دورية أكاديمية
Surgical complications are the main cause of pancreatic allograft loss in pancreas-kidney transplant recipients.
| العنوان: | Surgical complications are the main cause of pancreatic allograft loss in pancreas-kidney transplant recipients. |
|---|---|
| المؤلفون: | Sansalone CV; Kidney and Pancreas Transplantation Unit, Niguarda Hospital, Milan, Italy., Maione G, Aseni P, Mangoni I, De Roberto A, Soldano S, Minetti E, Broggi ML, Civati G |
| المصدر: | Transplantation proceedings [Transplant Proc] 2005 Jul-Aug; Vol. 37 (6), pp. 2651-3. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Science Inc Country of Publication: United States NLM ID: 0243532 Publication Model: Print Cited Medium: Print ISSN: 0041-1345 (Print) Linking ISSN: 00411345 NLM ISO Abbreviation: Transplant Proc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York, N.Y. : Elsevier Science Inc. Original Publication: New York Stratton. |
| مواضيع طبية MeSH: | Kidney Transplantation*/adverse effects , Kidney Transplantation*/mortality , Kidney Transplantation*/physiology, Diabetes Mellitus, Type 1/*surgery , Diabetic Nephropathies/*surgery , Intraoperative Complications/*epidemiology , Kidney Failure, Chronic/*surgery , Pancreas Transplantation/*physiology, Adult ; Drainage/methods ; Female ; Graft Survival ; Humans ; Male ; Middle Aged ; Pancreas Transplantation/adverse effects ; Pancreas Transplantation/mortality ; Patient Selection ; Retrospective Studies ; Survival Analysis ; Tissue Donors ; Treatment Failure ; Urinary Bladder/surgery |
| مستخلص: | We examined surgical complications among a group of diabetic type 1 patients (IDDM) with end-stage renal disease (ESRD) who had undergone pancreas-kidney transplantations (PK). Between October 1993 and August 2004, 70 SPK were performed using bladder (n = 14) or enteric (n = 56) drainage. Donors were selected according to standard criteria (mean age, 27.6 years; range, 17-49). All patients received cyclosporine-based immunosuppression. All pancreata functioned immediately, whereas 2 patients needed postoperative dialysis. Four patients (5.7%) lost their pancreatic graft due to vascular thrombosis; both patients underwent urgent allograft pancreaectomy and pancreas retransplantation (re-PT). One of them (1.4%) experienced a venous thrombosis and died due to a pulmonary embolism at 12 hours after re-PT. The other 3 patients had uneventful postoperative courses and were discharged with good pancreatic and renal function. Three patients in the bladder group (21.4%) had an anastomotic leak, which resolved with a bladder catheter. Four patients in the enteric group (7.1%) who experienced an anastomotic leak needed a second surgical procedure but in 3 of them allograft pancreatectomy was necessary. Relaparotomy was required in the other 3 patients due to hemorrhage (1 patient) or occlusion (2 patients). Acute rejection episodes, which occurred in 16 patients (22.8%), were treated with steroid boluses. With a mean follow-up of 72 months (range, 3-129), 2 patients have died at 8 and at 36 months, respectively, after SPK due to acute myocardial infarction (2.9%). Chronic rejection was the leading cause of pancreatic failure in 5 patients (7.1%) and of renal failure in 2 patients (2.8%). Patient, kidney, and pancreas survival rates were 95.8%, 92.9%, and 81.5%, respectively. Surgical complications were the leading cause of pancreatic allograft loss in IDDM and ESRD patients submitted to SPK. |
| تواريخ الأحداث: | Date Created: 20050927 Date Completed: 20060124 Latest Revision: 20061115 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.transproceed.2005.06.103 |
| PMID: | 16182775 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 0041-1345 |
|---|---|
| DOI: | 10.1016/j.transproceed.2005.06.103 |