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PubMed2002

Informed consent and the process of cadaver donation.

CONTEXT: Informed consent entails more than signing a document. Ideally, it should involve a process in which individuals are given sufficient information to make a voluntary decision. Little is known about the process of informed consent for cadaver donation. OBJECTIVE: To assess existing consent procedures for cadaver donation in a sample of US medical schools. DESIGN: Cross-sectional survey and content analysis of informational brochures and consent forms given to potential cadaver donors. SETTING AND PARTICIPANTS: The 22 largest medical schools in the United States, as ranked by the number of medical students in the Association of American Medical Colleges Institutional Profile System Annual Report 1995-1996. MAIN OUTCOME MEASURES: Description of dissection procedure, information provided about dissection, and the process for obtaining consent. RESULTS: Of the 22 schools studied, 18 schools (82%) mentioned the altruistic nature of cadaver donation. Twenty-one schools (96%) specified that bodies would be used to teach students, and 16 schools (73%) specified that bodies would be used for research. One school (4%) noted that organs could be permanently preserved for teaching purposes. Only 2 schools (9%) provided any description of the dissection procedures to be performed on the cadavers. Seven schools (32%) used the term dissect at least once. None of the schools offered to provide a complete account of the dissection procedure. CONCLUSIONS: The existing consent procedures for cadaver donations at US medical schools do not provide sufficient information to potential donors to constitute a fully informed consent.

Cadaver↗
PubMed1999

Vascular function in the cadaver up to six hours after cardiac arrest.

BACKGROUND: The aim of the study was to evaluate how well vascular function is retained in a cadaver kept in a room with a temperature of 21 degrees C. METHODS: The aorta and pulmonary artery of rats were investigated in organ baths as fresh controls and after 1, 2, 3, or 6 hours' storage in the cadaver. Six-hour-old cadaver aortas were transplanted and investigated after 24 hours and 60 days. RESULTS: After 3 hours' storage there was no significant decrease in smooth muscle contractile function in either aorta or pulmonary artery. After 6 hours' storage both the aorta and the pulmonary artery demonstrated a significant decrease in smooth muscle contractile function, 30% (p < 0.05) and 44% (p < 0.001), respectively, compared to fresh controls. Storing the aorta for 2 hours and the pulmonary artery for 6 hours caused no significant decrease in endothelium-dependent relaxing function. In aorta segments investigated after 3 and 6 hours there was a significant decrease in endothelium-dependent relaxation, 12% (p < 0.05) and 29% (p < 0.001), respectively. Six-hour-old cadaver aortas transplanted and investigated after 24 hours or 60 days demonstrated no significant changes in endothelium-dependent relaxation and smooth muscle function compared to fresh controls. CONCLUSION: The pulmonary artery can tolerate 3 hours of warm ischemia in the nonheart-beating cadaver without loss of endothelium-dependent relaxation and smooth muscle function. The dysfunction seen in 6-hour-old cadaver aortas was normalized after transplantation and 24 hours of reperfusion.

Animals↗
PubMedDate not supplied

The state of preservation of the cadaver of the Marquise of Tai found in the Han Tomb No. 1 in Mawangtui near Changsha as revealed by the fine structure of the muscle and other tissues.

The cadaver in the Han Tomb No. 1 at Mawangtui near Changsha, Human Province, excavated during the Great Proletarian Cultural Revolution and the movement to criticize Lin Piao and Confucius, is the remains of the wife of Litsang, the Marquis of Tai, the Chancellor of the principality of Changsha in the early Western Han Dynasty. The cadaver, buried underground for more than 2,100 years, is very well-preserved. The results presented in this paper are a part of the multidisciplinary investigations of the state of preservation of the cadaver, which, together with the studies of the pathological changes and the cause of death, and the attempts at unveiling the secret of preservation, constituted the main objectives of the coordinated research activities for the Han cadaver. This paper describes the fine structure of the muscle and other tissues of the cadaver. By an extensive analysis of the electron micrographs of the psoas muscle, by fractionation of various fragments of the same, and by simulation experiments with fresh human muscle incubated with cathepsins, it is possible to show that the muscle fibril assumes the shape of a bamboo shoot and is made up of a stack of alternate layers of two "half A disks" (one wing of the A cylinder minus the H zone) to one Z disk, held together by remnants of the microfilaments and wrapped up in the sarcoplasmic reticulum. The H zone of the A band and the I filaments have preferentially autolyzed. The best preserved portions of the Han muscle still retain antigenicity to a certain extent. The best-preserved of all proteins is collagen, retaining much of the macromolecular, chemical and biochemical characteristics, whereas pancreatic enzymes, cytochrome C and other stable proteins could no longer be detected. The separation of degradative processes into endogenous autolysis and exogenous putrefaction, the synthesis of the factor of macromolecular stability and the factor of autolytic environment, and the disentanglement of the changes occurring soon after death and the long-term gradual changes, have been discussed in an attempt to understand how the corpse changed in the course of time and why it was so well-preserved. The well-preservedness of the cadaver of the Marquise of Tai once again testifies to the creative wisdom of the labouring class of our ancestors.

