Combined ‘en bloc’liver and pancreas transplantation in patient with end-stage liver disease and type 2 diabetes mellitus

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Author:
HE Xiao-shun(Organ Transplantation Center,First Affiliated Hospital, Sun Yat-sen University , Guangzhou 510080, China)
JU Wei-qiang(Organ Transplantation Center,First Affiliated Hospital, Sun Yat-sen University , Guangzhou 510080, China)
ZHU Xiao-feng(Organ Transplantation Center,First Affiliated Hospital, Sun Yat-sen University , Guangzhou 510080, China)
WANG Dong-ping(Organ Transplantation Center,First Affiliated Hospital, Sun Yat-sen University , Guangzhou 510080, China)
WU Lin-wei(Organ Transplantation Center,First Affiliated Hospital, Sun Yat-sen University , Guangzhou 510080, China)
TAI Qiang(Organ Transplantation Center,First Affiliated Hospital, Sun Yat-sen University , Guangzhou 510080, China)
GUO Zhi-yong(Organ Transplantation Center,First Affiliated Hospital, Sun Yat-sen University , Guangzhou 510080, China)
HAN Ming(Organ Transplantation Center,First Affiliated Hospital, Sun Yat-sen University , Guangzhou 510080, China)
HUANG Jie-fu(Organ Transplantation Center,First Affiliated Hospital, Sun Yat-sen University , Guangzhou 510080, China)
Journal Title:
Chinese Journal of Organ Transplantation
Issue:
Volume 33, Issue 09, 2012
DOI:
10.3760/cma.j.issn.0254-1785.2012.09.006
Key Word:
Abdomen;Organ transplantation;Liver cirrhosis;Diabetes mellitus,type 2

Abstract: Objective To explore the clinical efficacy of the upper abdomen organ transplantation in the treatment of end stage liver disease and type 2 diabetes mellitus (T2DM).Methods The clinical data of 7 cases receiving liver-duodeno-pancreatic organ cluster transplantation in patients with end-stage liver disease and T2DM were retrospectively analyzed.The pancreas and the whole digestive tract of the recipients were reserved during operation,simple liver excision was executed,and abdominal multiple organs including pancreas,duodenum and part of jejunum were transplanted.The liver and kidney functions,blood glucose,C peptide,infection,rejection,vascular complications,biliary complications and other indicators were monitored postoperatively.Results No insulin was used in all the patients 1-7 days after operations,the blood glucose levels returned to almost normal, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin became normal after 1 week,and C peptide levels reached the normal range in 1 to 2 weeks.Among 7 patients,one died of graft-versus-host disease 1 month after operation,one got acute renal failure,one suffered from pulmonary infection, one had pancreatic leakage but recovered after unobstructed drainage,and no obvious complications were observed in the remaining patients.So far 6 live recipients were followed up for 1-39 months,the functions of the liver and pancreatic grafts were normal without hepatitis B and tumor recurrence, and the quality of life in the patients was satisfactory.Conclusion Liver-duodeno-pancreatic organ cluster transplantation is technically feasible and an effective method for the treatment of end-stage liver disease with T2DM.

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