Enteric drainage of pancreas transplants revisited.

Abstract

In the last few years the majority of pancreas transplants performed in this country have been drained through the bladder,1 which is a modification of the original Starzl technique of pancreatic duodenal grafts drained into the small intestine.2 However, urologic complication rates related to bladder drainage (BD) have remained high, which has lead to increased morbidity,3 lengthy hospitalizations, and an increase in cost. As better success rates of achieving an insulin-free state with normal carbohydrate metabolism have occurred in transplant centers performing simultaneous pancreas kidney transplantation (SPK), it is logical to extend this procedure, to a greater degree, to those diabetic patients requiring a solitary graft which heretofore have represented only a small percentage of the total number of pancreas transplants performed. To achieve this goal, however, success rates in the solitary organ group need to improve and morbidity must be low with subsequent lower cost. We report herein our recent experience within the last several months with 21 enteric-drained (ED) pancreases and 10 BD grafts.