Simultaneous kidney and pancreas transplantation at the San Raffaele Scientific Institute: clinical experience and results.

A. Secchi, R. Caldara, E. La Rocca, S. Martinenghi, M. Bernardi, D. Bonfatti, L. Caspani, R. Castoldi, G. Ferrari, G. Gallioli

Research output: Contribution to journalArticle

Abstract

Pancreas and kidney transplantation is performed in uremic IDDM patients to cure end-stage renal failure and diabetes. Seventy-two simultaneous kidney-pancreas transplantations were performed at our Institution between July 1985 and November 1994. All transplants were performed using heart-beating cadaver donors. The first 25 patients received 26 segmental pancreas according to Dubernard (KPS), whereas the last 46 patients received a whole, bladder-drained pancrea according to Sollinger (KPW). Mean pancreas cold and warm ischemia times were 294 +/- 14 and 44 +/- 2 minutes, respectively, in the KPS group and 660 +/- 37 and 40 +/- 8 minutes, respectively, in the KPW group. Twelve (48%) KPS patients and 19 (41%) KPW patients had postoperative pancreas surgical complications: vascular thrombosis led to graft failure in 5 KPS patients (20%) and 2 KPW patients (4%) (p = 0.01). Pancreatic fistula, hemorrhagic complications, and duodenum-bladder leakage were the surgical complications observed more frequently. Six KPS patients (24%) and 8 KPW patients (17%) underwent reintervention as a consequence of surgical complications. Fifteen KPS patients (60%) and 30 KPW patients (65%) experienced an acute kidney rejection episode, which was steroid-resistant in 14 KPW and 2 KPS patients. The actuarial survival rates for simultaneous kidney-pancreas recipients at one and 4 years were 92% and 84%, respectively, for KPS recipients, and 95% and 88%, respectively, for KPW patients. Kidney actuarial survival rates at one and 4 years were 96% and 76% respectively, for group KPS, and 93% and 89%, respectively, for KPW patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Original languageEnglish
Pages (from-to)255-263
Number of pages9
JournalClinical transplants
Publication statusPublished - 1994

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Pancreas Transplantation
Kidney Transplantation
Pancreas
Kidney
Urinary Bladder
Survival Rate
Pancreatic Fistula
Transplants
Cold Ischemia
Warm Ischemia
Type 1 Diabetes Mellitus
Duodenum
Cadaver
Chronic Kidney Failure

ASJC Scopus subject areas

  • Medicine(all)

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Simultaneous kidney and pancreas transplantation at the San Raffaele Scientific Institute : clinical experience and results. / Secchi, A.; Caldara, R.; La Rocca, E.; Martinenghi, S.; Bernardi, M.; Bonfatti, D.; Caspani, L.; Castoldi, R.; Ferrari, G.; Gallioli, G.

In: Clinical transplants, 1994, p. 255-263.

Research output: Contribution to journalArticle

Secchi, A, Caldara, R, La Rocca, E, Martinenghi, S, Bernardi, M, Bonfatti, D, Caspani, L, Castoldi, R, Ferrari, G & Gallioli, G 1994, 'Simultaneous kidney and pancreas transplantation at the San Raffaele Scientific Institute: clinical experience and results.', Clinical transplants, pp. 255-263.
Secchi, A. ; Caldara, R. ; La Rocca, E. ; Martinenghi, S. ; Bernardi, M. ; Bonfatti, D. ; Caspani, L. ; Castoldi, R. ; Ferrari, G. ; Gallioli, G. / Simultaneous kidney and pancreas transplantation at the San Raffaele Scientific Institute : clinical experience and results. In: Clinical transplants. 1994 ; pp. 255-263.
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abstract = "Pancreas and kidney transplantation is performed in uremic IDDM patients to cure end-stage renal failure and diabetes. Seventy-two simultaneous kidney-pancreas transplantations were performed at our Institution between July 1985 and November 1994. All transplants were performed using heart-beating cadaver donors. The first 25 patients received 26 segmental pancreas according to Dubernard (KPS), whereas the last 46 patients received a whole, bladder-drained pancrea according to Sollinger (KPW). Mean pancreas cold and warm ischemia times were 294 +/- 14 and 44 +/- 2 minutes, respectively, in the KPS group and 660 +/- 37 and 40 +/- 8 minutes, respectively, in the KPW group. Twelve (48{\%}) KPS patients and 19 (41{\%}) KPW patients had postoperative pancreas surgical complications: vascular thrombosis led to graft failure in 5 KPS patients (20{\%}) and 2 KPW patients (4{\%}) (p = 0.01). Pancreatic fistula, hemorrhagic complications, and duodenum-bladder leakage were the surgical complications observed more frequently. Six KPS patients (24{\%}) and 8 KPW patients (17{\%}) underwent reintervention as a consequence of surgical complications. Fifteen KPS patients (60{\%}) and 30 KPW patients (65{\%}) experienced an acute kidney rejection episode, which was steroid-resistant in 14 KPW and 2 KPS patients. The actuarial survival rates for simultaneous kidney-pancreas recipients at one and 4 years were 92{\%} and 84{\%}, respectively, for KPS recipients, and 95{\%} and 88{\%}, respectively, for KPW patients. Kidney actuarial survival rates at one and 4 years were 96{\%} and 76{\%} respectively, for group KPS, and 93{\%} and 89{\%}, respectively, for KPW patients.(ABSTRACT TRUNCATED AT 250 WORDS)",
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AU - Secchi, A.

