Enteric-portal venin drainage in simultaneous pancreas-kidney transplantation: a report of 4 cases

Abstract

Objective To discuss the surgical procedures and the clinical effects of the enteric-portal vein drainage in simultaneous pancreas-kidney (SPK) transplantation in the treatment of diabetes mellitus (DM) with end-stage renal disease (ESRD). Methods Enteric-portal vein drainage in SPK was performed on 4 patients with DM and chronic renal failure from May 2006 to September 2006. Multi-organ harvest (MOH) was carried out on 4 cases and duodenum artery of all donors received reconstruction. Donor's portal vein was anastomosed end to side with recipient's superior mesenteric vein. The abdominal aorta patch of celiac and superior mesenteric artery was anastomosed to recipient's external iliae artery through donor's iliac artery bypass. Donor's duodenuna was anastomosed with recipient's small intestine side to side.Immunosuppressant protocol was Tac-MMF-Pred. Results One case died at the 50th day post-operation due to intra-abdominal infection and MOSF. Three cases had excellent graft function by now. Canclusion Enteric-portal vein drainage in SPK (same side) bypassod through donor's iliac artery shows easier procedure, less severe trauma and wider scope of recipients. Moreover, one side of iliac artery is kept untouched, which will benefit the recipient' s second kidney transplantation when needed. Irfectious complications are the main cause of morbidity and mortality following SPK. Key words: Organ transplantation; Pancreas; Kidney; Arteriovenous anastomosis