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学科主题: 临床医学
题名:
A retrospective monocenter review of simultaneous pancreas-kidney transplantation with bladder drainage in China
作者: Bi Hai; Hou Xiao-fei; Ma Lu-lin; Luo Kang-ping; Wang Guo-liang; Zhao Lei; Liu Ya-li
关键词: pancreas transplantation ; kidney transplantation ; survival rate ; postoperative complications
刊名: CHINESE MEDICAL JOURNAL
发表日期: 2011-01-20
DOI: 10.3760/cma.j.issn.0366-6999.2011.02.009
卷: 124, 期:2, 页:205-209
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: SINGLE-CENTER ; ENTERIC DRAINAGE ; FOLLOW-UP ; OUTCOMES ; COMPLICATIONS
英文摘要:

Background 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.

Methods 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.

Results 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).

Conclusions SPKT is a valid therapeutic option for uremic diabetics although few hospitals in China can undertake SPKT. Chin Med J 2011;124(2):205-209

语种: 英语
WOS记录号: WOS:000286787300009
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/62679
Appears in Collections:北京大学第三临床医学院_泌尿外科_期刊论文

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作者单位: Peking Univ, Hosp 3, Dept Urol, Beijing 100191, Peoples R China

Recommended Citation:
Bi Hai,Hou Xiao-fei,Ma Lu-lin,et al. A retrospective monocenter review of simultaneous pancreas-kidney transplantation with bladder drainage in China[J]. CHINESE MEDICAL JOURNAL,2011,124(2):205-209.
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