renal allograft survival.
- This procedure is recommended as the primary treatment for Type I diabetic patients.