Abstract：
Simultaneous pancreas-kidney transplantation (SPKT) is the best treatment for selected individuals with type 1 diabetes mellitus and end-stage renal disease. Despite advances in surgical techniques, donor and recipient selection, and immunosuppressive therapies, SPKT remains a complex procedure with associated surgical complications and adverse consequences. We conducted a retrospective study that included 263 SPKT procedures performed between May 2000, and December 2022. A total of 65 patients (25%) required at least one relaparotomy, resulting in an all-cause relaparotomy rate of 2.04 events per 100 in-hospital days. Lower donor body mass index was identified as an independent factor associated with reoperation (OR .815; 95% CI: .725-.917, p = .001). Technical failure (TF) occurred in 9.9% of cases, primarily attributed to pancreas graft thrombosis, intra-abdominal infections, bleeding, and anastomotic leaks. Independent predictors of TF at 90 days included donor age above 36 years (HR 2.513; 95% CI 1.162-5.434), previous peritoneal dialysis (HR 2.503; 95% CI 1.149-5.451), and specific pancreas graft reinterventions. The findings highlight the importance of carefully considering donor and recipient factors in SPKT. The incidence of TF in our study population aligns with the recent series. Continuous efforts should focus on identifying and mitigating potential risk factors to enhance SPKT outcomes, thereby reducing post-transplant complications.
摘要：
胰肾联合移植（SPKT）是选择1型糖尿病和终末期肾病患者的最佳治疗方法。尽管手术技术取得了进展，捐赠者和接受者的选择，和免疫抑制疗法，SPKT仍然是一个复杂的过程，具有相关的手术并发症和不良后果。我们进行了一项回顾性研究，包括2000年5月至2022年12月期间进行的263例SPKT手术。共有65名患者（25％）需要至少一次剖腹手术，导致全因重新剖腹手术发生率为每100个住院日2.04个事件.较低的供体体重指数被确定为与再次手术相关的独立因素(OR.815;95%CI:.725-.917,p=.001)。技术故障（TF）发生在9.9％的病例中，主要归因于胰腺移植物血栓形成，腹腔感染,出血,吻合口漏.90天TF的独立预测因素包括36岁以上的供者年龄（HR2.513;95％CI1.162-5.434），既往腹膜透析（HR2.503；95%CI1.149-5.451），和特定的胰腺移植再干预。研究结果强调了在SPKT中仔细考虑捐赠者和接受者因素的重要性。我们研究人群中TF的发病率与最近的系列一致。持续的努力应侧重于识别和减轻潜在的风险因素，以提高SPKT的结果，从而减少移植后的并发症。
