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Clin Transplant Res 2024; 38(3): 203-211

Published online September 30, 2024

https://doi.org/10.4285/ctr.24.0033

© The Korean Society for Transplantation

Experience from 100 consecutive pancreas transplants amidst low national transplant activity: a retrospective study at a single center in Korea

Je Ho Ryu1,2 , Kwang Ho Yang1,2 , Rune Horneland3 , Su Hyun Ju4 , Byung Hyun Choi1,2

1Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
2Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
3Department of Vascular Surgery, Innlandet Hospital Trust, Brumunddal, Norway
4Pusan National University School of Medicine, Yangsan, Korea

Correspondence to: Byung Hyun Choi
Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea
E-mail: gmoolpop@gmail.com

Received: June 28, 2024; Revised: September 9, 2024; Accepted: September 9, 2024

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Since 1992, over 800 pancreas transplants have been performed in Korea. However, this number is significantly lower compared to the number of kidney or liver transplants.
Methods: Between 2015 and July 2023, Pusan National University Yangsan Hospital conducted 100 pancreas transplants, accounting for about 20% of all transplants performed in Korea during this period. The study comprised 27 simultaneous pancreas and kidney (SPK) transplants, 23 pancreas after kidney (PAK) transplants, and 50 pancreas transplant alone (PTA) cases. Duodenoduodenostomy was the primary surgical technique employed for exocrine drainage, along with various modifications of the venous outflow anastomosis.
Results: The availability of brain-dead donors for kidney transplants was lower compared to isolated pancreas transplants. Patients undergoing SPK transplants faced significantly longer waiting times than those receiving PTA or PAK transplants. The rate of surgical complications was acceptable, with a notably low thrombotic graft failure rate of 1.0%. In the PTA group, acute rejection of the graft pancreas occurred frequently (18.0%), though this was not statistically significant (P=0.328). The pancreas transplantation survival rates were 91.0%, 78.5%, and 75.4% at 1, 5, and 9 years, respectively. The PTA group exhibited a lower graft survival rate than the SPK and PAK groups, with marginal statistical significance (P=0.059).
Conclusions: Graft survival rates have improved over time due to advancements in surgical techniques and immunosuppressant strategies. By sharing our experiences, we aim to enhance the activity and success of pancreas transplantation in Korea.

Keywords: Pancreas transplant, Simultaneous pancreas and kidney transplant, Pancreas after kidney Transplant, Pancreas transplant alone