Simultaneous En-bloc Kidney and Pancreas Transplantation (SEBKP) from Pediatric Donors: Selection, Surgical Strategy, Management and Outcomes.

IF 8.9 2区 医学 Q1 SURGERY American Journal of Transplantation Pub Date : 2024-11-18 DOI:10.1016/j.ajt.2024.11.016
Riccardo Tamburrini, Ching-Yao Yang, Jennifer L Philip, Nikole A Neidlinger, Dixon B Kaufman, Jon S Odorico
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Abstract

Pediatric donors are underutilized for simultaneous pancreas-kidney transplantation (SPK) due to concern about technical complications and inadequate islet and/or renal mass. We analyzed our experience with simultaneous en-bloc kidney and pancreas transplantation (SEBKP) using pediatric donors on eight consecutive adult patients from 1997-2018. En-bloc kidney transplants were implanted intraperitoneally and contralaterally to right-sided pancreas grafts. All patients became insulin independent immediately; with one case of delayed kidney function and one case of insulin resistance; there were no graft thromboses. Donor age averaged 5.0±1.7 years and weight 19.8±4.8kg; recipients averaged 46.6±12.8 years and BMI 25.2±3.8kg/m2. Postoperative creatinine, glucose and c-peptide reflected good graft function. SEBKP transplantation is a safe technique providing excellent long-term glycemic control and kidney function to adult recipients.

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小儿捐献者肾胰同体移植(SEBKP):选择、手术策略、管理和结果。
由于担心技术并发症以及胰岛和/或肾脏质量不足,小儿供体在同步胰肾移植(SPK)中未得到充分利用。我们分析了 1997-2018 年间连续八名成年患者使用儿科供体进行肾胰同体移植(SEBKP)的经验。同种肾移植在腹腔内植入,与右侧胰腺移植对侧植入。所有患者均立即实现了胰岛素独立;其中一例出现肾功能延迟,一例出现胰岛素抵抗;无移植物血栓形成。供体平均年龄为(5.0±1.7)岁,体重为(19.8±4.8)公斤;受体平均年龄为(46.6±12.8)岁,体重指数为(25.2±3.8)公斤/平方米。术后肌酐、血糖和 c 肽反映了良好的移植功能。SEBKP 移植是一种安全的技术,可为成年受者提供良好的长期血糖控制和肾功能。
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来源期刊
CiteScore
18.70
自引率
4.50%
发文量
346
审稿时长
26 days
期刊介绍: The American Journal of Transplantation is a leading journal in the field of transplantation. It serves as a forum for debate and reassessment, an agent of change, and a major platform for promoting understanding, improving results, and advancing science. Published monthly, it provides an essential resource for researchers and clinicians worldwide. The journal publishes original articles, case reports, invited reviews, letters to the editor, critical reviews, news features, consensus documents, and guidelines over 12 issues a year. It covers all major subject areas in transplantation, including thoracic (heart, lung), abdominal (kidney, liver, pancreas, islets), tissue and stem cell transplantation, organ and tissue donation and preservation, tissue injury, repair, inflammation, and aging, histocompatibility, drugs and pharmacology, graft survival, and prevention of graft dysfunction and failure. It also explores ethical and social issues in the field.
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