The homolateral simultaneous pancreas-kidney transplantation: a single-center experience in China

Lei Zhang, Zheng Chen, Xingqiang Lai, Junjie Ma, Jiali Fang, Yuhe Guo, Guanghui Li, Lu Xu, Wei Yin, Yunyi Xiong, Luhao Liu, Rongxin Chen, Li Li


Background: To preliminarily explore the clinical effect of the homolateral simultaneous pancreas and kidney (SPK) transplantation in China.
Methods: SPK using the surgical technique was performed in 88 patients from September 2016 to July 2019 in the Department of Transplantation of the Second Affiliated Hospital of Guangzhou Medical University. Patients were followed up for 2 to 36 months to summarize the efficacy and complications.
Results: Up to now, 83 patients have achieved good clinical efficacy with no major surgical complications, but 3 patients died of severe infection and 2 have graft loss. The serum creatinine (Scr) at 1, 3, 6, 12, 24 months after operation were 118, 119, 116, 114, 110 umol/L; fasting blood glucose were 5.8, 5.0, 5.0, 4.9, 4.8 mmol/L; and glycated hemoglobin at 3, 6, 12, 24 months after transplantation were 5.2%, 5.5%, 5.2%, 5.1%. One- and 2-year patient, pancreas, and kidney graft survival rates were 96.1%, 93.8%, 95.0% and 96.1%, 93.8%, 95.0%. Main complications included 20 cases of kidney rejection (22.7%), 22 cases of pancreas rejection (25.0%), 31 cases of pulmonary infection (35.2%), 28 cases of gastrointestinal bleeding (31.8%), 2 cases of splenic vein thrombosis (2.3%), 2 case of artery thrombosis and anastomotic leak (2.3%) and 2 cases of pancreas allograft dysfunction (2.3%).
Conclusions: homolateral simultaneous pancreas-kidney transplantation has a definite therapeutic effect. The relatively simple surgical method can be done with a smaller wound in unilateral fossa iliaca.