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Two hundred consecutive simultaneous pancreas-kidney transplants with bladder drainage
H W Sollinger1, R J Ploeg, D E Eckhoff
1Department of Surgery, University of Wisconsin School of Medicine, Madison.
Surgery
|October 1, 1993
Summary
Simultaneous pancreas-kidney (SPK) transplantation offers excellent long-term survival for diabetic patients, despite higher costs and morbidity. This procedure is the preferred choice for carefully selected individuals with diabetes.
Area of Science:
- Nephrology
- Transplantation Surgery
- Diabetology
Background:
- University of Wisconsin has performed 288 pancreas transplantations since 1982.
- This study reviews 200 consecutive simultaneous pancreas-kidney (SPK) transplantations over a 7-year period.
Purpose of the Study:
- To evaluate the outcomes of 200 consecutive SPK transplantations.
- To assess immediate posttransplant function, surgical and infectious complications, rejection rates, and long-term survival.
Main Methods:
- Retrospective review of 200 consecutive SPK transplantations performed between December 1985 and October 1992.
- Analysis of immediate graft function, surgical and infectious complications, rejection episodes, patient survival, and graft survival at 5 years.
Main Results:
- Immediate function was observed in all but four pancreas transplants.
- Five-year patient survival was 90.2%, kidney survival 80.3%, and pancreas survival 78.6%.
- 54 surgical complications and 678 infectious episodes (most common: urinary tract infection) were recorded; 15 patients died, primarily from infection.
Conclusions:
- SPK transplantation is associated with increased cost and morbidity compared to kidney transplantation alone.
- Excellent long-term survival and benefits for diabetic complications support SPK as the procedure of choice for carefully selected diabetic patients.