Pancreas Transplant Research Today is a free monthly online journal that collates and summarizes the latest research about Pancreas Transplant, including details on risks, prognosis, procedure, surgery, organ donation.

Simultaneous pancreas-kidney transplantation in a large multicenter study: surgical complications.

Malaise J, Steurer W, Koenigsrainer A, Mark W, Margreiter R, Van Ophem D, Mourad M, Squifflet JP,

EUROSPK Central Office, Brussels, Belgium. jacques.malaise@chir.ucl.ac.be

Simultaneous pancreas-kidney (SPK) transplantation has evolved as an effective treatment modality for patients with end-stage nephropathy owing to type 1 diabetes mellitus. This kidney-pancreas transplant procedure includes a number of risks, one of them being surgical complications, which were analyzed in this large prospective multicenter study. PATIENTS AND METHODS: The analysis included 205 patients randomly assigned to tacrolimus (n = 103) or cyclosporine ME (n = 102) in the Euro-SPK001 study. Surgical complications were defined as any intervention in the postoperative course related to the transplant procedure. RESULTS: The number of patients undergoing relaparotomy was significantly lower among the tacrolimus group (26.2%) as compared to the cyclosporine ME group (43.1%, P = .0109). Relaparotomy was performed earlier in the cyclosporine ME group (day 14 +/- 17) compared to patients in the tacrolimus group (day 26 +/- 26, P = .0506). Graft vessel thrombosis, intra-abdominal hemorrhage, and enteric or ureteral leakage within the first 3 months occurred significantly more frequently in cyclosporine ME-treated patients. Donor age above 45 years showed a negative impact on surgical complications. Relaparotomy had no impact on patient survival but significantly affected pancreas and kidney graft survival in both groups. CONCLUSION: This prospective, randomized, multicenter trial in patients undergoing primary SPK demonstrated a benefit of tacrolimus over cyclosporine ME with regard to the incidence of surgical complications and, consecutively, to kidney and pancreas graft survival.

Published 26 September 2005 in Transplant Proc, 37(6): 2859-60.
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