SIMULTANEOUS PANCREAS-KIDNEY-TRANSPLANTATION - RECENT EXPERIENCE AT THE UNIVERSITY-OF-WISCONSIN

After a decade of rapid development, simultaneous pancreas - kidney (S PK) transplantation has become routine at the University of Wisconsin (UW). Since developing the concept of direct drainage of pancreas allo graft exocrine secretions into the urinary bladder at UW in 1982, we p erformed 381 SPK transplantations in this technique. Patient and graft survival following SPK transplantation has increased significantly fr om our early experience to the recent time. The one- and five-year pat ient survival rates for the entire series of 381 SPK transplantations were 96% and 88%, respectively. The actuarial one- and five-year kidne y allograft survival rates in these patients were 87% and 78%. The pan creas allograft survival rates were similar at 86% and 74%. Several ch anges are responsible for our current high level of success: UW preser vation solution, improved surgical technique, advances in immunosuppre ssion, and expeditious diagnosis and treatment of complications.