SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTAT ION - REPORT OF THE FIRST 2CASES IN CHILE

We report two insulin dependent diabetic patients with a past history of 21 and 30 years complicated with retinopathy, neuropathy and nephro pathy with arterial hypertension and kidney failure. Simultaneous panc reas-kidney transplantation was done 8 and 18 months after starting he modialysis, performing a double intraperitoneal implant with pancreato -duodeno-vesical anastomosis and contralateral kidney grafting with ur etero vesical anastomosis using antireflux techniques. In the second c ase, a second kidney transplant from the same donor was needed, due to a thrombosis of renal vein. There was one rejection episode in each c ase but renal or pancreatic function was not impaired. Other observed complications were metabolic acidosis and hyperkalemia due to urine lo ss of bicarbonate, moderate arterial hypertension and bacterial and fu ngal infections. There was a graft dysfunction due to the association of vancomycin and cyclosporin. In conclusion, in the two presented pat ients, simultaneous pancreas-kidney transplantations were successful a nd they remain free of insulin or dialytic therapy 4 and 9 months afte r the operation.