Long-Term Efficacy of Simultaneous Pancreas and Kidney Transplantation in Liver Transplant Recipient.

Abstract

Long-term efficacy of simultaneous pancreas and kidney transplantation in liver transplant recipient Jian Zhou, Linwei Wu, Weiqiang Ju, Xiaoping Wang, Xingyuan Jiao, Xiaoshun He, Zhiyong Guo Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Chian Objective: To investigate the long-term clinical effect of simultaneous pancreas and kidney transplantation in liver transplant recipient for treatment of diabetes and renal failure. Methods: A retrospective summary of clinical data of 2 cases performed simultaneous pancreas kidney transplantation after liver transplantation. The operative method was that kidney graft was firstly transplanted in the left iliac fossa; and then pancreas transplantation, placed in the right iliac fossa. Pancreatic drainage was achieved by side to side anastomosis between duodenum graft and jejunum in recipient. Immunosuppression regimen consisted of methylprednisolone, IL-2 monoclonal antibody, tacrolimus (FK506) and mycophenolate mofetil (MMF) in case one, case two with antithymocyte globulin, methylprednisolone, FK506 and MMF. Results: Normal function of pancreas transplanted in all 2 patients at 10 days post-transplant was presented, and blood sugar dropped to normal without insulin therapy. The function of kidney recovered to normal at 1 week after operation, but creatinine in case 2 after 1 week post-transplant had gradually increased. Renal biopsy examination showed injury of kidney induced by drugs, after transferring FK506 to rapamycin, and the function of kidney was recovered. At present, 2 patients were followed up for 42 months and 15 months respectively, and the functions of liver, kidney and pancreas transplanted in recipient were normal. Conclusion: Performing simultaneous pancreas and kidney transplantation in liver transplant recipient was safe and feasible. Quadruple immunosuppression can obtain good function of grafts, and long-term survival of grafts and recipient could be achieved.