PMID- 10654269
OWN - NLM
STAT- MEDLINE
DCOM- 20000222
LR  - 20191103
IS  - 1435-2443 (Print)
IS  - 1435-2443 (Linking)
VI  - 384
IP  - 6
DP  - 1999 Dec
TI  - Living-donor pancreas and small-bowel transplantation.
PG  - 544-9
AB  - BACKGROUND: In contrast to renal and liver transplantation, only a limited number 
      of pancreas and intestinal live-donor transplants have so far been reported. 
      PATIENTS: The vast majority of live segmental pancreas transplants have been 
      performed at the University of Minnesota. From 1979 to 1993, a total of 78 
      solitary pancreas transplants--28 after kidney and 49 pancreas transplants 
      alone--were performed and, from 1994 to August 1999, 27 simultaneous 
      pancreas/kidney transplants. For the first intestinal transplant, a segment of 
      ileum from the mother was used in Boston in 1964. In 1970, 170 cm of jejuno-ileum 
      from a human leukocyte antigen (HLA)-identical sister was removed and 
      transplanted in New York. In 1988, an intestinal transplant from a 
      haplo-type-identical sister was performed at Kiel University, Germany. In the 
      1990s, a few more intestinal transplants from live donors were reported to the 
      registry. RESULTS: No death occurred among pancreas or intestinal donors. 
      Altogether, seven pancreas donors required splenectomy and several donors 
      required drainage of abscesses or fluid collections. Three of the 78 pancreas 
      donors and at least two of the 27 pancreas/kidney donors required insulin 
      post-donation. Twenty-seven of the solitary segmental pancreas transplants failed 
      for technical reasons. Graft survival of technically successful pancreas 
      transplants was 68% after 1 year and 38% after 10 years. Patient and renal 
      allograft survival of combined kidney/pancreas transplants after 1 year was 100%, 
      while 1-year pancreas survival was 84%. The first recipient of a live-donor 
      intestinal transplant died only 12 h after surgery. The second case lived for 79 
      days and was able to eat for 6 weeks. A patient transplanted in 1988 lived for 4 
      years mainly on oral nutrition. Many of the live-donor intestinal transplants 
      carried out in the 1990s became long-term survivors. CONCLUSION: Pancreas and 
      small-bowel transplantation using organs from live donors is possible in 
      experienced centers, with no donor mortality and excellent survival rates for 
      recipients and grafts. Since abnormal glucose tolerance post-donation cannot be 
      excluded with certainty and since, for the time being, there is no pancreas or 
      small-bowel shortage in Europe, live donation of these organs should be 
      restricted mainly to highly sensitized patients with a cross-match-negative 
      relative or HLA-identical donor-intestinal recipient combinations.
FAU - Margreiter, R
AU  - Margreiter R
AD  - Innsbruck University Hospital, Department of Transplant Surgery, Austria. 
      raimund.margreiter@uibk.ac.at
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Langenbecks Arch Surg
JT  - Langenbeck's archives of surgery
JID - 9808285
SB  - IM
MH  - Diabetes Mellitus, Type 1/*surgery
MH  - Female
MH  - Humans
MH  - Intestine, Small/*transplantation
MH  - Kidney Transplantation/methods/statistics & numerical data
MH  - *Living Donors
MH  - Male
MH  - *Pancreas Transplantation/methods/statistics & numerical data
MH  - Registries
EDAT- 2000/02/02 09:00
MHDA- 2000/02/26 09:00
CRDT- 2000/02/02 09:00
PHST- 2000/02/02 09:00 [pubmed]
PHST- 2000/02/26 09:00 [medline]
PHST- 2000/02/02 09:00 [entrez]
AID - 10.1007/s004230050241 [doi]
PST - ppublish
SO  - Langenbecks Arch Surg. 1999 Dec;384(6):544-9. doi: 10.1007/s004230050241.