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Pancreatico-renal composite transplant: a new technique designed to decrease pancreatic graft thrombosis.

Clin Transplant

October 2005

Division of Kidney and Pancreas Transplantation, Department of Surgery, Thomas Jefferson Medical College, Philadelphia, PA 90048, USA.

Pancreas graft thrombosis continues to be a major cause of graft loss. The removal of the donor spleen is accompanied by a significant reduction in pancreas graft blood flow. It is likely that reduced blood flow contributes to thrombosis in concert with other factors.

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Pancreas transplantation has become an excellent therapeutic procedure for Diabetes mellitus. From 1965 to 1986, 830 patients received pancreas transplantation in the world and these figures were reached every year during the 90's. The characteristics of simultaneous kidney-pancreas transplantation (SPK), indications, operative techniques and complications are shown.

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Pancreas transplantation: results and indications.

Diabetes Metab

June 1998

Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon, France.

Pancreatic transplantation is the best method of replacing the endocrine function of the gland in Type 1 insulin-dependent diabetic patients. At the end of 1996, 9,000 pancreas transplants had been reported to the international Pancreas Transplant Registry. For 1994-1996, one-year pancreas survival rates were 81% for simultaneous pancreas and kidney transplantation (n = 1,516), 71% for pancreas after kidney (n = 141) and 64% for pancreas alone (n = 64).

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We have investigated the metabolic effects of segmental (neoprene-injected) pancreas transplantation versus whole (enteric-diverted) pancreas transplantation. Seventeen uremic insulin-dependent diabetes mellitus (IDDM) patients received a simultaneous pancreaticorenal transplant: in a prospective, randomized study, 9 patients received a segmental neoprene-injected graft (group A) while 8 patients received a total pancreaticoduodenal graft, with enteric diversion (group B). The immunosuppressive therapy was based on ALG, CsA, azathioprine, and steroids.

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The possibility of an immunological follow-up of the pancreas through the renal transplant after simultaneous pancreaticorenal transplantation (S.P.R.

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