Allograft pancreatectomy after pancreas transplantation with systemic-bladder versus portal-enteric drainage

From 1989 to 1997, we performed 159 pancreas transplantations (PTXs), including 117 simultaneous kidney–PTX (SKPT), 25 PTXs alone (PTA), and 17 sequential PTXs after kidney transplantations (PAKT). A total of 73 PTXs were performed with systemic‐bladder (S‐B) and 86 with portal‐enteric (P‐E) drainag...

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Bibliographic Details
Published in:Clinical transplantation 1999-12, Vol.13 (6), p.465-472
Main Authors: Stratta, Robert J, Osama Gaber, A, Hosein Shokouh-Amiri, M, Sudhakar Reddy, K, Francesca Egidi, M, Grewal, Hani P
Format: Article
Language:English
Subjects:
Biological and medical sciences
Drainage - methods
Duodenum
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Jejunum
Liver, biliary tract, pancreas, portal circulation, spleen
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Medical sciences
Other diseases. Semiology
pancreas transplantation
Pancreas Transplantation - methods
Pancreatectomy
Portal Vein
portal-enteric drainage
rejection
Reoperation
Retrospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
surgical complications
systemic-bladder drainage
thrombosis
Urinary Bladder
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Summary:From 1989 to 1997, we performed 159 pancreas transplantations (PTXs), including 117 simultaneous kidney–PTX (SKPT), 25 PTXs alone (PTA), and 17 sequential PTXs after kidney transplantations (PAKT). A total of 73 PTXs were performed with systemic‐bladder (S‐B) and 86 with portal‐enteric (P‐E) drainage. The need for allograft pancreatectomy (PCTY) may be considered as an index of technical morbidity after PTX. A total of 37 PCTYs (23%) were performed at a mean of 4.7 months after PTX. Twenty‐seven PCTYs were performed within 1 month, 30 (81%) within 3 months, and the remaining seven more than 6 months after PTX. The incidence of PCTY did not differ according to type of transplantation: simultaneous kidney–PTX (SKPT) (23%), PTA (24%), and PAKT (23.5%). Indications for PCTY were thrombosis (23), rejection (9), infection (3), and pancreatitis (2). During the study, a total of 70 pancreas grafts were lost, with PCTY performed in 37 (53%). PCTY was directly related to the timing of graft loss; 77% of grafts lost within 3 months of PTX required PCTY, while 25% of grafts lost after 3 months resulted in PCTY (p
ISSN:0902-0063
1399-0012
DOI:10.1034/j.1399-0012.1999.130605.x