Urological complications after simultaneous renal and pancreatic transplantation.
OBJECTIVE
To report the urological complications after simultaneous renal and pancreatic transplantation.


METHODS
Retrospective study.


METHODS
Teaching hospital, Italy.


METHODS
143 consecutive patients having simultaneous renal and pancreatic transplantation by one of three techniques. 33 segmental pancreas with duct occlusion, 77 whole pancreas with bladder diversion, and 33 enteric diversion with systemic (n = 26) or portal venous drainage (n = 7). Urological complications were related to the pancreatic transplant, to the renal transplant, or unrelated to the transplant.


METHODS
Morbidity.


RESULTS
After occlusion of the duct and enteric diversion, there were no urological complications related to the pancreatic transplant. On the other hand, among the 77 patients with pancreatic drainage into the bladder, urological complications were common (56/77; 73%). Complications related to the renal transplant were recorded in 6/33 (18%), 26/77 (34%) and 12/33 (36%), respectively. Complications unrelated to the transplant occurred in 6/77 patients (8%) in the bladder drainage group. Five patients after bladder drainage required cystoenteric conversion.


CONCLUSIONS
Enteric diversion is a safe alternative to bladder diversion and results in significantly fewer urological complications.
Orsenigo
Elena
E
Department of Surgery, Università Vita e Salute, Milan, Italy. elenaors@tiscali.it
Cristallo
Marco
M
Socci
Carlo
C
Castoldi
Renato
R
Secchi
Antonio
A
Colombo
Renzo
R
Invernizzi
Laura
L
Fiorina
Paolo
P
Naspro
Richard
R
Di Carlo
Valerio
V
D000328:Adult; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D009017:Morbidity; D016035:Pancreas Transplantation; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D014570:Urologic Diseases / Q000453:epidemiology*
D007166:Immunosuppressive Agents