Long-term follow-up of 53 cases of combined pancreas-kidney transplantation

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Author:
MING Chang-sheng(Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College,Huazhong University of Science and Technology, Wuhan 430030, China)
LUO Xian-zhang(Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College,Huazhong University of Science and Technology, Wuhan 430030, China)
GONG Nian-qiao(Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College,Huazhong University of Science and Technology, Wuhan 430030, China)
ZENG Fan-jun(Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College,Huazhong University of Science and Technology, Wuhan 430030, China)
ZHANG Wei-jie(Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College,Huazhong University of Science and Technology, Wuhan 430030, China)
CHEN Zhi-shui(Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College,Huazhong University of Science and Technology, Wuhan 430030, China)
CHEN Xiao-ping(Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College,Huazhong University of Science and Technology, Wuhan 430030, China)
Journal Title:
Chinese Journal of Organ Transplantation
Issue:
Volume 33, Issue 09, 2012
DOI:
10.3760/cma.j.issn.0254-1785.2012.09.004
Key Word:
Diabetes mellitus;Pancreas transplantation;Kidney transplantation;Rejection;Long-term survival

Abstract: Objective To determine the long-term results after combined pancreas-kidney transplantation at a single-center institution.Methods Fifty-three consecutive patients with insulin-dependent diabetes mellitus and end-stage nephropathy were followed up for more than three years after combined pancreas-kidney transplantation. Immunosuppressive protocol consisted of tacrolimus ( TAC ),mycophenolate mofetil (MMF),and steroids,and antithymocyte globulin or anti-CD25 receptor mAb.The impact of different risk factors was analyzed on long term patient and graft survival.Results The 3-,5- and 8-year survival rate in recipients was 90.1%,89.1 % and 80.0%,respectively.The 3-,5- and 8-year survival rate of pancreas grafts was 84.9%,84.8% and 60.0%,and that of kidney grafts was 83.0%,82.6% and 53.3%,respectively.Principal causes of death were Infection (n =4),renal failure (n =2),cardiovascular events (n =1 ),and cerebrovascular accident (n =1 ).Graft failure for the pancreas was caused by death with a functioning graft (n =6),rejection (n =2),thrombosis (n =1 ) and pancreatitis (n =1 ).Graft failure for the kidney was due to rejection (n =9),and death with a functioning graft (n =9).Conclusion This series representing the largest experience with long-term follow up in China confirms an excellent long-term survival.Infection,rejection and surgical complication were the major risk factors leading to deaths and graft loss.

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