학술논문

Pancreas Transplantation: Small-Center Experience in Type 1 Diabetes Mellitus in a High-Incidence Region.
Document Type
Article
Source
Transplantation Proceedings. Sep2015, Vol. 47 Issue 7, p2169-2172. 4p.
Subject
*PANCREAS transplantation
*MEDICAL centers
*TYPE 1 diabetes
*MEDICAL care
*DISEASE complications
Language
ISSN
0041-1345
Abstract
Background Pancreas transplantation (PT) is the best option of care for patients with type I diabetes mellitus (T1DM). Methods From July 2005 to September 2014, we performed 27 PT from deceased donors (24 simultaneous pancreas-kidney transplantations [SPKT] and 3 pancreas transplantations alone) in a region with a high incidence of T1DM. Results Enteric drainage and systemic venous derivation were accomplished for all PT. Cold and warm ischemia times were 291 ± 70 minutes and 32 ± 9 minutes, respectively. The rate of early re-operations was 33%, mainly because of bleeding occurrence. Mean donor age was 31 ± 11 years; all patients had ABO compatibility and negative cross-match. With a mean follow-up time of 2.3 years, no death was registered. Graft survival of PT was 96.7%, with 1 graft loss in the SPKT group (3.7%) after acute rejection. Nine patients were submitted successfully to re-operation for no life-threatening complications within 30 post-operative days. No early or late episode of vascular thrombosis, pancreatitis, or pancreatic fistula was observed. All patients with a functioning graft had excellent metabolic control, with mean glycosylated hemoglobin level at last follow-up of 5.5% and median fasting glucose level of 95 ± 13 mg/dL, comparable to that in the non-diabetic population. Conclusions In our experience, PT is an excellent therapeutic solution for patients with T1DM. Despite fewer than 5 PT performed per year, graft and patient outcomes were similar to those in high-volume centers. [ABSTRACT FROM AUTHOR]