Original Articles from the Central Surgical AssociationMortality after vascularized pancreas transplantation☆
Section snippets
Material and methods
From April 1989 through December 1995, 196 PTXs were performed in 186 diabetic patients at our center including 134 SKPTs, 59 solitary PTXs (42 PTA, 17 PAKT), and 3 combined liver-PTX (LP). All patients underwent a comprehensive pretransplantation evaluation as outlined previously.13 The medical evaluation was tailored to the individual based on specific signs or symptoms. The work-up was used to confirm the diagnosis of IDDM, determine the patient's operative risks, establish the absence of
Results
During a 7-year period, 196 PTXs were performed in 186 IDDM patients. Demographic and clinical characteristics of the study groups according to type of PTX are summarized in Table I. The mean age of the recipient group was 37 years with a mean duration of diabetes of 25 years at the time of PTX. A total of 58 patients (31%) had evidence of cardiac disease before transplantation. In the 134 patients undergoing SKPT, 73 (55%) received pretransplantation dialysis.
Results are depicted in Table II.
Discussion
With improvements in organ retrieval technology, surgical techniques, clinical immunosuppression, antimicrobial prophylaxis, and diagnostic methodology, success rates for vascularized PTX have steadily improved.11, 14 As a result, PTX has assumed an increasingly important role in the treatment of IDDM. In spite of increased morbidity, the addition of a pancreas transplantation to a kidney transplantation in an appropriately selected IDDM patient does not appear to jeopardize either the patient
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