Pankreas-Böbrek Nakili Hastalarda Koroner Arter Baypas Cerrahisi: Türkiye’deki İlk Olgu ve Literatürden Kısa Bir Derleme

Yıl 2016, Cilt: 19 Sayı: 2, 117 - 119, 01.08.2016

Burçin Abud Cengiz Özbek Soysal Turhan Kemal Karaarslan Yücel Karaman

Öz

Otuz yedi
yaşında erkek hasta kardiovasküler hastalık şikayetleri ile hastanemize
başvurdu. Hasta 7 yıl önce kombine pankreas-böbrek nakli, 4 yıl öncede nakili
böbreğin rejeksiyonundan dolayı ikinci kez böbrek nakli olmuş idi. Koroner
anjiyografi ile iki damar koroner arter hastalığı tanısı konan hastaya koroner
arter baypas cerrahisi uygulandı. Hastanın postoperatif dönemi stabil seyretti
ve hasta sorunsuz bir şekilde taburcu edildi. Koroner arter hastalığı gelişen
kombine pankreas-böbrek nakili hastalarda koroner arter baypas cerrahisi
güvenli bir şekilde uygulanabilir.

Anahtar Kelimeler

Kombine pankreas-böbrek nakli, böbrek nakli, koroner arter hastalığı, koroner arter baypas cerrahisi, kardiyopulmoner baypas

Coronary Artery Bypass Grafting in Kidney and Pancreas Transplantation: First Case in Turkey and a Short Literature Review

Öz

A
37-year-old man with symptoms of cardiovascular disease applied to our
hospital. Seven years ago, he had undergone combined kidney and pancreas
transplantation. Afterwards, 4 years ago, his renal transplantation was
repeated because of rejection. Coronary artery angiography revealed two-vessel
coronary artery stenosis. We performed coronary artery bypass grafting to treat
the coronary artery disease. The post-operative period was uneventful, and he
was discharged from the hospital without any complications. Coronary artery
diseases in recipients of combined kidney and pancreas transplantation can be
safely treated using coronary artery bypass grafting.

Anahtar Kelimeler

Combined kidney and pancreas transplantation, kidney transplantation, coronary artery disease, coronary artery bypass graft, cardiopulmonary bypass

Kaynakça

• 1. Wai PY, Sollinger HW. Long-term outcomes after simultaneous pancreas-kidney transplant. Curr Opin Organ Transplant 2011;16:128-34.
• 2. Morath C, Schmied B, Mehrabi A, Weitz J, Schmidt J, Werner J, et al. Simultaneous pancreas-kidney transplantation in type 1 diabetes. Clin Transplant 2009;21:115-20.
• 3. Mohan P, Safi K, Little DM, Donohoe J, Conlon P, Walshe JJ, et al. Improved patient survival in recipients of simultaneous pancreas-kidney transplant compared with kidney transplant alone in patients with type 1 diabetes mellitus and end-stage renal disease. Br J Surg 2003;90:1137-41.
• 4. Ziaja J, Marcinkowski W, Cierpka L, Wiecek A. The influence of simultaneous pancreas and kidney transplantation on long-term diabetic complications in patients with insulin dependent diabetes mellitus. Pol Merkur Lekarski 2003;15:455-8.
• 5. Jukema JW, Smets YFC, Van Der Pijl JW, Zwinderman AH, Vliegen HW, Ringers J. Impact of simultaneous pancreas and kidney transplantation on progression of coronary atherosclerosis in patients with end-stage renal failure due to type 1 diabetes. Diabet es Care 2002;25:906-11.
• 6. Larsen J, Larsen C, Hirst K, Miller SA, Ozaki CF, Taylor RJ. Lipid status after combined pancreas-kidney transplantation and kidney transplantation alone in type 1 diabetes mellitus. Transplantation 1992;54:992-6.
• 7. Eschertzhuber S, Hohlrieder M, Boesmueller C, Pomaroli A, Steurer W, Junker T, et al. Incidence of coronary heart disease and cardiac events in patients undergoing kidney and pancreatic transplantation. Transplant Proc 2005;37:1297-300.
• 8. Kim SI, Elkhammas EA, Henry ML, Davies EA, Bumgardner GL, Ferguson RM. Outcome of combined kidney/pancreas transplantation in recipients with coronary artery disease. Transplant Proc 1995;27:3071.
• 9. Biesenbach G, Königsreiner A, Gross C, Margreiter R. Progression of macrovascular diseases is reduced in type 1 diabetic patients after more than 5 years successful combined pancreas-kidney transplantation in comparison to kidney transplantation alone. Transpl Int 2005;18:1054-60.
• 10. Mitruka SN, Griffith BP, Kormos RL, Hattler BG, Pigula FA, Shapiro R, et al. Cardiac operations in solid-organ transplant recipients. Ann Thorac Surg 1997;64:1270-8.
• 11. Zhang L, Garcia JM, Hill PC, Haile E, Light JA, Corso PJ. Cardiac surgery in renal transplant recipients: Experience from Washington hospital center. Ann Thoracic Surg 2006;81:1379-84.
• 12. John R, Lietz K, Huddleston S, Matas A, Kenneth L, Shumway S, et al. Perioperative outcomes of cardiac surgery in kidney and kidney-pancreas transplant recipients. J Thorac Cardiovasc Surg 2007;133:1212-9.
• 13. Ono M, Wolf RK, Angouras DC, Brown DA, Goldstein AH, Michler RE. Short- and long-term results of open heart surgery in patients with abdominal solid organ transplant. Eur J Cardiothorac Surg 2002;21:1061-72.
• 14. Bromberg JS, Baliga P, Cofer JB, Rajagopalan PR, Friedman RJ. Stress steroids are not required for patients receiving a renal allograft and undergoing operation. J Am Coll Surg 1995;180:532-6.
• 15. Bolman RM, Anderson RW, Molina JE, Schwartsz JS, Levine B, Simmons RL, et al. Cardiac operations in patients with functioning renal allografts. J Thorac Cardiovasc Surg 1984;88:537-43.
• 16. Redmon JB, Teuscher AU, Robertson RP. Hypoglicemia after pancreas transplantation. Diabetes Care 1998;21:1944-50.