Retrospective analysis of surgical complications after pancreas-kidney transplantation

Objective To retrospectively analyze the surgical complications,treatments and prognosis of combined pancreas-kidney transplantation.Method Sixty cases of combined pancreaskidney transplantation were performed in Tongji Hospital from January 2000 to December 2011,and divided into reoperation group (RO) and non-reoperation group (NRO) according to whether the patients received reoperation.We analyzed donor and recipient characteristics,rate of relaparotomies,risk factors,as well as patient and graft survivals.Result Six patients died within 1 year after transplantation duo to infection (n =3),cardio-/cerebrovascular (CCV) events (n =2) and gastrointestinal bleeding (n =1).CCV events and infection were the leading causes of early death (5/6).Fifty-six patients achieved euglycemia,and no further insulin treatment was given in 14 ± 8 days post-transplantation.Graft pancreatectomy was performed on 6.7％ (4 patients).The causes of graft loss were as follows:bleeding,severe graft pancreatitis,pancreas graft thrombosis.Fifteen patients experienced delayed graft function (the median duration was 33 ± 12 days),and the remaining patients displayed immediate graft function.Death with a functioning graft was the principal cause for renal failure (3/6).Conclusion Surgical complications and the necessity for relaparotomy were associated with important morbidity and significantly reduced pancreas graft survival. Key words: Pancreas transplantation;  Kidney transplantation; Postoperative complications