Mortality after vascularized pancreas transplantation.

Background: Previous studies have questioned the safety of vascularized pancreas transplantation (PTX), particularly because diabetes is an independent risk factor for coronary artery disease and cardiac death.

Methods: A retrospective analysis of the timing and causes of death after PTX was performed. From April 1989 through December 1995, 196 PTXs were performed in 186 diabetic patients including 134 simultaneous kidney-PTXs, 59 solitary PTXs, and 3 combined liver-PTXs.

Immunosuppression in pancreas transplantation: progress, problems and perspective.

Through 1997, over 10,000 pancreas transplants have been performed world-wide, with 88% being simultaneous kidney-pancreas transplants (SKPTs). Current 1-year patient survival exceeds 90% and pancreas graft survival (complete insulin independence) exceeds 80% for SKPT, 70% for sequential pancreas after kidney transplant (PAKT), and 65% for pancreas transplant alone (PTA). According to Registry data, rejection accounts for 32% of graft failures in the first year after pancreas transplantation.

Design, development, and implementation of a critical pathway in simultaneous pancreas-kidney transplant recipients.

The purpose of this study was to assess the effect of implementation of a critical pathway after simultaneous pancreas-kidney transplantation on length of stay and hospital charges. Two well-matched groups were compared: 10 patients who received transplants in 1991 (before implementation of the critical pathway) and 10 patients who received transplants in 1995 (after implementation). For the initial transplant hospitalization, the critical pathway was associated with significant reductions in length of stay, total number of laboratory tests, clinical laboratory charges, and total inpatient charges with organ acquisition charges excluded.

Retransplantation in the diabetic patient with a pancreas allograft.

Background: Retransplantation has been considered a risk factor for both postoperative complications and diminished graft survival, especially in diabetic patients.

Methods: A retrospective survey was performed of a consecutive case series of 196 pancreas transplants in 186 diabetic patients. All patients underwent whole organ pancreas transplantation with bladder drainage.