Simultaneous en bloc kidney and pancreas transplantation 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 from pediatric donors: Selection, surgical strategy, management, and outcomes

Am J Transplant. 2024 Nov 19: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, Wisconsin, USA.
² Division of Transplantation, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, 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, Wisconsin, 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, Wisconsin, 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 due to concerns about technical complications and inadequate islet and/or renal mass. We analyzed our experience with simultaneous en bloc kidney and pancreas transplantation using pediatric donors on 8 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 1 case of delayed kidney function and 1 case of insulin resistance; there were no graft thromboses. Donor age averaged 5.0 ± 1.7 years and weight 19.8 ± 4.8 kg; recipient age averaged 46.6 ± 12.8 years and body mass index 25.2 ± 3.8 kg/m². Postoperative creatinine, glucose, and C-peptide reflected good graft function. Simultaneous en bloc kidney and pancreas transplantation is a safe technique providing excellent long-term glycemic control and kidney function to adult recipients.

Keywords: extended criteria; pancreas transplantation; pediatric donation; simultaneous en bloc kidney and pancreas transplantation; simultaneous kidney and pancreas transplant.