| [ Summary ] |
Simultaneous pancreas and kidney transplantation, SPK is indicated for type 1 diabetic patients with renal failure. SPK is an effective therapy that augments quality of life for recovery of a more normal life style, without insulin therapy or dialysis treatment. SPK ameliorates diabetic neuropathy with few autonomic complication, and stabilizes retinopathy. There was a statistics from the International Pancreas Registry indicate that 1-year patient survival rate was 96%, pancreas 1-year graft survival was 85%, and kidney 1-year graft survival rate was 90%. In Japan, 17 cases of pancreas and kidney transplantation, 15 cases of SPK and two cases of PAK, pancreas after kidney transplantation were performed up to September 2004. In these cases, all patients were alive at that time ; with 94% of pancreas 1-year graft survival rate and 100% of 1-year kidney graft survival rate was observed. To improve the efficacy of SPK, surgical complications as “Technical Failure” should be minimized. In Japanese series, the modified surgical procedure of vascular reconstruction of the gastroduodenal artery to the pancreas allograft has been employed, which allows us to keep the vascular supply for the pancreatic head and duodenum and results avoiding ischemia injury in most cases. |