Pancreas transplantation from living donors: A single center experience of 20 ca

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http://onlinelibrary.wiley.com/doi/10.1111/ajt.13738/abstract

Pancreas transplantation from living donors: A single center experience of 20 cases
Ji Yoon Choi, Joo Hee Jung, Hyunwook Kwon, Sung Shin, Young Hoon Kim and Duck Jong Han
American Journal of Transplantation
DOI: 10.1111/ajt.13738
Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)

Abstract
Living donor pancreas transplantation (LDPT) has several advantages over deceased donor pancreas transplantation(DDPT), including better human leukocyte antigen (HLA) matching, shorter ischemic time and shorter waiting time.It remains an attractive option for DM patients with ESRD.We reviewed 20 cases of LDPT performed in Asan Medical Center between October 1992 and March 2015.Six cases(30%) were pancreas transplantation alone(PTA), and the rest(70%) were simultaneous pancreas and kidney transplantation (SPK).Relations of donor and recipient were parents in 7(35%), siblings in 6(30%), spouse in 6(30%), and cousin in 1(5%). Graft survival in SPK at 1,3,5,and 10 years was 91.7%,83.3%,83.3% and 83.3% respectively, and that in PTA recipients was 50%,33.3%,16.7% and 16.7%,respectively(p=0.005).Causes of graft failure in SPK were thrombosis(1 case),and rejection(1 case), whereas those in PTA were non-compliance(2 cases),thrombosis(1 case),reflux pancreatitis(1 case),and chronic rejection (1 case).In terms of pancreas exocrine drainage, two grafts (25%) maintained their function in bladder drainage,while all grafts maintained in enteric drainage (p=0.000).Seven(35%) donors experienced minor pancreatic juice leakage and 1 underwent reoperation due to postoperative hematoma.Most donors maintained normoglycemia and normal renal function .However, 2 donors developed DM(at 1 and 90 months post donation),and were treated with oral hypoglycemic agents.Graft survival in PTA recipients was poorer than in SPK due to poor compliance and bladder drainage related problems.The surgical and metabolic complication rates of donors can be minimized by applying strict donor criteria. Therefore, LDPT with enteric drainage is an acceptable treatment for SPK.