A retrospective monocenter review of simultaneous pancreas-kidney transplantation with bladder drainage in China / 中华医学杂志(英文版)
Chinese Medical Journal
; (24): 205-209, 2011.
Article
em En
| WPRIM
| ID: wpr-321469
Biblioteca responsável:
WPRO
ABSTRACT
<p><b>BACKGROUND</b>Simultaneous pancreas-kidney transplantation (SPKT) frees the diabetic patient with end-stage nephropathy from dialysis and daily insulin injections. Herein, we review consecutive cases of SPKT with bladder drainage performed at our institution over an 8-year period.</p><p><b>METHODS</b>The study population included 21 patients (16 males and 5 females) who underwent SPKT between September 2001 and September 2009. Seven patients had type-1 diabetes and 14 had type-2 diabetes. Nineteen patients were on dialysis at the time of transplantation. Donation after cardiac death donors were selected for SPKT. The mean human leukocyte antigen match was 2 (range 0 - 4). SPKT was always performed using bladder drainage and vascular anastomoses to the systemic circulation. Immunosuppressive treatment consisted of anti-lymphocyte globulin induction followed by tacrolimus, mycophenolate mofetil, and prednisone.</p><p><b>RESULTS</b>The mean hospital stay was 45.43 days. After a mean follow-up of 39.4 months, survival rates for patient, kidney, and pancreas were 76.2%, 76.2%, and 66.7% at 1 year; 76.2%, 59.3%, and 55.6% at 5 years; and 57.1%, 39.5%, and 41.7% at 8 years, respectively. Major complications included anastomotic leaks, reflux pancreatitis, and rejection. Six patients died from septic shock (n = 3), duodenal stump leak (1), cardiac arrest (1), or renal failure (1). Eight kidney grafts were lost due to acute rejection (n = 2), chronic rejection (3), and death with a functioning graft (3). Pancreatic graft failure (9) was caused by thrombosis (n = 1), rejection (2), duodenal stump leak (1), and death with a functioning graft (5).</p><p><b>CONCLUSIONS</b>SPKT is a valid therapeutic option for uremic diabetics although few hospitals in China can undertake SPKT.</p>
Texto completo:
1
Base de dados:
WPRIM
Assunto principal:
Complicações Pós-Operatórias
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Cirurgia Geral
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Cateterismo Urinário
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Estudos Retrospectivos
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Mortalidade
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Transplante de Rim
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Transplante de Pâncreas
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Resultado do Tratamento
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Usos Terapêuticos
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Diabetes Mellitus Tipo 1
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
Chinese Medical Journal
Ano de publicação:
2011
Tipo de documento:
Article