title: Pancreas retransplantation: outcomes of 20 cases.
abstract: The objective of this paper was to evaluate our initial experience with pancreas retransplantation. From January 26, 1996 to February 2005, 285 pancreas transplantations were performed, including 20 (7%) retransplants. The causes of primary graft loss were graft thrombosis in 11 (55%, 7 venous and 4 arterial); 4 (20%) chronic rejections; 2 (10%) ischemia/reperfusion injury; 1 severe graft pancreatitis; 1 primary nonfunction; and 1 sepsis. Venous drainage was placed in the iliac vessels in 14 (70%), vena cava in 5 (25%), and portal drainage in 1. The exocrine drainage was vesical in 16 (80%) and enteric in 4 (20%). In 14 cases (70%), the primary graft was removed before and in 6 (30%) at the time of retransplantation. Immunosuppression was based on antilymphocyte induction, tacrolimus, mycophenolate mofetil, and steroids in all patients. One-year patient and graft survivals were 95% and 85%. In conclusion, pancreas retransplants were feasible with results comparable to a primary pancreas transplantation.
authors.affiliation: HEPATO, Hepatology and Organ Transplantation Department, Albert Einstein Hospital, São Paulo, Brazil.
authors.forename: T
authors.initials: T
authors.lastname: Genzini
authors.forename: F
authors.initials: F
authors.lastname: Crescentini
authors.forename: F C M
authors.initials: FC
authors.lastname: Torricelli
authors.forename: I
authors.initials: I
authors.lastname: Antunes
authors.forename: A
authors.initials: A
authors.lastname: Hayashi
authors.forename: N J
authors.initials: NJ
authors.lastname: Kim
authors.forename: E B
authors.initials: EB
authors.lastname: Rangel
authors.forename: E R
authors.initials: ER
authors.lastname: Belieacqua
authors.forename: H
authors.initials: H
authors.lastname: Noujaim
authors.forename: J R
authors.initials: JR
authors.lastname: de Sa
authors.forename: M
authors.initials: M
authors.lastname: Perosa
mesh_terms: D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D003928:Diabetic Nephropathies / Q000601:surgery; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D016035:Pancreas Transplantation / Q000706:statistics & numerical data*; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome