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New surgical technique for pediatric en-bloc kidney and pancreas transplantation: the pancreas piggy-back


Waldner, Matthias; Bächler, Thomas; Schadde, Erik; Schiesser, Marc; Immer, Franz; Clavien, Pierre-Alain; Brockmann, Jens Gunther (2013). New surgical technique for pediatric en-bloc kidney and pancreas transplantation: the pancreas piggy-back. Transplant International, 26(1):30-33.

Abstract

Combined pancreas and kidney transplantation is the therapy of choice for type I diabetes patients with associated end-stage renal disease. To counterbalance increasing waiting lists, there is a clear need to extend the organ donor pool. Although results following simultaneous pancreas and kidney transplantation (SPK) using pediatric organs are encouraging, there is still reluctance in accepting them. This reflects the fear of graft thrombosis and graft failure because of small vessels and little absolute islet cell mass. Simpler transplant techniques for pediatric SPK might lower this threshold. In this article, a novel technique using a "piggy-back" implantation of the pancreas onto the conduits of en-bloc grafted kidneys, performed in two consecutive cases, is presented. This technique is associated with less vascular manipulation, requiring only one arterial anastomosis onto the frequently arteriosclerotic arteries of the recipient for all three organs. One-year follow-up (14 and 12 months) proved excellent graft function of kidneys and pancreas.

Abstract

Combined pancreas and kidney transplantation is the therapy of choice for type I diabetes patients with associated end-stage renal disease. To counterbalance increasing waiting lists, there is a clear need to extend the organ donor pool. Although results following simultaneous pancreas and kidney transplantation (SPK) using pediatric organs are encouraging, there is still reluctance in accepting them. This reflects the fear of graft thrombosis and graft failure because of small vessels and little absolute islet cell mass. Simpler transplant techniques for pediatric SPK might lower this threshold. In this article, a novel technique using a "piggy-back" implantation of the pancreas onto the conduits of en-bloc grafted kidneys, performed in two consecutive cases, is presented. This technique is associated with less vascular manipulation, requiring only one arterial anastomosis onto the frequently arteriosclerotic arteries of the recipient for all three organs. One-year follow-up (14 and 12 months) proved excellent graft function of kidneys and pancreas.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Division of Surgical Research
04 Faculty of Medicine > University Hospital Zurich > Clinic for Reconstructive Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:26 January 2013
Deposited On:21 Mar 2013 11:12
Last Modified:05 Apr 2016 16:28
Publisher:Wiley-Blackwell
ISSN:0934-0874
Publisher DOI:https://doi.org/10.1111/j.1432-2277.2012.01569.x
PubMed ID:23072376

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