Fifteen Years' Experience With Pancreas Transplantation With Pancreaticoenterostomy

Author:

Groth Carl-Gustav1,Tydén Gunnar1,ÖStman Ja1

Affiliation:

1. Departments of Transplantation Surgery and Medicine, Karolinska Institute, Huddinge Hospital Stockholm, Sweden

Abstract

We report on 92 pancreas transplantations with exocrine diversion by pancreaticoenterostomy. All recipients suffered from long-term type I (insulin-dependent) diabetes. In most transplantations, cadaveric segmental grafts were used (n = 89). In a few patients, segmental grafts from related donors were used (n = 3), and in a few other patients, wholeorgan cadaveric grafts were used (n = 4). There were 9 retransplantations. Most pancreas transplantations were performed in uremie diabetic patients in combination with a kidney transplantation (n = 58). In a few patients the pancreas transplantation was performed after a kidney transplantation (n = 6). The remaining transplantations were in nonuremic diabetic patients who received only a pancreas (n = 25). Over the years, the results have improved considerably; in the 1986–1987 series the overall 1-yr patient survival (ps) and graft survival (gs) rates were 97 and 56%, respectively. The best results were achieved with the combined procedure (ps 100%, gs 77%); with pancreas only, the figures were inferior (ps 92%, gs 34%). Several factors explain the improved results. The incidence of graft thrombosis has been reduced by the use of anticoagulation, and posttransplantation pancreatitis has been reduced by avoiding ischemie injury to the graft. Cyclosporin has helped reduce the incidence of graft rejection, and monitoring of the exteriorized pancreatic juice has helped in the diagnosis of rejection.

Publisher

American Diabetes Association

Subject

Endocrinology, Diabetes and Metabolism,Internal Medicine

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1. Pancreas Graft Pathology;Transplantation of the Pancreas;2004

2. Are Hypoglycaemia and Other Adverse Effects Similar Among Sulphonylureas?;Adverse Drug Reactions and Toxicological Reviews;2002-12

3. PANCREAS TRANSPLANTATION: THE HISTOLOGIC MORPHOLOGY OF GRAFT LOSS AND CLINICAL CORRELATIONS;Transplantation;2001-06

4. Update of tacrolimus in pancreas transplantation;Diabetic Medicine;1997-11

5. Intraportal Delivery of Immunosuppressants to Intrahepatic Islet Allografts;Local Immunosuppression of Organ Transplants;1996

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