Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2017; 23(45): 8104-8108
Published online Dec 7, 2017. doi: 10.3748/wjg.v23.i45.8104
Simultaneous liver, pancreas-duodenum and kidney transplantation in a patient with hepatitis B cirrhosis, uremia and insulin dependent diabetes mellitus
Jiang Li, Qing-Jun Guo, Jin-Zhen Cai, Cheng Pan, Zhong-Yang Shen, Wen-Tao Jiang
Jiang Li, Qing-Jun Guo, Jin-Zhen Cai, Cheng Pan, Zhong-Yang Shen, Wen-Tao Jiang, Department of Liver Transplant, Tianjin First Central Hospital, Tianjin 300192, China
Wen-Tao Jiang, Department of Transplant Surgery, Tianjin First Central Hospital, Tianjin 300192, China
Author contributions: Guo QJ, Cai JZ, and Pan C performed transplant surgery and provided the intellectual content; Jiang WT summarized the clinical data; Li J performed the literature review and drafted the manuscript; Shen ZY contributed critical comments and revised the manuscript; all authors read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81400680; Tianjin Natural Science Foundation, No. 17JCQNJC12800.
Institutional review board statement: Approval from the ethics committee of the Tianjin First Central Hospital was obtained for this study.
Informed consent statement: The patient gave his written informed consent to this case report.
Conflict-of-interest statement: We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work. There is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Wen-Tao Jiang, MD, Professor, Department of Transplant Surgery, Tianjin First Central Hospital, No. 24, Fukang Road, Nankai District, Tianjin 300192, China. jiangwentao@sina.com
Telephone: +86-22-23626858 Fax: +86-22-23626199
Received: June 29, 2017
Peer-review started: June 30, 2017
First decision: July 13, 2017
Revised: August 27, 2017
Accepted: September 13, 2017
Article in press: September 13, 2017
Published online: December 7, 2017
Processing time: 158 Days and 23 Hours
Core Tip

Core tip: Combined orthotopic liver and heterotopic pancreas transplant has been usually reported in the literature. Here we present a new and more efficient en bloc technique for combined liver-pancreas transplant. Hepatectomy was performed in the standard fashion with caval cross-clamping. The liver, along with the en bloc duodenopancreatic graft, was then transplanted orthotopically without using veno-venous bypass. Graft kidney was implanted in right iliac fossa in accordance with the traditional classical manner. Postoperative recovery was uneventful and the patient was discharged on the 15th postoperative day with normal liver and kidney function. The insulin treatment was completely withdrawn 3 wk after operation, and the blood glucose level remained normal. The case findings support that abdominal organ cluster and kidney transplantation is an effective method for the treatment of end-stage liver disease combined with uremia and insulin dependent diabetes mellitus.