Cathepsins↗
PubMedDate not supplied

A comparative study of surgical techniques on the cervicomental angle in human cadavers.

BACKGROUND: The cervicomental (CM) angle is formed by the horizontal plane of the submental region and the vertical plane of the neck. OBJECTIVE: To compare the 2-dimensional effect of 4 surgical techniques on the CM angle in a human cadaver model. DESIGN: Anatomic presurgical and postsurgical comparative study performed on human cadavers preserved with ethylene glycol. SETTING: Academic medical research center in St Louis, Mo. SUBJECTS: Twelve cadaver specimens with obtuse CM angles with heads attached to the sternum and upper thorax. INTERVENTIONS: Standard superficial musculoaponeurotic system rhytidectomy techniques were performed on all cadaver heads. Four techniques were compared: (1) platysmal plication; (2) platysmal plication and plication of the anterior bellies of the digastrics; (3) platysmal plication, plication of the anterior bellies of the digastrics, and interlocking mastoid-to-mastoid sutures; and (4) platysmal plication and interlocking mastoid-to-mastoid sutures. MAIN OUTCOME MEASURES: The comparative changes in CM angle, the distance between the mentum and CM angle (mentum-CM distance), and the distance between the sternum and CM angle (sternum-CM distance) obtained with each of the 4 surgical techniques. Anatomic characteristics of the cadavers were also noted. RESULTS: On average, the CM angle was significantly reduced after all procedures (P<.001). The mean sternum-CM distance increased significantly (P =.01). A trend toward significance was observed in the change in mentum-CM distance (P =.10). The presence of a low hyoid was significantly associated with a smaller CM angle after surgery (P =.009) and demonstrated a trend toward significance with an increase in mentum-CM distance (P =.07), but it was not significantly associated with an increase in sternum-CM distance (P =.58). After controlling for the presence of a low hyoid, the mastoid-to-mastoid suture significantly reduced the CM angle by approximately 11.3 degrees (P =.002) and the sternum-CM distance by 1.15 cm (P<.001). CONCLUSIONS: The CM angle and the sternum-CM distance were significantly affected by all procedures. The addition of the mastoid-to-mastoid suture had the greatest effect on the CM angle, and the reduction in CM angle was strongly associated with an increase in the sternum-CM distance. Presence of a low hyoid was the only preoperative factor associated with a significant postoperative reduction in CM angle.

Aged↗
PubMed1975

Organ preservation in success of cadaver transplants.

The long-term function of 110 cadaver kidney transplants preserved by hypothermic perfusion was compared with that of 79 fresh cadaver kidneys. The one-month failure rate was 4 percent in the perfused kidneys in contrast to a 32 percent one-month failure rate reported by one cooperative group. These data were again confirmed in a prospective, paired study comparing perfused and fresh cadaver kidneys from the same donor. Thus, perfusion of kidneys was not harmful for cadaver transplantation. In fact, of 83 first cadaver transplants, less than 30 percent of perfused kidneys failed in the first year. There appears to be no evidence supporting the idea that bloodless hypothermic perfusion permanently damages human kidneys or increases the chances of rejection.

Acute Kidney Injury↗
PubMed1993

Permeabilities of alkyl p-aminobenzoates through living skin equivalent and cadaver skin.

