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  • Title: Portal and systemic venous drainage in pancreas and kidney-pancreas transplantation: early surgical complications and outcomes.
    Author: Quintela J, Aguirrezabalaga J, Alonso A, Fernandez C, Corbal G, Gomez M.
    Journal: Transplant Proc; 2009; 41(6):2460-2. PubMed ID: 19715951.
    Abstract:
    OBJECTIVE: The objective of this study was to perform a retrospective analysis of the clinical evolution and surgical complications comparing pancreas transplantation with systemic-enteric (SE) drainage versus portal-enteric (PE) drainage. METHODS: This review of 48 consecutive pancreas transplantation includes 39 simultaneous kidney and pancreas (SKP) and 9 pancreas after kidney (PAK) grafts as well as 2 retransplantations. Venous drainage was systemic (n = 29) or portal (n = 19). RESULTS: There were no significant differences in patient, kidney, or pancreas allograft survival rates. There were no significant differences in levels of creatinine, fasting glucose, C-peptide, cholesterol, and homeostatic model assessment (HOMA) of beta cells, namely HOMA-s and HOMA-IR index. HbA1c was lower at 6 months and 1 year in the PE group (P < .05). Twenty-two patients displayed early postoperative complications at a mean time of presentation of 12.8 days. All of these patients but 2 needed relaparotomy. The other two were treated either conservatively (1 enteric fistula) or by interventional radiology (arteriovenous fistula). There were 10 graft losses, 5 in each group, due to thrombosis, pancreatitis, and enteric fistulae. CONCLUSION: Early graft losses were related to pancreatitis and thrombosis. Intermediate-term endocrine function was similar in both groups.
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