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Challenges Associated with Pancreas and Kidney Retransplantation—A Retrospective Analysis

Simultaneous pancreas and kidney transplantation (SPK) is an accepted treatment for diabetic patients with renal failure, and is associated with increased survival and quality of life for recipients. There are only a few publications on the outcomes of simultaneous pancreas–kidney retransplantation...

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Autores principales: Pillokeit, Nina, Grzella, Sascha, Zgoura, Panagiota, Westhoff, Timm, Viebahn, Richard, Schenker, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396883/
https://www.ncbi.nlm.nih.gov/pubmed/34441932
http://dx.doi.org/10.3390/jcm10163634
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author Pillokeit, Nina
Grzella, Sascha
Zgoura, Panagiota
Westhoff, Timm
Viebahn, Richard
Schenker, Peter
author_facet Pillokeit, Nina
Grzella, Sascha
Zgoura, Panagiota
Westhoff, Timm
Viebahn, Richard
Schenker, Peter
author_sort Pillokeit, Nina
collection PubMed
description Simultaneous pancreas and kidney transplantation (SPK) is an accepted treatment for diabetic patients with renal failure, and is associated with increased survival and quality of life for recipients. There are only a few publications on the outcomes of simultaneous pancreas–kidney retransplantation (Re-SPK) after previous SPK and the loss of function of both grafts. A total of 55 patients with type 1 diabetes mellitus underwent pancreas retransplantation at our center between January 1994 and March 2021. Twenty-four of these patients underwent Re-SPK after a previous SPK. All 24 operations were technically feasible. Patient survival rate after 3 months, 1 year, and 5 years was 79.2%, 75%, and 66.7%, respectively. The causes of death were septic arterial hemorrhage (n = 3), septic multiorgan failure (n = 2), and was unknown in one patient. Pancreas and kidney graft function after 3 months, 1 year, and 5 years were 70.8% and 66.7%, 66.7% and 62.5%, and 45.8% and 54.2%, respectively. Relaparotomy was performed in 13 out of 24 (54.2%) patients. The results of our study show that Re-SPK, after previously performed SPK, is a technical and immunological challenge, associated with a significantly increased mortality and complication rate; therefore, the indication for Re-SPK should be very strict. Careful preoperative diagnosis is indispensable.
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spelling pubmed-83968832021-08-28 Challenges Associated with Pancreas and Kidney Retransplantation—A Retrospective Analysis Pillokeit, Nina Grzella, Sascha Zgoura, Panagiota Westhoff, Timm Viebahn, Richard Schenker, Peter J Clin Med Article Simultaneous pancreas and kidney transplantation (SPK) is an accepted treatment for diabetic patients with renal failure, and is associated with increased survival and quality of life for recipients. There are only a few publications on the outcomes of simultaneous pancreas–kidney retransplantation (Re-SPK) after previous SPK and the loss of function of both grafts. A total of 55 patients with type 1 diabetes mellitus underwent pancreas retransplantation at our center between January 1994 and March 2021. Twenty-four of these patients underwent Re-SPK after a previous SPK. All 24 operations were technically feasible. Patient survival rate after 3 months, 1 year, and 5 years was 79.2%, 75%, and 66.7%, respectively. The causes of death were septic arterial hemorrhage (n = 3), septic multiorgan failure (n = 2), and was unknown in one patient. Pancreas and kidney graft function after 3 months, 1 year, and 5 years were 70.8% and 66.7%, 66.7% and 62.5%, and 45.8% and 54.2%, respectively. Relaparotomy was performed in 13 out of 24 (54.2%) patients. The results of our study show that Re-SPK, after previously performed SPK, is a technical and immunological challenge, associated with a significantly increased mortality and complication rate; therefore, the indication for Re-SPK should be very strict. Careful preoperative diagnosis is indispensable. MDPI 2021-08-17 /pmc/articles/PMC8396883/ /pubmed/34441932 http://dx.doi.org/10.3390/jcm10163634 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pillokeit, Nina
Grzella, Sascha
Zgoura, Panagiota
Westhoff, Timm
Viebahn, Richard
Schenker, Peter
Challenges Associated with Pancreas and Kidney Retransplantation—A Retrospective Analysis
title Challenges Associated with Pancreas and Kidney Retransplantation—A Retrospective Analysis
title_full Challenges Associated with Pancreas and Kidney Retransplantation—A Retrospective Analysis
title_fullStr Challenges Associated with Pancreas and Kidney Retransplantation—A Retrospective Analysis
title_full_unstemmed Challenges Associated with Pancreas and Kidney Retransplantation—A Retrospective Analysis
title_short Challenges Associated with Pancreas and Kidney Retransplantation—A Retrospective Analysis
title_sort challenges associated with pancreas and kidney retransplantation—a retrospective analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396883/
https://www.ncbi.nlm.nih.gov/pubmed/34441932
http://dx.doi.org/10.3390/jcm10163634
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