Portal and systemic venous drainage in pancreas and kidney-pancreas transplantation: early surgical complications and outcomes.
OBJECTIVE
The objective of this study was to perform a retrospective analysis of the clinical evolution and surgical complications comparing pancreas transplantation with systemic-enteric (SE) drainage versus portal-enteric (PE) drainage.


METHODS
This review of 48 consecutive pancreas transplantation includes 39 simultaneous kidney and pancreas (SKP) and 9 pancreas after kidney (PAK) grafts as well as 2 retransplantations. Venous drainage was systemic (n = 29) or portal (n = 19).


RESULTS
There were no significant differences in patient, kidney, or pancreas allograft survival rates. There were no significant differences in levels of creatinine, fasting glucose, C-peptide, cholesterol, and homeostatic model assessment (HOMA) of beta cells, namely HOMA-s and HOMA-IR index. HbA1c was lower at 6 months and 1 year in the PE group (P < .05). Twenty-two patients displayed early postoperative complications at a mean time of presentation of 12.8 days. All of these patients but 2 needed relaparotomy. The other two were treated either conservatively (1 enteric fistula) or by interventional radiology (arteriovenous fistula). There were 10 graft losses, 5 in each group, due to thrombosis, pancreatitis, and enteric fistulae.


CONCLUSIONS
Early graft losses were related to pancreatitis and thrombosis. Intermediate-term endocrine function was similar in both groups.
Quintela
J
J
Service of General Surgery, Hospital Juan Canalejo, A Coruña, Spain. JQuintela@canalejo.org
Aguirrezabalaga
J
J
Alonso
A
A
Fernandez
C
C
Corbal
G
G
Gomez
M
M
D004322:Drainage / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology / Q000401:mortality / Q000706:statistics & numerical data; D016035:Pancreas Transplantation / Q000009:adverse effects* / Q000276:immunology / Q000401:mortality / Q000706:statistics & numerical data; D011168:Portal System / Q000601:surgery; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data; D016896:Treatment Outcome
D007166:Immunosuppressive Agents