Development and results of a novel pancreas transplant program in Spain: the surgeon's point of view.

Autor: Muñoz-Bellvis L; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Salamanca, Salamanca, España; Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Salamanca, España. Electronic address: luismb@usal.es., Esteban MDC; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Salamanca, Salamanca, España; Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Salamanca, España., Iglesias M; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Salamanca, Salamanca, España; Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Salamanca, España., González L; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Salamanca, Salamanca, España; Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Salamanca, España., González-Muñoz JI; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Salamanca, Salamanca, España; Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Salamanca, España., Muñoz-González C; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Salamanca, Salamanca, España; Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Salamanca, España., E Quiñones J; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Salamanca, Salamanca, España; Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Salamanca, España., Tabernero G; Servicio de Nefrología, Hospital Universitario de Salamanca, Salamanca, España., Iglesias RA; Servicio de Endocrinología, Hospital Universitario de Salamanca, Salamanca, España., Sayagués JM; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Salamanca, Salamanca, España; Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Salamanca, España., Fraile P; Servicio de Endocrinología, Hospital Universitario de Salamanca, Salamanca, España.
Jazyk: English; Spanish; Castilian
Zdroj: Cirugia espanola [Cir Esp (Engl Ed)] 2018 Apr; Vol. 96 (4), pp. 205-212. Date of Electronic Publication: 2018 Feb 28.
DOI: 10.1016/j.ciresp.2017.12.006
Abstrakt: Introduction: Simultaneous kidney-pancreas transplantation for patients with type 1 diabetes and end-stage chronic renal disease is widely performed. However, the rate of surgical morbidity from pancreatic complications remains high. The aim of this study was to describe the development and results of a new program, from the point of view of the pancreatic surgeon.
Methods: We analyzed 53 simultaneous kidney-pancreas transplantations performed over a period of seven years (2009-2016), with a median follow up of 39 months (range: 1-86 months).
Results: Out of the total of this series, two patients died: one patient because of cardiac arrest immediately after surgery; and another patient due to traffic accident, complicated by pneumonia. Among the 51 living patients, two grafts were lost: one due to chronic rejection four years after transplantation; and the other due to arterial thrombosis 20 days after transplantation (the only case requiring transplantectomy). In ten patients, one or more re-operations were necessary due to the following: graft pancreatitis (n=4), small intestinal obstruction (n=4), arterial thrombosis (n=1), fistula (n=1) and hemoperitoneum (n=1). Overall patient and graft survival rates after 1, 3 and 5 years were 98, 95 and 95% and 96, 93 and 89%, respectively.
Conclusions: This study has shown that the results of a new pancreas transplant program, which relies on the previous experience of other groups, do not demonstrate a learning curve. Adequate surgeon education and training, as well as the proper use of standardized techniques, should ensure optimal results.
(Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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