Segmental pancreatic transplantation with enteric exocrine diversion

Abstract

Abstract Fourteen combined cadaveric renal and segmentai pancreatic transplantations with both of the organs provided by the same donor were performed, and exocrine diversion was to the recipient's bowel. Nine of the grafts have failed because of technical surgical complications, and 2 grafts failed because of rejection. Three patients are carrying well‐functioning grafts 6, 19, and 24 months, respectively, after transplantation. Ten of the kidneys are functioning; thus, the use of combined transplantation has not jeopardized the results of renal grafting. Patients who had functioning pancreatic grafts had normal or near‐normal fasting blood glucose levels; studies of intravenous glucose tolerance test revealed k‐values around or just over 1.0 and glycosylated hemoglobin levels were normal. When azathioprine was replaced with cyclosporine, 4 of 6 patients showed a significant decline in k‐value. This deterioration in blood glucose control was reversible by dosage adjustment .