BACKGROUND AND OBJECTIVES: @entity740 ( @entity740 ) has become a critical problem due to immunosuppressant related nephrotoxicity in liver transplant (LTx) recipients, especially in @entity1 with pre-transplant risk factors. LTx recipients with uraemia and @entity6 have poor prognosis even when treated with dialysis and insulin. Simultaneous pancreas and kidney transplantation (SPK) has been proven to be an effective treatment for @entity1 with @entity6 , but rarely performed in @entity1 after LTx. Two cases of SPK after LTx were performed in our centre and we present our experience here. @entity1 AND METHODS: Two @entity1 received LTx because of @entity97 related @entity1575 ; both of them had pre-transplant @entity6 ( @entity6 ), which worsened after the administration of immunosuppressive drugs. These two @entity1 suffered from @entity740 and developed uraemia due to @entity2316 and immunosuppressive drugs induced @entity8 years after LTx. They relied on dialysis and insulin injection. SPK were performed years after LTx and the clinical data was retrospectively analyzed. RESULTS: SPK was successfully performed in these two @entity1 . Pancreatic fluid drainage was achieved via a side-to-side duodenojejunostomy into the proximal jejunum. No serious surgical complications, including @entity788 or @entity3472 were observed postoperatively. In both cases, kidney and pancreatic grafts were functioning well as evidenced by euglycemia without the need for insulin injections and normal serum- @entity1011 level 7days after the operation. One of the @entity1 presented with renal graft impairment 1week after the operation. @entity1140 was tapered and @entity3446 was used when the renal graft biopsy indicated @entity137 . The @entity1 's kidney graft function recovered gradually after the adjustment. Both @entity1 have good function of liver, kidney and pancreas grafts during a 60-month and 30-month period of follow up. CONCLUSIONS: SPK could serve as an effective option for @entity1 with @entity6 and @entity5507 after LTx. Perioperative management, especially the immunosuppressive strategy is crucial to improve the outcome of this procedure.

Simultaneous pancreas and kidney transplantation for liver transplant recipients with XXXX and @entity5507 .

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS', 'patient'] @entity97 :: ('10407', 'Species') :: ['HBV'] @entity8 :: ('MESH:D007674', 'Disease') :: ['renal toxicity'] @entity788 :: ('MESH:D010190', 'Disease') :: ['pancreatitis'] @entity137 :: ('MESH:D064420', 'Disease') :: ['drug toxicity'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetic uraemia', 'diabetes', 'diabetes mellitus', 'DM'] @entity2316 :: ('MESH:D003928', 'Disease') :: ['diabetic nephropathy'] @entity5507 :: ('MESH:D014511', 'Disease') :: ['uremia'] @entity740 :: ('MESH:D051436', 'Disease') :: ['Chronic kidney disease', 'CKD'] @entity3446 :: ('MESH:D020123', 'Chemical') :: ['rapamycin'] @entity3472 :: ('MESH:D010185', 'Disease') :: ['pancreatic fistula'] @entity1011 :: ('MESH:D003404', 'Chemical') :: ['creatinine'] @entity1575 :: ('MESH:D008103', 'Disease') :: ['liver cirrhosis'] @entity1140 :: ('MESH:D016559', 'Chemical') :: ['FK506']
@entity6 :: (MESH:D003920,Disease) :: ['diabetes']
