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Abstract
Background:
In this era of donor shortage, use of organs from living donors has increased significantly. Nonetheless, less than 1% of pancreas transplantations involve living donors, despite the immunological benefits, reduced cold ischemic time, and decreased waiting time. One reason for the paucity of donors is the high morbidity after open surgery. Using hand-assisted laparo-scopic donor surgery (HALDS) can be a favorable technique for living donors.
Methods:
Using HALDS, we performed three Simultaneous pancreas-kidney transplantations (SPKs) involving living donors. Two donors were women; one was a man.
Results:
Their mean age was 34.3±4.7 years, and their body mass index was 23.2±2.36 kg/m2. The mean operation time was 241±19.0 minutes and the mean cold-ischemic time of the kidney was 42.7±9.8 minutes, while that of the pancreas was 64.3±5.2 minutes. One donor developed a pancreatic fistula, which was controlled using conservative management. The donors’ pancreatic and renal functions were well preserved postoperatively.
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Fig. 2.
Exposed vessels during hand-assisted laparoscopic donor surgery. (A) Exposed renal artery and vein. (B) Splenic artery and vein were exposed when the pancreatic tail was lifted up using dissector and 2nd finger of operator.
Fig. 3.
Benching of the pancreas graft. (A) Cold perfusion with preservation solution right after the pancreas brought out from the living donor. (B) Pancreas graft after completing benching.
Fig. 4.
Abdominopelvic computer tomography. (A) Horizontal view. (B) Coronal view. Arrows indicate a cystic mass (pseudocyst) at the pancreatectomy site.
Table 1.
Characteristics and clinical outcomes of donors
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