Renal-pancreas transplantation. Experience in the Buenos Aires Nephrology Institute

Abstract

Between September 2006 and May 2009, 93 simultaneous renal-pancreas transplants, 7 isolated pancreas and 2 pancreas after Kidney transplants have been performed at the Renal Pancreas service (R-P) of Buenos Aires Nephrology Institute. Seventy of the receptors were males and 42 females, with an average age of 36.69 years (18-57 y); the time in waiting list was 180 days, the mean dialysis time was 25 months, and the mean ischemic time was 5 hours. With respect to the donors 76% (78/102) were conventional, and 23% (24/102) with expanded criteria. Immunosuppression: as induction therapy timoglobulin 1.5 mg/Kg for 5 days and metilprednisolone 500 mg intraoperatory; as maintenance tacrolimus 0.02mg/Kg and everolimus 0.75 mg/12 hrs, with decreasing steroid doses, 20 mg/day at 1 month. As surgical technique: bladder derivation in 37% of the cases and enteric derivation in 62%. In 10 cases the drainage of the endocrine secretion was venous portal and systemic in 92 of the cases.
With respect to complications there were 2 episodes of partial thrombosis with resolution of them, 5 patients presented delayed graft function (3 requiring hemodialysis), 4 patients required reintervention because of bleeding, 4 presented intrabdominal collections. There were 6 episodes of rejection in 6 patients, one was corticosteroid resistant. The mean time of hospital stay was 15 days, infection rate was 8%, predominantly Gram negative germs, reconvertion rate of bladder derivation to enteric for recurrent urinary tract infections was 2.94%. Global mortality was 8%, 6 patients in the first 3 months post transplant, 2 after one year of transplantation for infectious complications. With respect to survival 96% of the patients have a functioning graft and 91% are free from insulin.

How to cite this article:

Reniero L, Illanes G, Quarin C, Maurette R, Sanchez N, Casadei D. [Renal-pancreas transplantation. Experience in the Buenos Aires Nephrology Institute]. Rev Nefrol Dial Traspl. 2009;29(3):124-7.