Simultaneous En-bloc Kidney and Pancreas Transplantation (SEBKP) from Pediatric Donors: Selection, Surgical Strategy, Management and Outcomes

Riccardo Tamburrini; Ching-Yao Yang; Jennifer L Philip; Nikole A Neidlinger; Dixon B Kaufman; Jon S Odorico

doi:10.1016/j.ajt.2024.11.016

Simultaneous En-bloc Kidney and Pancreas Transplantation (SEBKP) from Pediatric Donors: Selection, Surgical Strategy, Management and Outcomes

Am J Transplant. 2024 Nov 18:S1600-6135(24)00704-4. doi: 10.1016/j.ajt.2024.11.016. Online ahead of print.

Authors

Riccardo Tamburrini¹, Ching-Yao Yang², Jennifer L Philip³, Nikole A Neidlinger³, Dixon B Kaufman³, Jon S Odorico⁴

Affiliations

¹ University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Division of Transplantation, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
² Division of Transplantation, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Surgery, National Taiwan University Hospital, College of Medicine National Taiwan University, Taipei, Taiwan.
³ University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Division of Transplantation, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; UWHealth Transplant Center, Madison, Wisconsin, USA.
⁴ University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Division of Transplantation, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; UWHealth Transplant Center, Madison, Wisconsin, USA. Electronic address: jon@surgery.wisc.edu.

PMID: 39566660
DOI: 10.1016/j.ajt.2024.11.016

Abstract

Pediatric donors are underutilized for simultaneous pancreas-kidney transplantation (SPK) due to concern about technical complications and inadequate islet and/or renal mass. We analyzed our experience with simultaneous en-bloc kidney and pancreas transplantation (SEBKP) using pediatric donors on eight consecutive adult patients from 1997-2018. En-bloc kidney transplants were implanted intraperitoneally and contralaterally to right-sided pancreas grafts. All patients became insulin independent immediately; with one case of delayed kidney function and one case of insulin resistance; there were no graft thromboses. Donor age averaged 5.0±1.7 years and weight 19.8±4.8kg; recipients averaged 46.6±12.8 years and BMI 25.2±3.8kg/m². Postoperative creatinine, glucose and c-peptide reflected good graft function. SEBKP transplantation is a safe technique providing excellent long-term glycemic control and kidney function to adult recipients.

Keywords: Extended Criteria; Simultaneous En-bloc Kidney and Pancreas Transplantation; pancreas transplantation; pediatric donation; simultaneous kidney and pancreas transplant.