The in vitro permeabilities of alkyl p-aminobenzoates through living skin equivalent (LSE) and cadaver skin were compared. Methyl, ethyl, and butyl p-aminobenzoates were used as model compounds. The permeabilities of these compounds through LSE and cadaver skin from an aqueous drug suspension were determined with a flow-through diffusion cell. The permeability coefficients of these esters in LSE were an order of magnitude higher than in cadaver skin. This was primarily because of low resistances offered by the outermost layer (i.e., stratum corneum) of LSE. In the case of cadaver skin, the permeability coefficient increased as the carbon chain length increased, whereas no appreciable change in the permeability coefficients of these esters in LSE was observed. These results clearly suggest that the LSE membrane offered very little resistance as opposed to cadaver skin. Therefore, the LSE membrane may not quantitatively represent a good human skin model for evaluating skin permeation of a drug from topical or transdermal formulations.

Alkylation↗
PubMed1995

The effects of a course in cadaver dissection on resident knowledge of pelvic anatomy: an experimental study.

OBJECTIVE: To determine whether a course in cadaver dissection can significantly increase resident knowledge of pelvic anatomy beyond that of current educational practices. METHODS: Thirteen first- and second-year residents were randomly assigned to a cadaver dissection course (seven) or a control group (six). The dissection group performed dissections with instruction, using a dissection guide designed specifically for the course. The control group received study references on pelvic anatomy and protected study time. Each participant took a practical and written examination at the beginning and end of the study. RESULTS: The two groups did not differ statistically in their scores on the pre-test. Both groups improved on the post-test, but the dissection group scored nearly 50% higher on the test than did the controls. The two groups differed significantly on the post-test, adjusted for pre-test performance (P < .01). In their evaluation of the course, participants from the dissection group emphasized its educational value and urged that it be offered to residents as a regular part of their training. CONCLUSION: Dissection of a human cadaver provides a valuable experience, allowing participants to gain a greater understanding of surgical anatomy and surgical procedures in a no-risk, unhurried setting. Residents who participated in a cadaver dissection course designed specifically for their needs showed a statistically significant increase in knowledge compared with those without this experience. Both objectively and subjectively, a cadaver dissection course is an excellent tool for instructing gynecology residents.

Cadaver↗
PubMed1985

Postmortem bacteriology of cadaver tissue donors: an evaluation of blood cultures as an index of tissue sterility.

Microbiological cultures were performed on the blood and bone marrow of 239 cadaver bone donors and 58 "beating heart cadaver" organ donors who had been asymptomatic of sepsis. The incidence of positive blood cultures was significantly lower among the "beating heart cadaver" donors (8.6%) as compared to other donors from whom tissues were excised up to 30 hr postmortem (38%). Microorganisms were isolated from the bones of 82 of 148 (55.4%) bone donors as well as from 36 of 53 (67.9%) "beating heart cadaver" donors who had negative blood cultures. The majority of microbial species recovered from the blood and bone marrow belonged to species normal to the skin microflora (coagulase-negative staphylococci, Bacillus and Propionibacterium species). Species of Clostridium were the second most common organisms isolated from the blood. Blood cultures alone were not useful as indicators of sepsis in cadaver tissue donors or as an index of the sterility of the tissues excised for transplantation.

Bacteriological Techniques↗
PubMed1992

An evaluation of the esophageal detector device using a cadaver model.

The study was conducted to evaluate the usefulness of an esophageal detector device (EDD) to correctly differentiate between esophageal and tracheal intubation. The study was conducted in the emergency department using 10 recently decreased cadavers (nine males, one female, age range 50-72 years). An 8-mm internal diameter endotracheal tube was placed orally into the trachea, and a second 8-mm ID tube was placed orally into the esophagus. Both tubes extended the same distance from the mouth, and the cuffs were not inflated. After placement of the tubes, the EDD was used by advanced life support providers (physicians, nurses, paramedics, and respiratory therapists) to determine if each tube was in the trachea or the esophagus. The persons who assessed the tube placement were not present when the tubes were placed into the cadavers. Multiple evaluators were allowed for each cadaver, but each evaluator only participated one time for each cadaver. The bulb of the EDD was squeezed by the evaluator, who then attached it to the endotracheal tube and rated the bulb inflation as immediate inflation, delayed inflation, or no inflation. Prior to participation in the study, evaluators were instructed in the use of the EDD. There were a total of 45 trials performed on the cadavers (median, four evaluations/cadaver, range, one-eight). For the tracheal tube, the EDD inflated immediately in all cases; it was thus 100% correct in identification of tracheal intubation. For the esophageal tube, the EDD did not inflate in 44 cases, and in one case it filled with vomitus; it thus correctly identified esophageal intubation in all cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1997

Intubation with laryngoscope versus transillumination performed by paramedic students on manikins and cadavers.

