Enteric conversion after bladder-drained pancreatic transplantation; a simple and safe salvage procedure.
OBJECTIVE
To present our experience with conversion from bladder to enteric drainage after simultaneous pancreatic and renal transplants, so that new transplant centres know that it is both safe and effective.


METHODS
Retrospective study.


METHODS
Teaching hospital, Republic of Ireland.


METHODS
Six patients who had simultaneous pancreatic and renal transplants for insulin-dependent diabetes and who subsequently developed complications of bladder drainage including recurrent episodes of dehydration and metabolic acidosis (n = 3), haematuria (n = 2), and urinary tract infections (n = 1).


METHODS
Conversion to enteric drainage.


METHODS
Resolution of symptoms.


RESULTS
All symptoms resolved, but one patient each developed pulmonary oedema, haematuria, and prolonged ileus. All three complications resolved on conservative treatment. All patients are well with surviving grafts a mean of 40 months later (range 19-50).


CONCLUSIONS
Conversion to enteric drainage is safe and effective in patients with refractory metabolic or urological complications of bladder drainage after simultaneous pancreatic and renal transplantation.
Connolly
E M
EM
Department of Urology and Transplantation, Beaumont Hospital, Dublin, Ireland. liz_connolly@hotmail.com
Baktavatsalam
R
R
O'Malley
K
K
Little
D M
DM
Hickey
D P
DP
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D007422:Intestines; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects* / Q000379:methods*; D001743:Urinary Bladder