Journal of Clinical Gastroenterology and Hepatology Open Access

Kidney and Pancreas Graft Surgical Re innervation in clinics

Annual Summit on Hepatology and Pancreatic Diseases

November 12-13, 2018 Paris, France

Dimitri Mikhalski, Anh Dung Hoang, Alexis Buggenhout, Desislava Germanova, Georgios Katsanos, Patrizia Loi, Tsy Yeng Choy and Very Coulic

CHU Erasme, Free Brussels University (ULB), Brussels, Belgium

Scientific Tracks Abstracts: J Clin Gastroenterol Hepatol

Abstract:

Background: Up to now the general opinion is that vascular connections of a graft to its recipient are necessary and enough to ensure the graft satisfactory function. Nevertheless a degradation of the functional performances of the grafts, especially pancreas ones, was observed in post-operation late delays in the absence of evident chronic rejection process. The benefit of surgical re innervation of syngeneic intestinal and pancreatic grafts was previously proved in experiments on dogs and rats: acceleration of functional recovery, good morphological and physiological results in late observation delays. The aim of the present pilot study was to investigate the technical feasibility of surgical reconstruction of the nervous connections between graft and recipient during transplantation surgery, to evaluate the eventual risk and to test the short delay results. Material and methods: A total of 30 patients were involved after similar kidney or pancreas transplantation: 10 with surgical re innervation, 20 for control without it. Observation delay: up to 12 months. Post-transplantation investigations were provided as usually. Results: A technique of suturing nervous plexus of the graft with the recipient sacral plexus nerves was elaborated. The manipulation did not excess 10 min after decamping of the recipient blood vessels. No surgical or post-operation complication was registered. The early post-operation course was easy. Conclusion: The first results of the surgically directed re innervation of pancreas and kidney grafts were encouraging. The long delay functional results (5 years and more) are necessary to evaluate the possible benefit of the immediate reconstruction of both vascular and nervous connections between grafts and recipients, as well as a physiologic proof of their neuro reflex links restoration.

Biography :

Dimitri Mikhalski currently working as a director of the transplantation department Hospital Erasme. He has completed his diploma in June 1998 at Katholieke Universiteit Leuven (KUL) Leuven, Belgium and Masters degree in People Friendship University (PFU) – Moscou, USSA. His research interest includes Full member Council of Organ Transplantation of Belgium and Consultant-Adviser Department "Conservation of the human organs "Superior Council of Health Care Belgium.

E-mail: dimitrimikhalski@hotmail.com