Intestine-interior vena cava drainage with simultaneous pancreas-kidney transplantation

Abstract

0bjective To assess the operation procedure and the clinical effects of the intestine-interior vena cava drainage with simultaneous pancreas-kidney(SPK)transplantation. Methods Three patients with diabetes mellitus and chronic renal failure underwent intestine-vena cava drainage with simultaneous SPK transplantation.Multi-organ harvest(MOH)was performed in all 3 cases and all the donor'S duodenum artery accepted reconstruction.Donor's portal vein was anastomosed end to side with recipient's interior vena cava.The abdominal artery patch of celiac and superior mesenteric arterv was anastomosed to recipient'S external iliac artery through donor'S iliac artery bypass.Donor' s duodenal were anastomosed side to side with recipient's small intestine. Results A1l patients recovered smoothly and the grafts'function was perfect.Gastrointestinal bleeding occurred in one case 10 days after surgery and was considered as intestinal anastomosis bleeding.He was treated with con- servative treatment and recovered. Conclusions SPK(same side)bypassed through donor's iliac ar- tery shows easier manipulation，less severe trauma and wider scope of recipient.Moreover.one side of iliac artery is kept untouched which will benefit the recipient'S second kidney transplantation when needed.Simultaneously，interior vena cava drainage with simultaneous SPK provides a better anatomic angle of portal vein and splenic vein，which can possibly decrease the incidence of vein thrombosis. Key words: Simultaneous pancreas-kidney transplantation; Intestinal; Vena cava,inferior; Diabetes mellitus,type 2; Uremia