title: Portal-endocrine and gastric-exocrine drainage technique of pancreas transplantation provides an easy access for evaluation of pancreatic allograft dysfunction: six-year experience at a single center.
abstract: BACKGROUND
  The aim of this study is to report our six-year experience with portal-endocrine and gastric-exocrine drainage technique of pancreatic transplantation, which was first developed and implemented at our center in 2007.
  
  
  METHODS
  In this study, the outcomes of all patients at our center who had pancreas transplantation with portal-endocrine and gastric-exocrine drainage technique were evaluated.
  
  
  RESULTS
  From October 2007 to November 2013, 38 patients had pancreas transplantation with this technique - 31 simultaneous kidney pancreas and seven pancreas alone. Median duration of follow-up was 3.8 years. One-, three-, and five-year patient and graft survival rates were 94%, 87%, 70% and 83%, 65%, 49%, respectively. For pancreas allograft dysfunction evaluation, 51 upper endoscopies were performed in 14 patients; donor duodenal biopsies were successfully obtained in 45 (88%). We detected nine episodes of acute rejection (eight patients) and seven episodes of cytomegalovirus (CMV) duodenitis (six patients). No patient developed any complication due to upper endoscopy.
  
  
  CONCLUSIONS
  Portal-endocrine and gastric-exocrine drainage technique of pancreas transplantation provides lifelong easy access to the transplanted duodenum for evaluation of pancreatic allograft dysfunction.
authors.affiliation: John C. McDonald Regional Transplant Center, Willis-Knighton Health System in Shreveport.
authors.forename: Gazi B
authors.initials: GB
authors.lastname: Zibari
authors.affiliation: John C. McDonald Regional Transplant Center, Willis-Knighton Health System in Shreveport.
authors.forename: Mohammad Kazem
authors.initials: MK
authors.lastname: Fallahzadeh
authors.affiliation: Department of Surgery at Louisiana State University Health Sciences in Shreveport.
authors.forename: Alireza
authors.initials: A
authors.lastname: Hamidian Jahromi
authors.affiliation: Department of Surgery at Louisiana State University Health Sciences in Shreveport.
authors.forename: Joseph
authors.initials: J
authors.lastname: Zakhary
authors.affiliation: John C. McDonald Regional Transplant Center, Willis-Knighton Health System in Shreveport.
authors.forename: David
authors.initials: D
authors.lastname: Dies
authors.affiliation: John C. McDonald Regional Transplant Center, Willis-Knighton Health System in Shreveport.
authors.forename: Greg
authors.initials: G
authors.lastname: Wellman
authors.affiliation: John C. McDonald Regional Transplant Center, Willis-Knighton Health System in Shreveport.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Singh
authors.affiliation: John C. McDonald Regional Transplant Center, Willis-Knighton Health System in Shreveport.
authors.forename: Hosein
authors.initials: H
authors.lastname: Shokouh-Amiri
mesh_terms: D000328:Adult; D064591:Allografts; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas; D016035:Pancreas Transplantation / Q000379:methods*; D011169:Portal Vein / Q000601:surgery*; D055031:Primary Graft Dysfunction / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery*