Simultaneous pancreas-kidney transplantation has gained acceptance as a therapeutic modality for patients with end-stage renal disease secondary to diabetes mellitus. In some instances, performing the procedure as conventionally described with renal revascularization from the left iliac vessels and pancreatic arterial inflow from the right iliac vessels may be difficult or undesirable. We describe our experience with an alternate operative technique utilizing a single arterial conduit to vascularize both organs. We believe that this technique may be of use in certain patients undergoing simultaneous pancreas-kidney transplantation.
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Introduction: The management of urinary tract stones, particularly kidney allograft stones, presents unique challenges for kidney transplant recipients because of their prevalence and specific clinical considerations. Here, we describe a case in which percutaneous nephrolithotomy was successfully used to fragment a large kidney allograft stone ≥20 mm in size.
Case Presentation: A 57-year-old woman who underwent ureteroureterostomy post simultaneous pancreas-kidney transplantation presented with gross hematuria after 15 years.
Assessing the Predictive Power of PIRCHE-II Scores for the Development of Donor-Specific Antibodies After Simultaneous Pancreas-Kidney Transplantation.
Transpl Int
January 2025
Department of Nephrology, University Hospital Zurich, Zurich, Switzerland.
Article Synopsis
- The study investigates the development of donor-specific antibodies (dnDSA) in simultaneous pancreas/kidney transplant recipients (SPKTRs) compared to kidney transplant recipients (KTRs), finding a higher incidence of dnDSA in SPKTRs at one year post-transplant.
- Independent risk factors for dnDSA development identified include preformed DSA and younger donor age, with high PIRCHE-II scores for HLA-DQ correlating significantly with dnDSA.
- However, the research highlights that total PIRCHE-II scores may not reliably predict dnDSA risk, suggesting caution in using this measure for post-transplant assessment.
Simultaneous pancreas-kidney (SPK) transplantation is a recognized treatment for patients with insulin-dependent diabetes and advanced chronic kidney disease or end-stage renal disease (ESRD), offering significant survival benefits. However, it is associated with a higher risk of venous thrombosis, which can jeopardize the survival of the pancreaticoduodenal graft. This case report describes a patient with type 2 diabetes, hypertension, and ESRD who developed acute, occlusive deep vein thrombosis (DVT) involving the right common femoral, profunda femoral, and greater saphenous veins on postoperative day 1 (POD1) following a deceased donor SPK transplant, despite systemic prophylactic anticoagulation.
View Article and Find Full Text PDFBariatric surgery prior to pancreas transplantation: a retrospective matched case-control study.
Surg Obes Relat Dis
December 2024
Division of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, Minnesota.
Background: The clinical impact of bariatric surgery (BS) prior to pancreas transplantation (PTx) is unclear.
Setting: University of Minnesota Hospital, Minneapolis, MN.
Methods: This was a single center retrospective case-controlled study of all patients January 1, 1998 and May 1, 2024 with a history of BS prior to PTx.
Deceased Donor Renal Allograft Utility in Adult Single and Multi-organ Transplantation in the United States.
Transplant Direct
January 2025
Department of Surgery, Division of Transplantation, Thomas Jefferson University Hospital, Philadelphia, PA.
Background: Deceased donor multiorgan transplants utilizing kidneys (MOTs) can improve outcomes for multiorgan recipients but reduces kidneys for chronic renal failure patients.
Methods: We reviewed the Organ Procurement and Transplantation Network database from 2015 through 2019, for adult deceased donor kidney transplants. Recipients were classified as kidney transplant alone (KTA) (n = 62,252) or MOTs pancreas-kidney, simultaneous pancreas-kidney (n = 3,976), liver-kidney, simultaneous liver-kidney (n = 3,212), heart-kidney, simultaneous heart-kidney (n = 808), and "other"-kidney, simultaneous "other" kidney (n = 73).
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