Pancreas transplantation: advantages of both enteric and bladder drainage combined in a two-step approach

Clinical Transplantation
Pieter van de LindeAlexander F M Schaapherder

Abstract

Although there is a tendency to perform enteric drainage of pancreas transplants in simultaneous pancreas-kidney (SPK) transplantation, bladder drainage is still preferable in pancreas transplantation alone (PTA) or after a previous kidney transplantation (PAK). Our hypothesis was that enteric conversion of a bladder drained pancreas is an effective and safe procedure. We studied the complication rate and physiological effects of enteric conversion in patients with primary bladder-drained SPK transplantation. We performed 51 enteric conversions in bladder-drained SPK transplant recipients. As we observed a low complication rate, with time enteric conversions were also performed for less strict and severe indications. The main indications for conversion were urological problems, metabolic complications and reflux-pancreatitis. The median transplantation-conversion interval was 12 months (range 2-40 months). Post-operative complications consisted of seven urinary tract infections, two low-grade superficial wound infections, one minor bleeding, one phlebitis and one paralytic ileus. In two patients, a relaparotomy was necessary. No graft rejection following enteric conversion was found. Long-term renal and pancreatic function were...Continue Reading

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Citations

Feb 9, 2011·Diabetes Technology & Therapeutics·Cyrus JahansouzKenneth L Brayman
Jul 14, 2010·Transplantation Proceedings·A Arjona-SánchezS Rufián-Peña
Sep 1, 2009·Transplantation Proceedings·J Medina PoloF de la Rosa
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Dec 1, 2010·Clinical Transplantation·Axel KleespiesMartin K Angele
May 18, 2011·Journal of Intensive Care Medicine·Joseph R Scalea, Matthew Cooper
Jul 1, 2016·World Journal of Transplantation·Hany El-HennawyFowler Smith
Apr 2, 2009·Current Opinion in Organ Transplantation·Jeremy Goodman, Yolanda Tai Becker
Dec 14, 2018·Transplant International : Official Journal of the European Society for Organ Transplantation·Wouter H KoppAndries E Braat
Jan 14, 2021·World Journal of Transplantation·Joana Ferrer-Fàbrega, Laureano Fernández-Cruz

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