A Cadaveric Case of Pancreas Re-transplantation for IDDM Patient from a Polycystic Kidney Donor with Hemodialysis

Masahiro Tanemura, Toshinori Ito, Fumihiro Uchikoshi, Koichi Kawamoto, Chyu Matsuda, Hiroshi Komoda, Yuichi Fumimoto, Toru Kitagawa, Toshiro Nishida and Hikaru Matsuda

Department of Surgery (E1), Osaka University Graduate School of Medicine

A 38-year-old man with a history of insulin-dependent diabetes mellitus (IDDM) since age 14, underwent cadaveric simultaneous pancreas-kidney transplantation at age 35, but required transplant pancreatectomy on day 7 after the transplantation, due to portal vein thrombosis. Renal allograft function was, however, well preserved. He subsequently recovered with good renal function. Two years and 10 months later, pancreas re-transplantation from a polycystic kidney donor with hemodialysis was conducted. Initial evaluation by abdominal ultrasound showed multiple cysts in the kidneys and liver, but no cystic change was detected in the pancreas. Ultimately, we decided to use the pancreas for transplantation. This is, to our knowledge, the first cadaveric case of pancreas re-transplantation in Japan since the brain death law went into effect in 1997. The patient had uneventful clinical course through out hospitalization and suffered no surgical complications, such as rejection or infection. He was discharged on postgrafting 33 day without insulin support and restarted his regular work 3 month after transplantation. Polycystic kidney disease is a systemic disorder with slow progressive deterioration of different organ functions. Typically, the kidneys begin to develop cystic enlargement in adulthood. Given the shortage of cadaveric donors in Japan, polycystic kidney donors with normal organ function are potential candidate organ donors provided that organs are carefully evaluated before donation.

Key words
pancreas, retransplantation, polycystic kidney disease

Reprint requests
Masahiro Tanemura Department of Surgery (E1), Osaka University Graduate School of Medicine
2-2 Yamadaoka, Suita, 565-0871 JAPAN

Accepted
July 28, 2004

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