Seventeen paramedic students, all of whom are novice intubators, performed laryngoscopic and Trachlight intubation after supervised training for 90 min on two manikins (Laerdal, AMBU) and 30 min on cadavers. A maximum of two intubation attempts lasting a maximum 30 s each were permitted on each manikin and the cadaver. The time for confirming tube placement by auscultation and securing the tube was added. Laryngoscopic intubation was successful on cadavers and both manikins in 94-100% of the trials. Intubation with the Trachlight was 100% successful in the Laerdal manikin, but significantly lower than with the laryngoscope in the AMBU manikin (65%), and in cadavers (50%). The mean intubation time was significantly longer (30-44 s) with the Trachlight compared with laryngoscopic intubation (10-23 s) in both manikins and cadavers. The present results do not indicate that intubation with the Trachlight is an improvement upon laryngoscopic intubation for novices.

Allied Health Personnel↗
PubMed2003

The relationship between the diameters of the adult cricoid ring and main tracheobronchial tree: a cadaver study to investigate the basis for double-lumen tube selection.

OBJECTIVE: Previous investigation of the adult cadaver larynx has shown that the cricoid diameter never exceeds that of the glottis. This further analysis looks at the anatomic relationships between the diameter of the cricoid ring and those of the main tracheobronchial tree to discover how they relate to double-lumen tube selection. DESIGN: Prospective. SETTING: A city mortuary. PARTICIPANTS: Adult cadavers undergoing autopsy. INTERVENTIONS: The trachea was partially transected above the first ring to expose the cricoid cartilage from below and was then further opened with a progressive longitudinal incision to allow access to the tracheobronchial tree. MEASUREMENTS AND MAIN RESULTS: In 59 male and 49 female white cadavers, the largest of a graduated series of cylindrical sounds that the cricoid ring would accommodate was noted. They were then used to measure the maximum diameters of the main tracheobronchial tree. In both sexes, the mean diameter of the cricoid was shown to be the same as that of the left main bronchus, the left main bronchus to cricoid ratio almost invariably exceeded 83% (against the maximum double-lumen tube tip-to-body ratio of 80%), and the coefficient of correlation (r) between the cricoid and left main bronchial diameters was 0.6. For the trachea and left main bronchus, r was 0.5 in male cadavers and 0.45 in female cadavers. CONCLUSIONS: The dimensions of the cricoid ring best define those of the main bronchi. Knowing its diameter should assist anesthesiologists with double-lumen tube selection.

Aged↗
PubMed2003

Quality and quantity of DNA in cadavers' serum.

We investigated the quality and quantity of DNA in sera obtained from 16 cadavers who were left at room temperature or placed in a refrigerator for cadavers within 3 days of their death. The causes of death were as follows: asphyxia, 4; hemorrhage, 4; fire, 3; cold, 1; subdural bleeding, 1; sepsis, 1; cerebral contusion, 1; and pulmonary thromboembolism, 1. When examined using agarose gel electrophoresis, the samples from the victims who died from sepsis and pulmonary thromboembolism exhibited smear patterns, while the other samples exhibited ladder patterns. The size of each band was an integer multiple of approximately 180 bp, considered to be characteristic of apoptosis. The DNA concentration in the cadavers' sera ranged from 3.0 to 258.9 ng/ml. DNA types (D1S80, HLADQA1, TH01, and PM) were determined for all the samples except for the sample from the victim who died from sepsis. The detected types were the same as those obtained from paired bloodstain samples, except for in the asphyxia victim. D1S80 typing of the serum sample from the asphyxia victim showed the loss of the longer allelic hetero-band. These results suggest that the quantity of DNA in serum from cadavers is sufficient for DNA typing, but that the degradation of DNA may proceed quickly, depending on the temperature of the area in which the cadaver is left as well as the pathological conditions that the victim had experienced.

Adolescent↗
PubMed2001

Absorbed doses from spiral CT and conventional spiral tomography: a phantom vs. cadaver study.

