Experience with 100 consecutive simultaneous kidney-pancreas transplants with bladder drainage.

Abstract:

:From December 1985 to December 1989, 100 consecutive simultaneous pancreas-kidney (SPK) transplants were performed at the University of Wisconsin Hospital and Clinics. Bladder drainage technique was used for all grafts. One- and three-year patient survival was 93% and 90%; kidney survival, 90% and 85%; and pancreas survival, 86% and 84%. Quadruple immunosuppressive therapy was used in all patients and consisted of either MALG or OKT3 induction, and cyclosporine, prednisone, and azathioprine maintenance therapy. OKT3 induction therapy was used in 42 patients and Minnesota antilymphocyte globule in 58 patients, with equivalent results except for more opportunistic infection with OKT3. The duodenal button technique was used in the first 17 patients with systemic anticoagulation and was associated with significantly more postoperative bleeding and infection compared with the duodenal segment technique. The most common surgical complication of the duodenal segment technique was urine leak (13%), which usually occurred from the distal duodenal segment. The most common urologic complication of bladder drainage was hematuria (13%), which was usually self-limited. Within 6 months of transplantation, 84% of patients developed urinary tract infections, and 25% of patients had opportunistic infections. The surgical techniques and immunosuppressive methods used in this series are reviewed, and strategies for preventing medical and surgical complications are outlined.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Sollinger HW,Knechtle SJ,Reed A,D'Alessandro AM,Kalayoglu M,Belzer FO,Pirsch J

doi

10.1097/00000658-199112000-00010

subject

Has Abstract

pub_date

1991-12-01 00:00:00

pages

703-11

issue

6

eissn

0003-4932

issn

1528-1140

journal_volume

214

pub_type

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