Kidney transplantation together with another solid organ from the same donor--a single-center progress report.

摘要

AIM: The aim of this study was to update our center's experience with combined renal transplants. SUBJECTS AND METHODS: Between January 1987 and March 1997, 93 segmental pancreas and kidney transplants with bladder drainage and cyclosporine A-based immunosuppression were performed followed by another 40 combined pancreatoduodenal-renal transplants with enteric drainage and FK-based immunosuppression until December 1998. After a mean observation time of 87 and 13.6 months respectively, 1-year survival for patient, kidney and pancreas was 95%, 90% and 77% and 100%, 97.5% and 87.5%, respectively. Rejection and graft thrombosis were major causes of graft loss in the bladder drainage group and peripancreatitis in the enteric drainage group. From 23 December 1983, 20 patients received a combined liver-kidney transplant. RESULTS: Main indications were glomerulonephritis and viral-induced cirrhosis. 5-year survival for patients and kidneys was 70% and for liver 62%. No rejections were identified in renal transplants, suggesting a potential immunoprotective effect of the liver. Septic complications were responsible for early death and disease recurrence for late patient loss. CONCLUSIONS: From our experience with combined kidney transplants, we conclude that simultaneous transplantation of the pancreas does not adversely affect the outcome of renal transplantation and that after combined liver-kidney transplantation, the liver appears to immunologically protect the kidney.