Solitary pancreas and simultaneous pancreas-kidney transplantation from living donors

We studied retrospectively 106 pancreas transplants from living donors. Of these, 83 were solitary pancreas transplants, done between June 1979 and De cember 1997 (51 pancreas transplants alone for non-uremic recipients as wel l as 32 pancreas-after-kidney transplants for previously uremic recipients with a functioning kidney graft), and 23 were simultaneous pancreas-kidney transplants (SPK), done between March 1994 and December 1997. In all, 105 ( 99%) donors were genetically related to the recipients. Perioperative donor mortality was 0%. Donor complications included 9 splenectomies as well as 4 operatively drained and 7 percutaneously managed peripancreatic fluid col lections. We noted hyperglycemia in 3 (3%) donors (all among the initial ca ses in this series). The 1-year graft survival rate was 50% for solitary pa ncreas recipients and 78% (pancreas) and 100% (kidney) for SPK recipients. Of the 5 pancreas graft losses which occurred after SPK, 3 were due to thro mbosis, 1 to pancreatitis and infection, and 1 to chronic rejection. Curren tly, sill kidney grafts and 18 pancreas grafts are functioning in these 23 dual organ recipients (with 0% recipient mortality). Living donor pancreas and SPK grafting is associated with low donor morbidity and good graft outc ome. With stringent donor criteria and appropriate counseling of the prospe ctive donor/recipient pairs, living donor pancreas transplants may become a more widely applied therapeutic alternative for selected non-uremic and ur emic patients with Type I diabetes.