Outcomes of simultaneous pancreas-kidney transplant and pancreas transplant after kidney transplant in our institute：a single center experience

Abstract

【Objective】The outcome of simultaneous pancreas and kidney transplant (SPK) and pancreas transplant after kidney transplant (PAK) in our institution was studied.【Methods】The medical records of both types of transplants (5 SPK, 3 PAK) until April 2015 were retrospectively reviewed for patient characteristics, overall patient and survival rate of both organ grafts, and their postoperative complications.【Results】All patients has been suffered from type 1 diabetes for many years. The average waiting period for SPK was ranged from 22〜65 (median 30) months. The overall graft survival were 80％ in the kidney, and 100％ in the pancreas at each three point at 1-, 3- and 5-year post-SPK. On the other hand, they were 66.7％, 33.3％, 33.3％ in the kidney graft and 100％ in the pancreas at 1-, 3- and 5-year post-PAK. We explored pancreas graft thromboses in the early period of pancreas transplantation within one week. Six cases out of 8 cases developed graft thrombosis (3 in SPK, 3 in PAK). One case lost the pancreas graft in spite of the following antithrombotic therapy. One kidney graft developed minimal kidney graft infarction, however；the kidney graft function has not apparently affected. Another kidney graft lost the function according to the persistent pyelonephritis based on the empting dysfunction due to neurogenic bladder.【Conclusions】Our study showed that the overall pancreas graft survival rate in SPK was slightly superior to that in PAK and great care about graft thrombosis after pancreas transplant in part in case of PAK. The overall kidney graft survival rate was good in SPK and PAK. The other complication such as neurogenic bladder dysfunction should be evaluated and managed properly.