Journal of the Pancreas Open Access

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Expert Review - (2021) Volume 0, Issue 0

Simultaneous Pancreas and Kidney Transplantation: A Retroperitoneal "Bilateral Rutherford-Morison Incision" Approach

Antoine Buemi*, Tom Darius, Arnaud Devresse, Michel Mourad

Department of Surgery, Surgery and Abdominal Transplantation Division, Saint-Luc University Clinics, Catholic University of Louvain, Brussels, Belgium

Corresponding Author:
Antoine Buemi
Department of Surgery
Surgery and Abdominal Transplantation Division
Saint-Luc University Clinics, Catholic University of Louvain
Brussels, Belgium
Tel: 027642297
E-mail: [email protected]

Received Date: October 18th, 2021; Accepted Date: October 29th, 2021

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Pancreas; Pancreas transplantation; Kidney transplantation; SPKT; Retroperitoneal systemic-enteric drainage


Simultaneous pancreas-kidney transplantation (SPKT) is a technically challenging procedure with several possible post-operative complications and must be carried out in a short period of time in order to reduce organ ischemiareperfusion damage [1, 2, 3].

Here, we describe a modified model of retroperitoneal systemic-enteric drainage that facilitate SPK graft transplantation by a “bilateral Rutherford-Morison incision” approach and to reduce both kidney and pancreas cold ischemia time.

Since February 2018, we performed 2 SPKT with this surgical technique. We started the procedure with the kidney transplantation through a left Rutherford-Morison incision into the retroperitoneal space.

Parallelly a second surgical team proceeds to the backtable pancreas preparation.

When the kidney transplantation procedure is completed, the pancreas graft is ready to be implanted through a right Rutherford-Morison incision and a fully retroperitoneal approach during the vascular suture realization. The enteric suture was performed after bringing a jejunal loop through a peritoneal window and the graft was covered by colon and mesocolon ascendens and was positioned in the right retroperitoneal space.

SPKT demographics data and results are shown in Table 1.


The clinical course of both patients was followed for 36 months.

No episode of acute rejection or graft dysfunction and no additional morbidity due to the modified technique were observed.

We believe that this bilateral retroperitoneal approach that we describe for the first time provides two major contributions. Firstly, it leads to an easy access to the recipient vessels. Secondly, it reduces the ischemia time by performed kidney grafting while the pancreas back-table work-up is running Table 2.



No financial interest to disclose.


No funding was required.


No conflict of interest to disclose.