[Simultaneous pancreas-kidney transplantation: evolution and future perspective].

Abstract

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. The main features of the donors and preoperative study of the recipients to be accepted as candidates are referred. The experience of the Department of General and Digestive Surgery, and Abdominal Organ Transplantation of the Doce de Octubre Hospital with the first 11 SPK on end-stage diabetic renal failure is commented. The age range was 24 and 43 years. Eight patients had diabetic retinopathy. One patient died after 1 year of the transplant. Another patient had portal venous thrombosis and the pancreatic graft was removed. Eight patients live insulin-free and 1 needs moderate doses of insulin. None of the patients died as a consequence of the transplant though 2 of them had Mucor infection.