Surgical treatment of simultaneous pancreas-kidney transplantation： causes and outcomes

Abstract

Objective To analyze the complications, treatments and prognosis of simultaneous pancreas-kidney transplantation, especially on surgical complications and treatments. Method The causes and outcomes of surgical treatment in 70 cases of simultaneous pancreas-kidney transplantation performed between Dec. 1999 and June 2012 were retrospectively analyzed in our center. Result Sixteen patients （22. 9%） underwent one or more reoperations. The causes for reoperation were as follows： 2 cases of hematuria, 4 cases of abdominal hemorrhage, 4 cases of abdominal infection, 4 cases of pancreatic thrombosis, 2 cases of renal graft＇s artery rupture, 1 case of renal allograft rupture, 1 case of intestinal fistula, and i case of pancreatic fistula. Eight pancreas grafts were lost in the first year. Pancreateetomy was performed on the other 5 cases： 4 cases of pancreatic thrombosis, 1 case of intestinal fistula, accounting for 43.8% of the patients subject to reoperation. The recipients, kidney, pancreas survival rate in reoperation group at I year was 87. 5 %, 75 %, and 56. 3% respectively; and that in control group at 1 year was 98. 1%, 98. 1%, and 98. 1 % respectively. There was significant difference in kidney survival rate （P〈0. 01, chi-square = 6. 79）, and pancreas survival rate （P〈0. 01, chi-square = 17. 47） between two groups. Conclusion Although simultaneous pancreas-kidney transplantation provides a successful and effective treatment for diabetics with end-stage renal disease, surgical treatment due to complications is still an important factor in short-term survival on the grafts. Key words: Kidney transplantation; Pancreas transplantation; Combined transplantatiom Surgical complication; Diabetes; Surgical treatment