For several radiological examinations, a clinician can select between conventional and spiral computed tomography. Using both techniques, this study aimed at evaluating the difference in absorbed doses when examining a single lateral jaw segment in a human cadaver head and Rando phantom. The present study involved the placement of thermoluminescent dosimeter (TLD) chips (GR-200) in the thyroid gland, and bilaterally, in the parotid and submandibular glands and the lenses of the eyes in both a human cadaver and a Rando phantom at corresponding locations. Consecutive conventional spiral tomographic examinations were carried out in both the left upper and lower premolar area, using a Cranex TOME multifunctional unit. Each examination consisted of 4 slices with a 2 mm slice thickness and exposure parameters of 57 kV, 56 seconds and 1.6-2.0 mA. Regarding spiral computed tomography (CT), a Somatom Plus S scanner (Siemens, Erlangen, Germany), with a slice thickness of 1 mm with settings at 120 kV and 165 mA, was used on both phantoms and separately in the upper and lower jaw. With conventional tomography, the findings of the present study showed that the parotid and submandibular glands on the side near the X-ray tube received the highest dose, both for the cadaver head (doses ranging from 0.5 to 1.3 mGy) and the phantom (doses ranging from 0.6 to 2.6 mGy). For CT of the upper jaw, the highest doses were delivered to the parotid glands with an average absorbed dose of 9.2 and 10.6 mGy for the cadaver head and phantom, respectively. The submandibular glands received the highest doses during CT examination of the lower jaw with an average of 7.8 and 12.9 mGy for the cadaver head and phantom, respectively. It appears from the present investigation that if small edentulous regions are examined, radiation doses during conventional tomography remain much lower than during CT imaging. However, when multiple tomographic cuts are required, a spiral CT examination can replace a series of conventional examinations, especially in cases such as the rehabilitation of an edentulous upper jaw or a more complex surgery.

Aged↗
PubMed2003

Improved scoring system to assess adult donors for cadaver renal transplantation.

We previously proposed a quantitative approach to assess donor organs for cadaver renal transplantation. To improve on our original scoring system, we studied 34 324 patients who received cadaver renal transplants from adult donors between 1994 and 1999 and were reported to the UNOS Scientific Renal Transplant Registry. A scoring system was developed from five donor variables (age, 0-25 points; history of hypertension, 0-4; creatinine clearance before procurement, 0-4; cause of death, 0-3; HLA mismatch, 0-3) that showed a significant correlation with renal function and long-term graft survival. Cadaver kidneys were stratified by cumulative donor score: grade A, 0-9 points; grade B, 10-19; grade C, 20-29; and grade D, 30-39. The influence of donor score on renal function and graft survival was most severe above 20 points, designated 'marginal' kidneys. In summary, a donor scoring system developed from a large population database was useful in predicting outcome after cadaver renal transplantation. The improved system provides a quantitative approach to evaluation of marginal kidneys and may improve allocation of these organs in cadaver renal transplantation.

Adult↗
PubMed2002

Sonographic imaging of the posterolateral structures of the knee: findings in human cadavers.

PURPOSE: To evaluate and characterize the use of sonography in imaging the posterolateral structures of the knee in human cadavers. TYPE OF STUDY: In vitro laboratory investigation using human cadavers and sonography. METHODS: Three cadaver knees were dissected to expose the posterolateral corner with the skin and subcutaneous tissue removed. The iliotibial band, biceps femoris muscle and tendon, lateral gastrocnemius tendon, the lateral collateral ligament, the popliteus tendon, the popliteofibular ligament, the arcuate ligament, and the fabellofibular ligament (when present) were identified. Following the soft tissue dissection, sonography was performed to characterize these structures. The technique was refined using this "open" examination method as anatomical and structural detail was noted. After adequate familiarization with this technique, researchers performed sonography on 2 pairs of thawed fresh-frozen cadaver knees, 1 pair with a fabella and 1 pair without a fabella. After sonographic examination of all of the posterolateral structures, the knees were dissected and the structures previously identified by sonography were verified. RESULTS: In all 4 cadaver specimens, all posterolateral structures were identified based on their imaging characteristics and surrounding bony and soft tissue landmarks. We also present dissection photographs and sonographic images depicting our study findings. CONCLUSIONS: Sonographic imaging may provide the clinician with valuable information regarding the posterolateral structures of the knee. To our knowledge, this is the first study to investigate the sonographic findings of these structures. This technique may assist the physician evaluating these injuries and help in preoperative planning for repair or reconstructive procedures. Further research is needed to determine the accuracy of sonography in identifying injured posterolateral corner knee structures in vivo.

Aged↗
PubMed2001

Length and width of the tendinous portion of the palmaris longus: a cadaver study of adult Japanese.

