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A 3-Year Experience

David Shaffer, MD; Peter N. Madras, MD; Anthony I. Sahyoun, MD; Mark E. Williams, MD; Anthony Kaldany, MD; John A. D'Elia, MD; Anthony P. Monaco, MD

Arch Surg. 1992;127(5):574-578.

Abstract
• Between May 1988 and September 1991, we performed 26 simultaneous kidney and pancreas transplants and one pancreas transplant after a kidney transplant. All transplants consisted of bladder drainage via a duodenal segment. Actuarial patient, kidney, and pancreas graft survival rates at 12 months were 96%, 88%, and 85%, respectively, and at 24 months were 96%, 88%, and 81%, respectively, and were not significantly different from those of diabetic recipients of cadaver kidney transplants alone. Excellent long-term glycemic control was obtained as monitored by fasting blood glucose and glycosylated hemoglobin levels and by oral glucose tolerance tests. The mean period of hospitalization and number of hospital admissions in the first year posttransplant were significantly greater for patients who received combined kidney and pancreas transplants than for those who received cadaver kidney transplants alone. Combined kidney and pancreas transplants can be performed with patient and graft survival comparable to those of kidney transplants alone, with excellent long-term glycemic control, but result in increased morbidity in the first postoperative year.

(Arch Surg. 1992;127:574-578)

Author Affiliations
From the Divisions of Organ Transplantation (Drs Shaffer, Madras, Sahyoun, and Monaco) and Nephrology (Drs Williams, Kaldany, and D'Elia), New England Deaconess Hospital and Harvard Medical School, Boston, Mass.

Footnotes
Accepted for publication January 25, 1992.

Presented at the 72nd Annual Meeting of the New England Surgical Society, Quebec City, September 28, 1991.

Reprint requests to Division of Organ Transplantation, New England Deaconess Hospital, 185 Pilgrim Rd, Boston, MA 02215 (Dr Shaffer).

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