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Pancreatic transplantation with delayed duct occlusion versus bladder drainage: long-term results.

Authors
  • Königsrainer, A
  • Steurer, W
  • Aichberger, C
  • Gassner, R
  • Schmid, T
  • Margreiter, R
Type
Published Article
Journal
Diabetologia
Publication Date
Aug 01, 1991
Volume
34 Suppl 1
Identifiers
PMID: 1936691
Source
Medline
License
Unknown

Abstract

Between April 1985 and August 1990 a total of 51 combined pancreas kidney transplants and 6 single pancreas transplants were performed in 51 Type 1 (insulin - dependent) diabetic patients suffering from end-stage diabetic nephropathy and three patients with proliferative retinopathy. In 17 transplants the pancreatic duct was occluded with a mean delay of 53 days (Group 1). Because of a high incidence of local complications associated with a prolonged hospitalization this technique was abandoned despite favourable results: The actual survival rates for patients, pancreas and renal allografts at 1 year are 94%, 72% and 93%, respectively. From 1987 a total of 39 consecutive segmental pancreas grafts were anastomosed with the urinary bladder (Group 2). Pancreatic secretions were temporarily drained to the exterior in all patients via a duct catheter. Monitoring of the exocrine function including pancreatic secretion cytology and pancreatic secretion neopterin excretion proved to be reliable rejection markers. Survival rates at 1 year were calculated to be 90%, 74% and 89% for all patients, pancreas grafts and renal grafts. Apart from local complications in group I which did not cause any graft loss, the surgical complication rate was comparably low in both groups.

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