Evaluation of the outcomes and complications of use of extended carotid artery with Y-graft technique versus conventional Y-graft technique in pancreatic transplant surgery in the treatment of type 1 diabetic patients; A prospective randomized controlled trial

To study a specific arterial reconstruction policy for pancreatic transplants and its outcome

A therapeutic clinical trial with the control group, not blinded, randomized, on 60 patients. Samples are randomly allocated into two groups using random allocation software 2.0.

In this therapeutic RCT, samples are selected by available sampling method from patients with type 1 diabetes who require SPK transplantation. Samples will be divided into intervention (n=30) and control (n=30) groups by simple randomization.Two different techniques for SPK transplantation in these patients at Abu Ali Sina Transplant Hospital in Shiraz are studied and compared in terms of results and complications.

-Inclusion criteria: Patient's consent Pancreas transplant form Having a simultaneous pancreas-kidney (SPK) transplant Patients with diabetic nephropathy who undergo portal venous drainage Exclusion criteria: Unwillingness to participate in study Patients who undergo systemic venous drainage Patients who undergo pancreas transplant alone (PTA)

Both intervention and control groups include patients who are candidates SPK transplant in patients with type 1 diabetes. In intervention group, the extension of the right iliac artery is passed through the mesentery and placed next to the SMV for anastomosis. The Y graft is completely shortened and the carotid artery is removed from the donor for extension. In control group, a long Y graft is placed directly in the right iliac artery, while trying to reach the maximum length to maintain the anastomosis without stretching.

1. Operation time 2. Incidence of arterial complications 3. Incidence of postoperative pancreatitis 4. The cold ischemic phase 5. The warm ischemic time 6. Transplant rejection 7. Mortality

Randomization is done by simple randomization method with individual units with the help of the help of Excel program randomization capability. In this method, for each of the numbers 1 to 60, one of letters of A (for the intervention group) and B (for the control group) are assigned equally. To execute a random sequence, the method of hiding numbered envelopes is used. In this method, the envelopes are numbered based on a random sequence, and inside the envelopes, the desired intervention, on which random allocation is written based on letter A or B, is provided to the executor with the condition that the envelopes are completely sealed, and the researcher, based on the order of patients' entry. Allocates them in the intervention group and the control group. The envelopes will be the same shape and will be prepared by an independent researcher. Patients are assigned to one of the two groups in order of enrollment by number.