Perioperative outcomes and phase-specific intraoperative glycemic management in simultaneous pancreas-kidney transplantation: A single-center case series

Table 1 Demographic and preoperative clinical characteristics of patients undergoing simultaneous pancreas-kidney transplantation

Variables	Age (years)	Sex	BMI (kg/m2)	Type of diabetes	Use of insulin pump	ESRD stage	Dialysis modality	C-peptide (ng/mL)
Case 1	42	M	20.13	T1DM	Yes	IV	Pre-D	3.16
Case 2	37	F	21.18	T1DM	Yes	V	PD	2.64
Case 3	25	F	19.74	T1DM	No	IV	Pre-D	< 0.03
Case 4	35	M	24.46	T1DM	No	V	PD	< 0.1
Case 5	36	F	20.7	T1DM	No	IV	Pre-D	4.06
Case 6	41	M	26.87	T1DM	No	V	Pre-D	NA
Case 7	38	M	25.64	T1DM	No	V	HD	NA
Case 8	43	M	25.06	T2DM	No	V	HD	NA
Case 9	48	F	26.73	T2DM	No	V	HD	NA
Case 10	40	F	23.64	T1DM	No	V	HD	15.4
Case 11	39	M	19.79	T1DM	No	V	HD	NA

All patients had a diagnosis of diabetes mellitus and chronic kidney disease in advanced stages (IV-V); six out of seven were receiving dialysis therapy at the time of transplantation. BMI: Body mass index; M: Male; F: Female; HD: Hemodialysis; PD: Peritoneal dialysis; Pre-D: Predialysis; NA: Not available; T1DM: Type 1 diabetes mellitus.

Table 2 Intraoperative variables, n (%)

Variables	Induction glycemia mg/dL (mmol/L)	Pancreas cold ischemia time	Pancreas warm ischemia time	Renal cold ischemia time	Renal warm ischemia time	Intraoperative glycemic variability mg/dL (mmol/L)	Post reperfusion glycemia mg/dL (mmol/L)
Case 1	172 (9.6)	6 hours 56 minutes	42 minutes	8 hours	30 minutes	110-210 (6.1-6.7)	116 (6.4)
Case 2	143 (7.9)	8 hours 39 minutes	29 minutes	11 hours 40 minutes	30 minutes	68-274 (3.8-15.2)	203 (11.3)
Case 3	97 (5.4)	9 hours 19 minutes	29 minutes	11 hours 49 minutes	NA	63-275 (3.5-15.3)	75 (4.2)
Case 4	93 (5.2)	7 hours 55 minutes	NA	10 hours 50 minutes	45 minutes	93-198 (5.2-11)	99 (5.5)
Case 5	101 (5.6)	6 hours 16 minutes	40 minutes	8 hours 34 minutes	45 minutes	99-453 (5.5-25-2)	109 (6.1)
Case 6	100 (5.6)	8 hours 18 minutes	30 minutes	11 hours 5 minutes	40 minutes	88-290 (4.9-16.1)	120 (6.7)
Case 7	88 (4.9)	8 hours 11 minutes	35 minutes	11 hours 30 minutes	45 minutes	108-232 (6-12.9)	108 (6.0)
Case 8	112 (6.2)	9 hours 44 minutes	40 minutes	8 hours 18 minutes	40 minutes	73-201 (4.1-11.2)	146 (8.1)
Case 9	94 (5.2)	9 hours 30 minutes	30 minutes	6 hours 11 minutes	48 minutes	94-294 (5.2-16.3)	190 (10.6)
Case 10	114 (6.3)	6 hours 13 minutes	35 minutes	8 hours	35 minutes	166-332 (9.2-17.9)	83 (4.6)
Case 11	254 (14.1)	7 hours 14 minutes	40 minutes	10 hours 36 minutes	40 minutes	83-234 (4.6-13)	166 (9.2)

Cold and warm ischemia times for each graft are shown, expressed in hours and minutes. NA: Not available.

Table 3 Immediate postoperative metabolic evolution

Variables	Peak POP glycemia (md/dL, first 24 hours)	Hypoglycemia	POP insulin requirement	Amylase (U/L)	Lipase (U/L)	Creatinine (mg/dL)
Case 1	140	Yes	No	174	94.7	0.8
Case 2	121	No	No	101	2163	2.5
Case 3	164	No	No	387	58	3.8
Case 4	449	No	Yes	95	16.8	11.3
Case 5	130	No	Yes	223	138.2	3.5
Case 6	134	Yes	No	135	35	1.4
Case 7	123	No	No	52	82.8	5.2
Case 8	300	No	Yes	422	22.5	11.4
Case 9	104	No	Yes	148	91.8	6.3
Case 10	64	No	No	184	502	3.9
Case 11	108	No	No	124	372	5.4

Postoperative glycemia: Peak of blood glucose values during the first 24 hours. Hypoglycemia: Any recorded value < 70 mg/dL (< 3.9 mmol/L). Amylase and lipase: Peak values during the first 24 hours postoperatively. Creatinine: Highest value during the first 24 hours postoperatively. POP: Postoperative.