title: Retroperitoneal pancreas transplantation with systemic-enteric drainage--case report.
abstract: Enteric drainage and intraperitoneal graft position is the preferred technique for pancreas transplantation at most transplant centers. The technique of retroperitoneal pancreas transplantation was first described by Boggi et al. [Transplantation,79 (2005), 1137]. In this case report, a modified model of retroperitoneal pancreas transplantation with systemic-enteric drainage is presented. A 48-yr-old patient underwent combined retroperitoneal pancreas and kidney transplantation because of type-I-diabetes, and diabetic nephropathy. At the time of transplantation, the patient had a body mass index of 31 and severe atherosclerosis of the iliac vessels. After mobilization of the colon and mesocolon ascendens, the vessels of the pancreas graft were anastomosed end-to-side to the aorta and to the inferior caval vein of the recipient. For exocrinous drainage, a side-to-side duodenojejunostomy was performed after bringing a jejunal loop through a window in the right colon mesentery. The graft was in a retroperitoneal position. The patient was insulin-independent after 48 h, the lipase and amylase levels were within the normal range. The first experience with retroperitoneal pancreas transplantation with systemic-enteric drainage showed that the technique was safe and had technical advantages when compared with the classic method.
authors.affiliation: Division of Surgery, Department of Transplantation, Medical University of Graz, Graz, Austria. judith.kahn@meduni-graz.at
authors.forename: Judith
authors.initials: J
authors.lastname: Kahn
authors.forename: Florian
authors.initials: F
authors.lastname: Iberer
authors.forename: Daniela
authors.initials: D
authors.lastname: Kniepeiss
authors.forename: Doris
authors.initials: D
authors.lastname: Duller
authors.forename: Estrella
authors.initials: E
authors.lastname: Jakoby
authors.forename: Karlheinz
authors.initials: K
authors.lastname: Tscheliessnigg
mesh_terms: D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000379:methods*; D012187:Retroperitoneal Space