Liver and Pancreas Transplantation Unit, General and Digestive Surgery Department, Reina Sofía University Hospital, Cordoba, Spain; GC18 Translational Research in Surgery of Solid Organ Transplantation - Maimonides Biomedical Research Institute of Cordoba, Spain.
Liver and Pancreas Transplantation Unit, General and Digestive Surgery Department, Reina Sofía University Hospital, Cordoba, Spain; GC18 Translational Research in Surgery of Solid Organ Transplantation - Maimonides Biomedical Research Institute of Cordoba, Spain.
Transplant Proc. 2023 Dec;55(10):2259-2261. doi: 10.1016/j.transproceed.2023.09.007. Epub 2023 Nov 15.
Simultaneous pancreas-kidney transplantation is the optimal treatment for patients with type 1 diabetes and renal failure. The use of pancreas grafts from donation after circulatory death (DCD), using normothermic regional perfusion (NRP), is still marginal worldwide, mainly due to possible additional risks of graft dysfunction and complications compared with grafts from donors after brain death.
Case series of patients who underwent simultaneous pancreas-kidney transplantation after DCD-NRP between January 2018 and September 2022. This study evaluated early postoperative grafts and survival outcomes.
Four patients were included. One patient lost the pancreatic graft due to arterial thrombosis requiring transplantectomy. Another patient required a laparotomy due to hemoperitoneum. Overall, 1-year pancreas and kidney graft survival was 75% and 100%, respectively. One patient developed a lymphoma during the follow-up.
The use of pancreas grafts from DCD after NRP preservation is safe and feasible. Comparative studies with donors after brain death grafts and larger series are required to confirm the feasibility of DCD-NRP pancreas transplantation.
胰肾联合移植是 1 型糖尿病伴肾衰竭患者的最佳治疗方法。在全球范围内，使用来自心跳死亡后捐献（DCD）的胰腺移植物，采用常温区域性灌注（NRP）的方法仍较为少见，主要是因为与脑死亡供体的移植物相比，其可能存在移植物功能障碍和并发症的额外风险。
这是一项回顾性病例系列研究，纳入了 2018 年 1 月至 2022 年 9 月期间接受 DCD-NRP 后胰肾联合移植的患者。本研究评估了患者术后早期的移植物和生存结局。
共纳入 4 例患者。1 例患者因动脉血栓形成导致移植肾切除而失去胰腺移植物。另 1 例患者因腹腔积血而行剖腹探查术。总的来说，1 年时胰腺和肾脏移植物的存活率分别为 75%和 100%。1 例患者在随访期间发生淋巴瘤。
使用 DCD-NRP 保存的胰腺移植物是安全可行的。需要与脑死亡供体的移植物进行对比研究和更大的系列研究，以证实 DCD-NRP 胰腺移植的可行性。
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