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Simultaneous Pancreas and Kidney Transplantation

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Transplantation of the Pancreas

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Abstract

For many patients with type 1 diabetes mellitus and renal failure, simultaneous pancreas and kidney (SPK) transplantation offers a chance at a renewed life free from insulin and dialysis. Although initial attempts at the procedure were fraught with complications and rejections, advances over the last 50 years in surgical techniques and immunosuppressant agents have greatly improved the success and availability of this procedure. Indeed, many factors are considered in ensuring a successful SPK transplant. Donor and recipient selection can direct the type of kidney and pancreas transplants an individual receives, mitigate perioperative complications, and impact the long-term outcomes. A successful SPK transplant also relies heavily on technical finesse. In this chapter, we review the key aspects of organ assessment, graft preparation, and implantation. The implanting surgeon is faced with many decisions: placement of the grafts (contralateral vs. ipsilateral), pancreatic venous drainage (systemic vs. portal), pancreatic exocrine drainage (enteric vs. systemic), and if a Roux-en-Y loop should be used with enteric exocrine drainage. Surgeon preference and anatomical considerations will determine the techniques so that a successful SPK transplant is performed and transforms the life of a patient for many years forward.

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Authors and Affiliations

  1. Division of Transplantation, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA

    Wen Xie, Rami Kantar & Laura DiChiacchio

  2. Department of Surgery, Division of Transplantation, Medical University of South Carolina, Charleston, SC, USA

    Joseph R. Scalea

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  1. Wen Xie
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  2. Rami Kantar
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  3. Laura DiChiacchio
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  4. Joseph R. Scalea
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Correspondence to Joseph R. Scalea .

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Editors and Affiliations

  1. Department of Surgery, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA

    Rainer W. G. Gruessner

  2. Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA

    Angelika C. Gruessner

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Xie, W., Kantar, R., DiChiacchio, L., Scalea, J.R. (2023). Simultaneous Pancreas and Kidney Transplantation. In: Gruessner, R.W.G., Gruessner, A.C. (eds) Transplantation of the Pancreas. Springer, Cham. https://doi.org/10.1007/978-3-031-20999-4_22

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