24 May 2019 : Original article
Comparison of Ipsilateral and Contralateral Simultaneous Pancreas and Kidney Transplantation: A Single-Center Analysis with 5-Year OutcomeStavros Papachristos1ACDEF*, Afshin Tavakoli1ABD, Raman Dhanda1B, Ravi Pararajasingam1AB, Tunde Campbell1BDE, Bence Forgacs1ABCDE
Ann Transplant 2019; 24:298-303
BACKGROUND: It is routine to implant the pancreas on the right and the renal graft on the left iliac fossa during a simultaneous kidney and pancreas transplant (cSPK). Ipsilateral placement of both organs on the same side raises concerns that the pancreas graft might compromise the distally placed kidney. However, ipsilateral SPK (iSPK) can be faster than the conventional contralateral graft placement and allows for preservation of the other side for future transplants.
MATERIAL AND METHODS: In a single unit, 67 SPK transplantations (cSPK n=49, iSPK n=18) were performed from 2008 to 2011. The decision for graft placement was made during the procedure. Donor and recipient demographics, surgical complications, reoperations, surgical time, and patient and graft survival with 5-year follow-up were compared between the 2 groups.
RESULTS: Duration of operation was shorter in the iSPK group. Recipient and donor demographics were comparable, apart from more females receiving ipsilateral graft placement. The broader female pelvis was probably the determining factor contributing to this outcome. The iSPK group included marginally younger recipients. The ipsilateral group also demonstrated a trend to improved survival of patient, pancreas, and kidney graft, at 1- and 5-year follow-up. There was no difference in complication rates between the 2 groups.
CONCLUSIONS: There were no significant differences in overall outcomes. iSPK is a safe procedure, which proves similar patient and graft survival as with cSPK. Both procedures have comparable surgical complication rates. iSPK is a safe and quicker procedure that allows for preservation of the contralateral side for potential subsequent transplants.
Keywords: Kidney Transplantation, Organ Transplantation, Pancreas Transplantation, Age Factors, Follow-Up Studies, Graft Survival, Middle Aged, operative time, Postoperative Complications, Sex Factors
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