Open AccessMETABOLIC EFFECTS OF URINARY DIVERSION OF EXOCRINE SECRETIONS IN PANCREATIC TRANSPLANTATION
Author(s) -
Dai D. Nghiem,
Thomas A. Gonwa,
Robert J. Corry
Publication year - 1987
Publication title -
transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.45
H-Index - 204
eISSN - 1534-6080
pISSN - 0041-1337
DOI - 10.1097/00007890-198701000-00016
Subject(s) - medicine , urinary system , metabolic acidosis , bicarbonate , urinary diversion , transplantation , sepsis , acidosis , concomitant , gastroenterology , urology , bladder cancer , cancer , cystectomy
We have compared the metabolic consequences of two forms of exocrine drainage for pancreaticoduodenal transplant, duodenojejunostomy (DJ) and duodenocystostomy (DC). DC offered the advantage of avoiding opening of the recipient small intestine with its potential for wound sepsis, as well as a reliable method for early detection of pancreatic rejection as measured by an abrupt fall in urinary amylase and bicarbonate concentration. However, DC led to a large urinary loss of bicarbonate with a concomitant mild metabolic acidosis. During periods of renal dysfunction, the patients with DC developed severe hyperchloremic acidosis. Use of DC for pancreatic exocrine diversion may require patients to take supplemental bicarbonate even with a well-functioning renal transplant.