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Simultaneous Pancreas and Kidney Composite Graft Transplantation with Retroperitoneal Systemic-Enteric Drainage

Shinichiro Ono, Tamotsu Kuroki, Amane Kitazato, Tomohiko Adachi, Yin-Yin Chen, Shin-Chin Chen, Susumu Eguchi, Yi-Ming Shyr, Shin-E Wang

(Departments of Surgery, Nagasaki University, Graduate School of Biomedical Sciences, Nagasaki, Japan)

Ann Transplant 2014; 19:586-590

DOI: 10.12659/AOT.891350


Background: Simultaneous pancreas and kidney transplantation is the treatment of choice for diabetes mellitus patients with associated end-stage renal disease. Limited vascular access could be encountered in patients with severe atherosclerosis, and/or severe obesity and in re-transplant patients. We describe a modified technique that facilitates simultaneous pancreas and kidney (SPK) composite graft transplantation with retroperitoneal systemic-enteric drainage for patients with limited vascular access.
Material and Methods: Since April 2012, we performed a modified technique for 2 patients with limited vascular access. SPK composite graft was constructed during the back-table preparation and transplanted in the right retroperitoneal space, finally covered by the ascending colon and its mesocolon.
Results: The 2 patients achieved good pancreas grafts function with normal blood glucose immediately after the completion of reperfusion. Their kidney grafts have also shown good function. They have not had any rejection episodes or postoperative complications after the SPK composite graft transplantation.
Conclusions: We propose that simultaneous pancreas and kidney composite graft transplantation with retroperitoneal systemic-enteric drainage can be a viable option for patients with limited vascular access.

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