Challenges associated with pancreas and kidney retransplantation

  • Simultaneous pancreas and kidney transplantation (SPK) is an accepted treatment for diabetic patients with renal failure, and is associated with increased survival and quality of life for recipients. There are only a few publications on the outcomes of simultaneous pancreas–kidney retransplantation (Re-SPK) after previous SPK and the loss of function of both grafts. A total of 55 patients with type 1 diabetes mellitus underwent pancreas retransplantation at our center between January 1994 and March 2021. Twenty-four of these patients underwent Re-SPK after a previous SPK. All 24 operations were technically feasible. Patient survival rate after 3 months, 1 year, and 5 years was 79.2%, 75%, and 66.7%, respectively. The causes of death were septic arterial hemorrhage (\(\it n\) = 3), septic multiorgan failure (\(\it n\) = 2), and was unknown in one patient. Pancreas and kidney graft function after 3 months, 1 year, and 5 years were 70.8% and 66.7%, 66.7% and 62.5%, and 45.8% and 54.2%, respectively. Relaparotomy was performed in 13 out of 24 (54.2%) patients. The results of our study show that Re-SPK, after previously performed SPK, is a technical and immunological challenge, associated with a significantly increased mortality and complication rate; therefore, the indication for Re-SPK should be very strict. Careful preoperative diagnosis is indispensable.

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Metadaten
Author:Nina PillokeitGND, Sascha GrzellaGND, Panagiota ZgouraGND, Timm Henning WesthoffORCiDGND, Richard ViebahnORCiDGND, Peter SchenkerORCiDGND
URN:urn:nbn:de:hbz:294-85128
DOI:https://doi.org/10.3390/jcm10163634
Parent Title (English):Journal of clinical medicine
Subtitle (English):a retrospective analysis
Publisher:MDPI
Place of publication:Basel
Document Type:Article
Language:English
Date of Publication (online):2022/01/07
Date of first Publication:2021/08/17
Publishing Institution:Ruhr-Universität Bochum, Universitätsbibliothek
Tag:diabetes type 1; mortality; retransplantation; simultaneous pancreas-kidney transplantation
Volume:10
Issue:16, Article 3634
First Page:3634-1
Last Page:3634-13
Institutes/Facilities:Marienhospital Herne, Medizinische Klinik I
Knappschaftskrankenhaus Bochum, Chirurgische Klinik
Dewey Decimal Classification:Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit
open_access (DINI-Set):open_access
Licence (English):License LogoCreative Commons - CC BY 4.0 - Attribution 4.0 International