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Background There is still controversy about which preservation solution in pancreas transplantation could be the best. The aim of this study was to analyze our initial experience with Custodiol solution (CuS) compared with Viaspan solution (VS) and Celsior solution (CS) in pancreas transplantation. Methods A retrospective study included 94 consecutive pancreatic transplants, from 2007 until 2015. We compared 3 groups, depending on preservation solution: Viaspan (n = 41), Celsior (n = 40), or Custodiol (n = 13). The primary end point was patient and pancreas survival at 1 year after pancreas transplantation. Results The recipient and donor characteristics were similar except in cold ischemia time; it was higher with Celsior. No differences were found in postoperative complications and pancreas graft function at 3 months, 6 months, and 1 year (glucose, HbA1c, C-peptide, creatinine). The pancreas and patient survival at 1 year was comparable (pancreas survival: VS, 80%; CS, 90%; CuS, 92%; log-rank, 0.875; and patient survival: VS, 92%; CS, 97%; CuS, 100%; log-rank, 0.9). Conclusions In our institution, the Custodiol solution in pancreas transplantation presented similar outcomes in terms of postoperative complications, pancreas graft function, and 1-year survival.

Background C3 glomerulonephritis (C3GN) is an unusual entity that is caused by dysregulation and hyperactivity of the alternative complement pathway. Renal biopsy immunofluorescence study shows C3 deposits with absence of immunoglobulins and markers of the classical complement pathway. More than 50% of cases develop end-stage renal disease. Less well-known is the course of C3GN after kidney transplantation. Case Report We present the case of a 60-year-old woman with chronic kidney disease secondary to chronic glomerulonephritis of unknown origin who received a kidney transplant. Two years later, she presented worsening renal function with non-nephrotic proteinuria and microhematuria. Complement testing revealed low serum levels of C3. Kidney biopsy showed alterations compatible with C3GN that we interpreted as a relapse of the underlying disease.

Background Induction therapy for simultaneous pancreas-kidney (SPK) transplantation. Both thymoglobulin (ATG) and basiliximab are the most-used types of induction antibodies therapies in clinical practice. The aim of our report was to analyze our experience comparing 2 induction therapies, for SPK transplantation in terms of pancreas and patient survival, as well as rejection rate. Methods We reviewed retrospectively a total of 97 SPK transplantations in our institution. The cases were divided according to induction therapy in 2 groups, basiliximab (n = 38) and ATG (n = 59). Rejection, patient and graft survival, and postoperative complications were analyzed. Results Survival in the ATG group was better without statistical difference at 1-, 3-, and 5-year follow-up (97%, 95%, and 95% versus 92%, 90%, and 87%, respectively). No difference was detected in pancreas graft survival after 1-, 3-, and 5-year follow-up (basiliximab 85%, 80%, and 77% versus ATG 84%, 84%, and 81%, respectively; log-rank, 0.847). Overall cellular rejection and early rejection were more common in the basiliximab group (30 versus 14%, and 21% versus 6%). In the multivariate analysis considering human leukocyte antigen (HLA) mismatches, the ATG group was a protective factor for cellular rejection. Major complications (Grade III-IV) and median length of the hospital stay were higher in the basiliximab group (55% versus 34%, P = .057, and 21 versus 16 days, P = .056). Conclusions The pancreas graft survival was not affected by induction therapy. ATG induction therapy compared with basiliximab is associated with lower overall and early rejection rate. Over time this difference disappears.