Transplantation proceedings · 2005
Donors with a maximum body weight of 50 kg for simultaneous pancreas-kidney transplantation.
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Schulz T, Schenker P, Flecken M, Kapischke M
Аннотация
INTRODUCTION: Pediatric donors are rarely used for simultaneous pancreas-kidney transplantation (SPK). But the age of the donors may be less important than the body weight (BW). Therefore we retrospectively analyzed our data on SPK donors with a maximum BW of 50 kg.
METHODS: Between June 1994 and December 2003, 22 patients received SPK transplants from cadaveric donors with a maximum BW of 50 kg (range, 25-50 kg; median, 42.4 kg). The median donor-recipient weight ratio was 0.61 (range, 0.47-0.91).
RESULTS: Two kidney grafts (9.1%) displayed delayed graft function (2 and 9 dialyses). One patient needed insulin for 2 days (<20 IU/d), and the other patient for 1 month at a maximum of 7 IU/d. Four pancreas grafts (18.2%) were lost owing to graft thrombosis. One-year survival for patients was 95.5%; for kidneys, 86.4%; and for the pancreas, 72.7%. After a median observation period of 78 months, 6 acute rejection episodes were observed in 5 patients (22.7%). Five acute rejections were treated successfully, but 1 patient lost both organs. Two patients died of severe infections, at 3 months and 3 years, respectively, after SPK. Four kidney and 3 pancreas grafts developed chronic allograft dysfunction.
CONCLUSIONS: Our results show that 1-year graft function in this series was less than the results reported to the International Pancreas Transplant Registry. The Main reason for early pancreas loss was graft thrombosis (18.2%). After a median observation period of 78 months, pancreas graft survival was 59.1%.
METHODS: Between June 1994 and December 2003, 22 patients received SPK transplants from cadaveric donors with a maximum BW of 50 kg (range, 25-50 kg; median, 42.4 kg). The median donor-recipient weight ratio was 0.61 (range, 0.47-0.91).
RESULTS: Two kidney grafts (9.1%) displayed delayed graft function (2 and 9 dialyses). One patient needed insulin for 2 days (<20 IU/d), and the other patient for 1 month at a maximum of 7 IU/d. Four pancreas grafts (18.2%) were lost owing to graft thrombosis. One-year survival for patients was 95.5%; for kidneys, 86.4%; and for the pancreas, 72.7%. After a median observation period of 78 months, 6 acute rejection episodes were observed in 5 patients (22.7%). Five acute rejections were treated successfully, but 1 patient lost both organs. Two patients died of severe infections, at 3 months and 3 years, respectively, after SPK. Four kidney and 3 pancreas grafts developed chronic allograft dysfunction.
CONCLUSIONS: Our results show that 1-year graft function in this series was less than the results reported to the International Pancreas Transplant Registry. The Main reason for early pancreas loss was graft thrombosis (18.2%). After a median observation period of 78 months, pancreas graft survival was 59.1%.