We examined 72 forearms of 36 cadavers to measure the length and width of the tendinous portion of the palmaris longus in adult Japanese. The palmaris longus muscles were absent in both arms in 1 cadaver and in a unilateral arm in 1 cadaver. Double palmaris longus muscles were found in 1 arm in another cadaver. Most cadavers had a typical palmaris longus muscle and tendon shape. The mean length and width of the tendons were 124.6 +/- 17.0 and 4.5 +/- 0.7 mm, respectively, in male specimens and 108.3 +/- 16.4 and 4.0 +/- 0.7 mm in female specimens, respectively. The mean lengths of the forearms were 240.0 +/- 12.6 mm in male specimens and 218.8 +/- 14.6 mm in female specimens. There was a statistically significant correlation between the lengths of the palmaris longus tendon and forearm. These results indicate that one can estimate the length of palmaris longus tendons before surgical intervention.

Adult↗
PubMed1974

Correlation between MLC stimulation and graft survival in living related and cadaver transplants.

"Multiple MLC's" (parallel tests in recipient, donor and globulin-poor plasma) were performed in 211 consecutive transplant donor-recipient pairs(2) The two-way MLC's were performed on patients' lymphocytes before immunosuppression. All grafts regarded as "successful" were at risk for at least six months. Patients with a low MLC (Stimulation Index less than 8 times controls) usually had successful grafts (graft survival was 83% in related transplants and 76% in cadaver transplants). Patients with high MLC's had poor graft survival (0% graft survival in related transplants and 32% in cadaver transplants). An adjusted graft survival was calculated to exclude patients who died with normal renal function (serum creatinine less than 2 mg%). The adjusted graft survival was 91% for living related transplants and 88% for cadaver transplants. Falsely low MLC's occurred when the recipient's plasma contained low-titer cytotoxic antibodies. In 15 recipients of cadaver kidneys, the MLC in recipient plasma was significantly lower than MLC's in donor or globulin-poor plasma. Since the MLC when using cadaver donors was necessarily retrospective, the results were not known pre-transplant and all 15 grafts were rejected. In living related pairs, however, we were able to screen for such antibody activity and could avoid humoral presensitization and cellular compatibility.

Cadaver↗
PubMed2000

Simultaneous cadaver pancreas living-donor kidney transplantation: a new approach for the type 1 diabetic uremic patient.

OBJECTIVE: To review the authors' experience with a new approach for type I diabetic uremic patients: simultaneous cadaver-donor pancreas and living-donor kidney transplant (SPLK). SUMMARY BACKGROUND DATA: Simultaneous cadaver kidney and pancreas transplantation (SPK) and living-donor kidney transplantation alone followed by a solitary cadaver-donor pancreas transplant (PAK) have been the transplant options for type I diabetic uremic patients. SPK pancreas graft survival has historically exceeded that of solitary pancreas transplantation. Recent improvement in solitary pancreas transplant survival rates has narrowed the advantage seen with SPK. PAK, however, requires sequential transplant operations. In contrast to PAK and SPK, SPLK is a single operation that offers the potential benefits of living kidney donation: shorter waiting time, expansion of the organ donor pool, and improved short-term and long-term renal graft function. METHODS: Between May 1998 and September 1999, the authors performed 30 SPLK procedures, coordinating the cadaver pancreas transplant with simultaneous transplantation of a laparoscopically removed living-donor kidney. Of the 30 SPLKs, 28 (93%) were portally and enterically drained. During the same period, the authors also performed 19 primary SPK and 17 primary PAK transplants. RESULTS: One-year pancreas, kidney, and patient survival rates were 88%, 95%, and 95% for SPLK recipients. One-year pancreas graft survival rates in SPK and PAK recipients were 84% and 71%. Of 30 SPLK transplants, 29 (97%) had immediate renal graft function, whereas 79% of SPK kidneys had immediate function. Reoperative rates, early readmission to the hospital, and initial length of stay were similar between SPLK and SPK recipients. SPLK recipients had a shorter wait time for transplantation. CONCLUSIONS: Early pancreas, kidney, and patient survival rates after SPLK are similar to those for SPK. Waiting time was significantly shortened. SPLK recipients had lower rates of delayed renal graft function than SPK recipients. Combining cadaver pancreas transplantation with living-donor kidney transplantation does not harm renal graft outcome. Given the advantages of living-donor kidney transplant, SPLK should be considered for all uremic type I diabetic patients with living donors.

Adult↗