P-161

Aortic clamping in pancreas transplantation. Is there any harm to the transplanted kidney graft?

M. Perosa, H. Noujaim, L.T. Mota, J.R. Branez, L.E. Ianhez, R.A. Oliveira, L.O. Ogawa, E.T.M. Shiroma, T. Genzini
HEPATO, Organ Transplantation, São Paulo, Brazil

Some special clinical situations may require the need of aortic clamping during a pancreas transplant (PT). The most important problem during this maneuver is ischemic injury to a previous transplanted kidney and its consequence is not well established.
Objective: Demonstrate experience with aortic clamping in PT without special kidney allograft protection measures and its impact on post-transplant kidney function.

Methods: Five patients who underwent PT, being 4 PAK and 1 SPK (in whom a kidney graft had just been transplanted), had a need of aortic clamping. The pancreas graft was placed at right by retrocolic portal-enteric drainage in all cases. Serum creatinine was evaluated at pre and post-transplant.

Results: The indication for aortic clamping was: severe calcification of iliac artery wall (2 cases), use of prior arterial stump (retransplantation) that emerged from the aorta (1 case), a Y graft that has not reached the common iliac artery (1 case), and a previous ipsilateral kidney graft in the right fossa (1 case). The mean serum creatinine was 1.1, 1.15, 0.95 and 1.0 mg/dl, respectively, in the pre-operative, post-operative 1 , 7 and at discharge for PAKs. There was one pancreas graft failure due to venous thrombosis. All patients passed urine during the postoperative period and no significant alterations were noticed in the daily serum creatinine levels following the procedure. In one case there was graft pyelonephritis treated with antibiotics. The SPK patient required dialysis for 1 week, after which recovered renal function. Patient, kidney and pancreatic graft survival was 100%, 100% and 80% respectively.

Conclusions: The need of aortic clamping in selected cases of PT does not seem to affect the transplanted kidney even without protection measures.

P-161

Aortic clamping in pancreas transplantation. Is there any harm to the transplanted kidney graft?

M. Perosa, H. Noujaim, L.T. Mota, J.R. Branez, L.E. Ianhez, R.A. Oliveira, L.O. Ogawa, E.T.M. Shiroma, T. Genzini
HEPATO, Organ Transplantation, São Paulo, Brazil

Some special clinical situations may require the need of aortic clamping during a pancreas transplant (PT). The most important problem during this maneuver is ischemic injury to a previous transplanted kidney and its consequence is not well established.
Objective: Demonstrate experience with aortic clamping in PT without special kidney allograft protection measures and its impact on post-transplant kidney function.

Methods: Five patients who underwent PT, being 4 PAK and 1 SPK (in whom a kidney graft had just been transplanted), had a need of aortic clamping. The pancreas graft was placed at right by retrocolic portal-enteric drainage in all cases. Serum creatinine was evaluated at pre and post-transplant.

Results: The indication for aortic clamping was: severe calcification of iliac artery wall (2 cases), use of prior arterial stump (retransplantation) that emerged from the aorta (1 case), a Y graft that has not reached the common iliac artery (1 case), and a previous ipsilateral kidney graft in the right fossa (1 case). The mean serum creatinine was 1.1, 1.15, 0.95 and 1.0 mg/dl, respectively, in the pre-operative, post-operative 1 , 7 and at discharge for PAKs. There was one pancreas graft failure due to venous thrombosis. All patients passed urine during the postoperative period and no significant alterations were noticed in the daily serum creatinine levels following the procedure. In one case there was graft pyelonephritis treated with antibiotics. The SPK patient required dialysis for 1 week, after which recovered renal function. Patient, kidney and pancreatic graft survival was 100%, 100% and 80% respectively.

Conclusions: The need of aortic clamping in selected cases of PT does not seem to affect the transplanted kidney even without protection measures.