Consolidation of enteric drainage for exocrine secretions in simultaneous pancreas-kidney transplant.
BACKGROUND
Management of the exocrine drainage of the pancreatic graft in simultaneous pancreas kidney (SPK) transplantation has been a matter of debate for years. There is currently a trend toward a more physiological enteric drainage (ED). This study compared short- and long-term complications and graft survival in patients with enteric versus bladder exocrine secretion drainage.


METHODS
Between January 1995 and November 2005, we performed 75 SPK transplants: 55 with ED and 20 with bladder drainage (BD). The rates of complications and graft survival were monitored over at least 36 months after transplantation.


RESULTS
Mean posttransplant follow-up was 119.5 +/- 6.6 months. Urinary infection, hematuria, reflux pancreatitis, and repeat surgery rates were all significantly higher among the BD area. There was no intergroup difference in rejection rates or in the incidence of graft thrombosis, transplantectomy, anastomotic dehiscence, or intra-abdominal abscesses. Pancreas and kidney graft survival rates were similar in the two groups.


CONCLUSIONS
In our experience, ED was more physiological than BD, and was associated with fewer complications.
Arjona-Sánchez
A
A
Department of Surgery, Reina Sofia Hospital, Córdoba, Spain.
Muñoz-Casares
F C
FC
Ruiz-Rabelo
J
J
Navarro
M D
MD
Lopez-Andreu
M
M
Regueiro
J C
JC
Padillo-Ruiz
F J
FJ
Rufián-Peña
S
S
D000293:Adolescent; D000328:Adult; D048909:Diabetes Complications / Q000601:surgery; D003956:Dialysis / Q000379:methods; D004322:Drainage / Q000379:methods; D005088:Exocrine Glands / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006470:Hemorrhage / Q000453:epidemiology; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D016035:Pancreas Transplantation / Q000379:methods* / Q000401:mortality; D010195:Pancreatitis / Q000453:epidemiology; D010530:Peritoneal Dialysis / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors; D001743:Urinary Bladder / Q000378:metabolism; D014552:Urinary Tract Infections / Q000453:epidemiology