The effect of pregnancy on simultaneous pancreas-kidney transplant recipients has previously been described, but experience is limited. We describe the case of a thirty-five-year-old female who previously underwent simultaneous pancreas-kidney transplant for type 1 diabetes mellitus-complicated nephropathy. An integrated multidisciplinary team including the transplant team, nephrologist, endocrinologist, and obstetrician closely followed progress during pregnancy. Blood glucose levels and HbA1c remained within normal limits, and she did not require insulin treatment at any point. She experienced deterioration in renal indices and underwent an uncomplicated, elective Caesarean section at thirty-week gestation. She delivered a male infant of 1.18 kg, appropriate for gestational age, who had hypothermia and respiratory distress, which required intubation and ventilation and an eleven-week stay in the special care baby unit. At eighteen-month followup the infant shows normal development, and there has been no deterioration in either grafts' function.
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http://dx.doi.org/10.1155/2011/983592 | DOI Listing |
Case Rep Transplant
January 2025
Comprehensive Transplant Center, Department of Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Kidney allograft torsion (KAT) is a rare but critical complication of kidney transplantation that can lead to graft loss due to acute ischemia. This report presents a case of KAT resulting in graft loss 9 months following intraperitoneal simultaneous pancreas and kidney (SPK) transplant and reviews previous reports to identify potential high-risk features. A 38-year-old female with end-stage renal disease secondary to Type 1 diabetes mellitus underwent an intraperitoneal enteric drained SPK transplant.
View Article and Find Full Text PDFTransplantation
January 2025
Faculty of Medicine and Health, University of Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Background: Simultaneous pancreas-kidney (SPK) transplantation is an effective treatment option for type 1 diabetes mellitus and concurrent end-stage kidney disease. However, the diabetogenic effects of immunosuppression can counteract the beneficial effects of sustained normoglycemia. Long-term metabolic trends that reflect cardiovascular risk are reported poorly in the literature.
View Article and Find Full Text PDFIntroduction: 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.
Transpl Int
January 2025
Department of Nephrology, University Hospital Zurich, Zurich, Switzerland.
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.
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