The bladder drainage technique in pancreas transplantation--the Tübingen experience.
Starting in 1987 renal- and pancreaticoduodenal--transplantations were performed simultaneously in a consecutive series of 40 patients with Type 1 diabetes mellitus and end-stage renal disease. Exocrine secretion of the pancreatic graft does not seem to be a crucial problem anymore when using the bladder drainage technique. No pancreatic fistulae were seen. No graft lost its function due to early post-operative graft thrombosis. Early post-operative graft pancreatitis and recurrent urinary tract infections remain the drawbacks of the bladder drainage technique. Despite a strong immunestimulation of the recipient by the combined pancreaticoduodenal/renal allograft all but two rejection episodes could be reversed by using different monoclonal/polyclonal antibodies. Actuarial 1-year-graft survival rate reaches 85% for the pancreas as well as the kidney. Thus, simultaneous pancreas-kidney transplantation can be performed with a high success rate when using the technique described.
Hopt
U T
UT
Department of Surgery, Eberhard-Karls-University, Tübingen, FRG.
Büsing
M
M
Schareck
W D
WD
Becker
H D
HD
D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000601:surgery; D005500:Follow-Up Studies; D005858:Germany; D006084:Graft Rejection; D006801:Humans; D007165:Immunosuppression Therapy; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods / Q000502:physiology; D016035:Pancreas Transplantation / Q000379:methods* / Q000502:physiology; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D001743:Urinary Bladder / Q000601:surgery*