AU - Caldara, R.

AU - La Rocca, E.

AU - Martinenghi, S.

AU - Bernardi, M.

AU - Bonfatti, D.

AU - Caspani, L.

AU - Castoldi, R.

AU - Ferrari, G.

AU - Gallioli, G.

PY - 1994

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N2 - Pancreas and kidney transplantation is performed in uremic IDDM patients to cure end-stage renal failure and diabetes. Seventy-two simultaneous kidney-pancreas transplantations were performed at our Institution between July 1985 and November 1994. All transplants were performed using heart-beating cadaver donors. The first 25 patients received 26 segmental pancreas according to Dubernard (KPS), whereas the last 46 patients received a whole, bladder-drained pancrea according to Sollinger (KPW). Mean pancreas cold and warm ischemia times were 294 +/- 14 and 44 +/- 2 minutes, respectively, in the KPS group and 660 +/- 37 and 40 +/- 8 minutes, respectively, in the KPW group. Twelve (48%) KPS patients and 19 (41%) KPW patients had postoperative pancreas surgical complications: vascular thrombosis led to graft failure in 5 KPS patients (20%) and 2 KPW patients (4%) (p = 0.01). Pancreatic fistula, hemorrhagic complications, and duodenum-bladder leakage were the surgical complications observed more frequently. Six KPS patients (24%) and 8 KPW patients (17%) underwent reintervention as a consequence of surgical complications. Fifteen KPS patients (60%) and 30 KPW patients (65%) experienced an acute kidney rejection episode, which was steroid-resistant in 14 KPW and 2 KPS patients. The actuarial survival rates for simultaneous kidney-pancreas recipients at one and 4 years were 92% and 84%, respectively, for KPS recipients, and 95% and 88%, respectively, for KPW patients. Kidney actuarial survival rates at one and 4 years were 96% and 76% respectively, for group KPS, and 93% and 89%, respectively, for KPW patients.(ABSTRACT TRUNCATED AT 250 WORDS)

AB - Pancreas and kidney transplantation is performed in uremic IDDM patients to cure end-stage renal failure and diabetes. Seventy-two simultaneous kidney-pancreas transplantations were performed at our Institution between July 1985 and November 1994. All transplants were performed using heart-beating cadaver donors. The first 25 patients received 26 segmental pancreas according to Dubernard (KPS), whereas the last 46 patients received a whole, bladder-drained pancrea according to Sollinger (KPW). Mean pancreas cold and warm ischemia times were 294 +/- 14 and 44 +/- 2 minutes, respectively, in the KPS group and 660 +/- 37 and 40 +/- 8 minutes, respectively, in the KPW group. Twelve (48%) KPS patients and 19 (41%) KPW patients had postoperative pancreas surgical complications: vascular thrombosis led to graft failure in 5 KPS patients (20%) and 2 KPW patients (4%) (p = 0.01). Pancreatic fistula, hemorrhagic complications, and duodenum-bladder leakage were the surgical complications observed more frequently. Six KPS patients (24%) and 8 KPW patients (17%) underwent reintervention as a consequence of surgical complications. Fifteen KPS patients (60%) and 30 KPW patients (65%) experienced an acute kidney rejection episode, which was steroid-resistant in 14 KPW and 2 KPS patients. The actuarial survival rates for simultaneous kidney-pancreas recipients at one and 4 years were 92% and 84%, respectively, for KPS recipients, and 95% and 88%, respectively, for KPW patients. Kidney actuarial survival rates at one and 4 years were 96% and 76% respectively, for group KPS, and 93% and 89%, respectively, for KPW patients.(ABSTRACT TRUNCATED AT 250 WORDS)

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