Kenjo Akira, Sato Naoya, Azuma Takayasu, Nishimagi Atsushi, Tsukida Shigeyuki, Suzushino Seiko, Muto Makoto, Chiba Hiroto, Watanabe Junichiro, Haga Junichiro, Kofunato Yasuhide, Ishigame Teruhide, Kimura Takashi, Marubashi Shigeru
Department of Hepato-Biliary-Pancreatic and Transplant Surgery, Fukushima Medical University.
Fukushima J Med Sci. 2025 Apr 19;71(2):119-128. doi: 10.5387/fms.24-00052. Epub 2025 Feb 8.
This study evaluated the outcomes of simultaneous pancreas-kidney transplantation (SPK) at Fukushima Medical University between 2001 and 2024. We retrospectively reviewed ten adult patients who underwent SPK. We aimed to clarify the important aspects of patient management in patients undergoing SPK, focusing on perioperative outcomes and long-term complications.The median postoperative observation period was 1,968 days. Postoperative complications were observed in all patients. Most were classified as Clavien-Dindo (CD) grade I or II, but major complications, including CD grade IIIa or higher, were observed in four patients (40%) with zero mortality. Despite the loss of one kidney graft due to primary non-function, the 5-year survival rates for both patients and pancreatic grafts remained at 100%. However, there was one case each of pancreatic graft loss, kidney graft loss, and patient death after 5 years post-transplantation, all attributed to late-onset complications, including recurrent type 1 diabetes, focal segmental glomerulosclerosis, and cardiovascular disease.The short-term outcomes of SPK at our institution were favorable, with a trend toward a reduction in the comprehensive complication index (CCI) observed in the latter five cases compared with the first five cases, suggesting potential improvements in perioperative management. Long-term monitoring and collaboration with physicians are essential to enhance patient outcomes. .
本研究评估了2001年至2024年间福岛医科大学同期胰肾联合移植(SPK)的结果。我们回顾性分析了10例接受SPK的成年患者。我们旨在阐明接受SPK患者的重要管理方面,重点关注围手术期结果和长期并发症。术后中位观察期为1968天。所有患者均观察到术后并发症。大多数并发症分类为Clavien-Dindo(CD)I级或II级,但4例(40%)患者出现了包括CD IIIa级或更高等级的严重并发症,无死亡病例。尽管有1例肾移植因原发性无功能而丢失,但患者和胰腺移植的5年生存率均保持在100%。然而,移植后5年各有1例胰腺移植丢失、肾移植丢失和患者死亡,均归因于迟发性并发症,包括复发性1型糖尿病、局灶节段性肾小球硬化和心血管疾病。我们机构SPK的短期结果良好,与前5例相比,后5例的综合并发症指数(CCI)有下降趋势,表明围手术期管理可能有所改善。长期监测以及与医生的合作对于提高患者预后至关重要。