Investigators at the University of Minnesota are reporting a first. Although living-related transplants of individual organs are still relatively new, the Minnesota group has successfully taken the procedure a step further by performing living-related pancreas and kidney transplants during the same operation.
According to Rainer W.G. Gruessner, MD, PhD, Professor of Surgery, he and his colleagues performed simultaneous pancreas-kidney transplants between March 1994 and March 1997 in 12 women and 8 men with type I insulin-dependent diabetes mellitus. At follow-up, all 20 of the kidney grafts and 15 of the pancreas grafts were functioning, and no deaths occurred. The five failures of pancreas grafts were attributable to thrombosis in three patients, rejection in one, and intra-abdominal infection and graft pancreatitis in one. Complications also occurred in eight of the donors.
Overall, the procedure was judged a success, and the investigators envision that, with continued good outcomes, simultaneous living-related pancreas-kidney transplantation could become an alternative for endocrine replacement therapy.
Transplanting the organs simultaneously was a natural extension of the work that Dr. Gruessner and his colleagues have carried out over the past several years. "Our initial experience was based on pancreas transplants alone," he told Transplant News Network. "Until 1994, all we did were living-related pancreas transplants and then sequential living-related kidney transplants." They then decided to combine the procedures.
Although living-related pancreas transplants usually are associated with less rejection than transplants from a cadaveric donor, the living-related transplants are far more technically demanding for the surgeon. "You only can transplant a portion of the pancreas, with much smaller blood vessels than you would use from a cadaver donor," Dr. Gruessner said. However, technical failures are less common than immunologic failures.
For Your Information:
Rainer W.G. Gruessner, MD, PhD
University of Minnesota Hospital, Department of Surgery
Box 90 UMHC, 420 Delaware Street S.E., Minneapolis, MN 55455
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