Summary
Between April 1985 and August 1990 a total of 51 combined pancreas kidney transplants and 6 single pancreas transplants were performed in 51 Type 1 (insulin — dependent) diabetic patients suffering from end-stage diabetic nephropathy and three patients with proliferative retinopathy. In 17 transplants the pancreatic duct was occluded with a mean delay of 53 days (Group 1). Because of a high incidence of local complications associated with a prolonged hospitalization this technique was abandoned despite favourable results: The actual survival rates for patients, pancreas and renal allografts at 1 year are 94%, 72% and 93%, respectively. From 1987 a total of 39 consecutive segmental pancreas grafts were anastomosed with the urinary bladder (Group 2). Pancreatic secretions were temporarily drained to the exterior in all patients via a duct catheter. Monitoring of the exocrine function including pancreatic secretion cytology and pancreatic secretion neopterin excretion proved to be reliable rejection markers. Survival rates at 1 year were calculated to be 90%, 74% and 89% for all patients, pancreas grafts and renal grafts. Apart from local complications in group I which did not cause any graft loss, the surgical complication rate was comparably low in both groups.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Dubernard JM, Traeger J, Neyra P, Touraine JL, Tronchant D, Blanc-Bunnot N (1978) A new method of preparation of segmental pancreatic graft for transplantation: trials in dogs and in men. Surgery 84: 633–639
Klima G, Margreiter R, Königsrainer A, Steiner E, Schmid T (1989) Pancreatic juice cytology (PJC) for early detection of pancreas allograft rejection. Transplant Proc 21: 2782–2783
Königsrainer A, Steiner E, Spielberger M, Aigner F, Schmid T, Margreiter R (1987) Delayed duct occlusion: a new technique for pancreas transplantation. Lang Arch Chir 372: 67–72
Königsrainer A, Schmid Th, Habringer Ch, Then P, Margreiter R (1990a) A new technique for venous anastomosis of pancreatic allografts. Eur Surg Res 22: 279–282
Königsrainer A, Reibnegger G, Öfner D, Klima G, Tauscher T, Margreiter R (1990b) Pancreatic juice Neopterin excretion — reliable marker for detection of pancreatic allograft rejection. Transplant Proc 22: 671–672
Königsrainer A, Feichtinger H, Waitz W, Ebner A, Scheiber K, Mack D, Margreiter R (1990c) Does pancreatic juice have a detrimental effect on bladder mucosa? Transplant Proc 22: 1600–1601
Margreiter R, Königsrainer A, Steiner E, Schmid T, Pernthaler H (1988) Improved results of pancreatic transplantation with the delayed duct occlusion technique. Transplant Proc 19: 889–890
Margreiter R, Steiner E, Königsrainer A, Aigner F, Spielberger M, Bösmüller C (1989) Results of pancreas transplantation in Innsbruck. In: Dubernard JM, Sutherland DER (eds) International handbook of pancreas transplantation, Kluwer Academic, Dordrecht, pp 379–381
Roxvall LI, Frisk B, Hedman L, Nyberg G (1988) Graft pancreatitis and hemorrhagic cystitis. Transplant Int 1: 228–229
Sollinger HW, Kalayoglu M, Hoffmann RM, Deierhoi MH, Belzer FO (1985) Experience with pancreaticocystostomy in 24 consecutive pancreas transplants. Transplant Proc 17: 141–143
Steiner E, Klima G, Niederwieser D, Königsrainer A, Margreiter R (1987) Monitoring of the pancreatic allograft by analysis of exocrine secretion. Transplant Proc 19: 2336–2338
Sutherland DER, Moudry KC (1989) Pancreas transplantation registry report. Transplant Proc 21: 2759–2762
Tom WW, Munda R, First MR, Alexander JW (1987) Autodigestion of the glans penis and urethra by activated pancreatic exocrine enzymes. Surgery 102: 99–101
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Königsrainer, A., Steurer, W., Aichberger, C. et al. Pancreatic transplantation with delayed duct occlusion versus bladder drainage: long-term results. Diabetologia 34 (Suppl 1), S4–S7 (1991). https://doi.org/10.1007/BF00587607
Issue Date:
DOI: https://doi.org/10.1007/BF00587607