title: [Double kidney-total pancreas transplantation with bladder reimplantation. 25 cases].
abstract: Twenty five double kidney-pancreas transplantations were performed according to the total pancreas transplantation technique with drainage of exocrine secretions into the bladder via a vesicoduodenostomy. 72% of kidney-pancreas grafts were functional at one year and 59% were functional at four years. The authors observed a slightly higher rejection rate (0.56 versus 0.34) and a higher incidence of urinary tract infection (60% versus 35%) following double pancreas and renal transplantation than after isolated renal transplantation. Complications were rare: two venous thromboses and two cases of urethritis requiring of rediversion of the duodenum into the intestine. These good results, comparable to those reported in the international registry, reflect the value of the pancreatic and renal transplantation technique using a total pancreas drained into the bladder. It would probably be preferable to transplant patients earlier, when chronic renal failure secondary to insulin-dependent diabetes induces end-stage renal failure and the need for haemodialysis.
authors.affiliation: Service d'Urologie, Hôpital de Bicêtre, Le Kremlin Bicêtre.
authors.forename: P
authors.initials: P
authors.lastname: Eschwege
authors.forename: G
authors.initials: G
authors.lastname: Benoit
authors.forename: P
authors.initials: P
authors.lastname: Blanchet
authors.forename: L
authors.initials: L
authors.lastname: Alexandre
authors.forename: C
authors.initials: C
authors.lastname: Hesse
authors.forename: D
authors.initials: D
authors.lastname: Zucman
authors.forename: A
authors.initials: A
authors.lastname: Edouard
authors.forename: A
authors.initials: A
authors.lastname: Decaux
authors.forename: H
authors.initials: H
authors.lastname: Bensadoun
authors.forename: F
authors.initials: F
authors.lastname: Andraud
authors.forename: P
authors.initials: P
authors.lastname: Chanson
authors.forename: P
authors.initials: P
authors.lastname: Bouchard
authors.forename: A
authors.initials: A
authors.lastname: Jardin
authors.forename: B
authors.initials: B
authors.lastname: Charpentier
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000379:methods*; D012092:Replantation / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery*