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Enteric conversion after pancreatic transplantation: resolution of symptoms and long‐term results
Author(s) -
Kleespies Axel,
Mikhailov Michael,
Khalil Philipe N.,
Preissler Gerhard,
Rentsch Markus,
Arbogast Helmut,
Illner WolfDieter,
Bruns Christiane J.,
Jauch KarlWalter,
Angele Martin K.
Publication year - 2010
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2010.01363.x
Subject(s) - medicine , surgery , acute pancreatitis , transplantation , pancreas transplantation , incidence (geometry) , pancreatitis , pancreas , urinary system , genitourinary system , gastroenterology , prospective cohort study , kidney transplantation , physics , optics
Kleespies A, Mikhailov M, Khalil PN, Preissler G, Rentsch M, Arbogast H, Illner W‐D, Bruns CJ, Jauch K‐W, Angele MK. Enteric conversion after pancreatic transplantation: resolution of symptoms and long‐term results.
Clin Transplant 2011: 25: 549–560. © 2010 John Wiley & Sons A/S. Abstract: Purpose: Bladder drainage (BD) of pancreatic transplants is associated with a unique set of complications. We intended to analyze the incidence, indications, complications and long‐term results of enteric conversion procedures (EC). Methods: Using a prospective database, 32 EC patients out of 433 simultaneous pancreas–kidney‐transplant (SPK) recipients were identified. Graft and patient survival rates were compared with those after primary enteric drainage (ED). Results: The mean SPK‐EC interval was 5.0 yr, and the mean patient follow‐up was 13.8 yr. Indications for EC were genitourinary symptoms (62.5%), duodenal complications (15.6%), graft pancreatitis (12.5%), pyelonephritis (6.3%), and metabolic acidosis (3.1%). All patients reported significant long‐term resolution of symptoms. Surgical complications, reoperations, early graft loss, and 30‐d mortality occurred in 31.3%, 25.0%, 6.3%, and 3.1% of cases, respectively. Pancreatic graft and patient survival rates at 1, 5, and 10 yr after SPK were comparable between EC patients and ED patients at the same institution. Conclusion: For the treatment of symptoms associated with BD, EC results in excellent long‐term graft function and significant resolution of symptoms even years after SPK. Postoperative morbidity after EC including early reoperation and graft loss, however, has to be considered.