Renopancreatic Transplantation: Evaluation of 15 Years in 131 Patients
| Autor: | C.G. Marmanillo, R. Zamprogna, C. Langaro, J.E. Nicoluzzi, M. Luvizotto, M. Macri, M. Takahashi, R.T. Belila |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Basiliximab medicine.medical_treatment 030230 surgery 03 medical and health sciences 0302 clinical medicine Diabetes mellitus medicine Humans Diabetic Nephropathies Survival rate Cause of death Retrospective Studies Immunosuppression Therapy Transplantation Thymoglobulin business.industry Graft Survival Immunosuppression Middle Aged medicine.disease Combined Modality Therapy Kidney Transplantation Tacrolimus Surgery Survival Rate surgical procedures operative Diabetes Mellitus Type 1 Treatment Outcome 030211 gastroenterology & hepatology Female Pancreas Transplantation business Brazil medicine.drug |
| Zdroj: | Transplantation proceedings. 50(3) |
| ISSN: | 1873-2623 |
| Popis: | Background The most common multiple-organ transplant is the simultaneous pancreas-kidney transplantation (SPK). It is usually offered to patients who have insulin-dependent diabetes mellitus and those with diabetic nephropathy and renal failure that has already been established. In this study we present the results of 15 years of SPK in a transplant hospital center in Parana, Brazil, and evaluated survival, immunosuppression, and transplant-related problems. Methods This study was a retrospective analysis of 131 SPK transplants performed at the Angelina Caron Hospital between January 2001 and December 2015. Results The mean age of SPK recipients was 34 years, with slight a predominance of males (50.4%). Mean graft ischemia time was 11 hours. Exocrine drainage was predominantly vesical, but this approach was abandoned after 2011. As for immunosuppression, induction was performed with basiliximab or thymoglobulin and maintained with prednisone, mycophenolate mofetil, tacrolimus, and/or sirolimus. Patient survival increased from 68.1% in 2001 to 2005 to 77.6% in 2011 to 2015. Graft survival at the end of the period was 85.7% for kidney and 75.5% for pancreas. The main surgery-derived problems for pancreas and kidney was thrombosis (15% and 6%, respectively). The main clinical problems were rejection of the pancreas (18.3%) and urinary infection of the kidney (33.3%). The main cause of death was intra-abdominal sepsis (11.4%). Conclusion There was an improvement in survival rates over the time frame observed, but it remains necessary to adopt measures to reduce transplant-derived problems, including review of the antibiotic therapy protocol and measures to avoid graft thrombosis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect