Successful surgical salvage of pancreas allograft.
BACKGROUND
Early and late complications related to the pancreas after simultaneous kidney-pancreas transplantation (SKPT) frequently result in graft loss. The authors describe a surgical rescue technique that allows salvage of the pancreatic graft when surgical complications appear after the transplant.


METHODS
Of 158 patients who underwent SKPT, 7 were identified with posttransplant complications that required surgical salvage of the pancreas allograft. The surgical salvage technique consisted of the following: pancreatoduodenectomy with conversion from whole-pancreas transplant with bladder or enteric diversion to segmental graft with duct injection (three cases) and conversion from whole-pancreas transplant with duct injection (four cases).


RESULTS
Five of seven pancreas allografts are still functioning, with a mean follow-up of 28 months (range, 6-42 months).


CONCLUSIONS
The described surgical treatment may be useful for surgical salvage of the pancreatic allograft, without major impairment of endocrine function.
Orsenigo
Elena
E
Department of Surgery, San Raffaele Scientific Hospital, Milan, Italy. elenaors@libero.it.
Cristallo
Marco
M
Socci
Carlo
C
Castoldi
Renato
R
Fiorina
Paolo
P
Invernizzi
Laura
L
Caldara
Rossana
R
Secchi
Antonio
A
Di Carlo
Valerio
V
D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D010179:Pancreas / Q000601:surgery*; D016035:Pancreas Transplantation / Q000009:adverse effects*; D016577:Pancreaticoduodenectomy; D016879:Salvage Therapy; D014184:Transplantation, Homologous