Introduction: Simultaneous kidney-pancreas transplantation for patients with type 1 diabetes and end-stage chronic renal disease is widely performed. However, the rate of surgical morbidity from pancreatic complications remains high. The aim of this study was to describe the results of a new (low volume) program, from the point of view of the pancreatic surgeon.
Materials and Methods: We analyzed 53 simultaneous pancreas-kidney transplants performed over a period of seven years (2009-2016), with a median follow up of 39 months (range: 1-86 months).
Results: Of the total of this series, two patients died; one patient because of a cardiac arrest immediately after surgery and another patient due to traffic accident complicated with a pneumonia. Among the 51 patients alive two grafts were lost, one due to chronic rejection four years after transplantation and the other one due to arterial thrombosis 20 days after transplantation, being this case the only required a transplantectomy. In ten patients one or more surgical reinterventions have been necessary due to the following diagnosis: graft pancreatitis (n=3), small intestinal occlusions (n=4), arterial thrombosis (n=1), complicated fistula (n=1) and hemoperitoneum (n=1). Patient and graft overall survival rates at 1, 3 and 5 years were 98%, 95% and 95% and 96, 93 and 89%; respectively.
Conclusions: This study has shown that the results of new pancreatic transplant program, which rely on previous experience of other groups, do not reflect a learning curve. Adequate personal education and learning, the use of standardized and adequate techniques, should assure optimal results.