Whole pancreas transplantationTen Years of Simultaneous Pancreas-Kidney Transplantation: A Retrospective Single-Center Analysis of Prospectively Obtained Data
Section snippets
Patients and Methods
From 1999 to 2010 55 SPKs were performed in our center and data were prospectively obtained. All transplantations were performed using systemic-enteric drainage. The arterial anastomosis of superior mesenteric artery and splenic artery was performed using an arterial Y graft. The portal vein was sutured to the lower caval or iliac vein directly.4, 5 The immunosuppressive protocol included induction therapy with basiliximab (20 mg bolus) preoperative and on day 4, respectively. Maintenance
Statistical Analysis
SPSS program 19.0 for Windows (SPSS, Chicago, Ill, United States) was used for statistical analysis. Pancreas graft survival was calculated using the Kaplan-Meier method with statistical significance determined using the log-rank test based on the exact permutation distribution. P < 0.05 was considered significant. For the following parameters with potential influence on organ survival, univariate analyses were performed: P-PASS (</≥17), BMI (</≥25), and donor age (</≥30 years).
Results
In summary, 55 patients received SPK. The patients had suffered from IDDM 1 over a median duration of 27 years. The median duration of dialysis was 2 years. Further donor and recipient data as well as postoperative data are shown in Table 1.
The overall survival rate after 5 years was 83% and after 10 years was 78%. Pancreas graft survival rate was 59% after 5 years and 53% after 10 years. Three patients (5%) needed retransplantation of SPK and 6 patients (11%) needed singular pancreas
Discussion
Several studies have proven the advantage of SPK on patient survival.6, 7 Therefore, SPK should be considered, but suitable pancreas grafts are a scarce resource in the ET area.8, 9 In an effort to expand the donor pool, marginal grafts are accepted. By analyzing 3180 reported pancreas donors between 2002 and 2005, the ET Pancreas Advisory Committee developed the P-PASS.3 A score of <17 identifies an “ideal” donor; scores ≥17 reduce donor acceptance rates, but the impact of P-PASS on clinical
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Cited by (0)
D.B. Foltys and J.M. Kaths contributed equally to this publication.