2023 年 58 巻 2 号 p. 83-91
Despite the high number of marginal donors, the results of pancreas transplantation in Japan are excellent. The results of kidney transplantation from cadaver donors are also good. The pancreas and kidneys are often procured en bloc from brain-dead donors. Kidneys are procured not only from brain-dead donors but also from donors after circulatory death. For pancreas and kidney procurement from a brain-dead donor, the aorta and inferior vena cava are cannulated, cross-clamped, and perfused in situ with UW solution. The pancreas and kidneys are procured en bloc after the small intestine and liver are procured. On the back table, the pancreas and the two kidneys are separated. Thereafter, the kidneys are separated from each other. Regarding kidney procurement from donors after circulatory death, there are cases where a double-balloon catheter is placed before cardiac arrest and in situ perfusion is started immediately after cardiac arrest, and there are cases where cannulation is performed after laparotomy in the operating room. Both kidneys are collected together (en bloc) and separated on the back table.
