Bladder Versus Enteric Drainage of Exocrine Secretions in Pancreas Transplantation: A Retrospective Analysis of the United Network for Organ Sharing Database. Issue 5 (May 2018)

• Record Type: Journal Article
• Authors: Siskind, Eric J.; Amodu, Leo I.; Pinto, Sonia; Akerman, Meredith; Jonsson, Johann; Molmenti, Ernesto P.; Ortiz, Jorge
• Is Part Of: Pancreas. Volume 47:Issue 5(2018)
• Publication Date: 2018-05
• Subjects: bladder -- drainage -- enteric -- exocrine -- pancreas transplantation -- Roux-en-Y -- BMI - body mass index -- DCD - donor after cardiac death -- PAK - pancreas after kidney -- PTA - pancreas transplant alone -- PWK - pancreas with living donor kidney -- SPK - simultaneous pancreas-kidney transplant -- UNOS - United Network for Organ Sharing; Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000001043
• Languages: English
• ISSNs: 0885-3177

Abstract

Abstract : Objectives: The method for drainage of exocrine secretions in pancreas transplantation remains a matter of debate. Different methods have evolved over time. Most data on these methods are from single-center studies with small sample sizes. Larger studies have yielded conflicting results. Methods: Data from the United Network for Organ Sharing database on all adult subjects who received pancreas and kidney-pancreas transplants between 1996 and 2012 were analyzed (n = 19, 934). Subjects were divided into 3 groups: enteric drainage with Roux-en-Y (n = 4308), enteric drainage without Roux-en-Y (n = 11, 145), and bladder drainage (n = 4481). Primary end points were patient and graft survival at 1, 3, 5, 10, and 15 years. Results: There was a patient and graft survival advantage with enteric drainage without Roux-en-Y reconstruction compared with the other methods. This was consistent at 1, 3, 5, 10, and 15 years. Conclusions: Our study demonstrated increased graft and patient survival when comparing enteric drainage of the transplanted pancreas without Roux-en-Y reconstruction to enteric drainage with Roux-en-Y and bladder drainage at 1, 3, 5, 10, and 15 years. Based on this study, we recommend enteric drainage without Roux-en-Y reconstruction as the method of choice in pancreas transplantation.