Experience with simultaneous XXXX .

@entity1 @entity8 @entity500 @entity6 @entity229 @entity205 @entity1723 @entity1011
With refinements in surgical techniques and increased clinical experience, there has been a resurgence of interest in vascularized pancreas transplantation. From December 1986 to April 1988, 30 whole-organ vascularized pancreas transplants with pancreatico duodenocystostomy were performed simultaneously with renal transplantation. The recipient population consisted of 20 @entity1 and ten @entity1 , with a mean age of 34.7 years (range of 25-53 years). The mean duration of @entity1723 ( @entity1723 ) was 22.6 years (range of 10-37 years). The mean pancreas preservation time was 8.7 hours (range 3-19 years). All @entity1 were immediately insulin-independent. Simultaneous pancreas-kidney engraftment was performed to both iliac fossae via a lower midline incision (n = 28) or through a bilateral lower abdominal incision (n = 2). The mean operating time was 5.9 hours, and packed cell transfusion requirement was 1.3 units. The mean length of hospital stay was 27.4 days. Recipients averaged 2.3 admissions (1-7), with ten @entity1 (34.4%) requiring only one hospital admission. Postoperative immunosuppression consisted of @entity205 , @entity229 , @entity500 , and Minnesota antilymphoblast globulin (MALG). A total of 49 episodes of rejection occurred in 26 @entity1 . Actuarial @entity1 survival rate at two years is 96.3%. The kidney and pancreas survival rates for the same time interval is 94.0% and 84.0%, respectively. Mean serum @entity1011 at present is 1.75 mg/dl. In conclusion, renal transplantation in concert with pancreas transplantation has a dramatic positive impact on pancreas allograft survival. Combined engraftment does not appear to jeopardize renal allograft functional survival. In view of these results, simultaneous @entity8 appears to be the treatment of choice for Type I @entity6 @entity1 .
