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

Publication ,  Journal Article
Sollinger, HW; Knechtle, SJ; Reed, A; D'Alessandro, AM; Kalayoglu, M; Belzer, FO; Pirsch, J
Published in: Ann Surg
December 1991

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.

Duke Scholars

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

December 1991

Volume

214

Issue

6

Start / End Page

703 / 711

Location

United States

Related Subject Headings

  • Urinary Bladder
  • Tissue and Organ Procurement
  • Survival Rate
  • Surgery
  • Preoperative Care
  • Postoperative Complications
  • Postoperative Care
  • Pancreas Transplantation
  • Organ Preservation
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Sollinger, H. W., Knechtle, S. J., Reed, A., D’Alessandro, A. M., Kalayoglu, M., Belzer, F. O., & Pirsch, J. (1991). Experience with 100 consecutive simultaneous kidney-pancreas transplants with bladder drainage. Ann Surg, 214(6), 703–711. https://doi.org/10.1097/00000658-199112000-00010
Sollinger, H. W., S. J. Knechtle, A. Reed, A. M. D’Alessandro, M. Kalayoglu, F. O. Belzer, and J. Pirsch. “Experience with 100 consecutive simultaneous kidney-pancreas transplants with bladder drainage.Ann Surg 214, no. 6 (December 1991): 703–11. https://doi.org/10.1097/00000658-199112000-00010.
Sollinger HW, Knechtle SJ, Reed A, D’Alessandro AM, Kalayoglu M, Belzer FO, et al. Experience with 100 consecutive simultaneous kidney-pancreas transplants with bladder drainage. Ann Surg. 1991 Dec;214(6):703–11.
Sollinger, H. W., et al. “Experience with 100 consecutive simultaneous kidney-pancreas transplants with bladder drainage.Ann Surg, vol. 214, no. 6, Dec. 1991, pp. 703–11. Pubmed, doi:10.1097/00000658-199112000-00010.
Sollinger HW, Knechtle SJ, Reed A, D’Alessandro AM, Kalayoglu M, Belzer FO, Pirsch J. Experience with 100 consecutive simultaneous kidney-pancreas transplants with bladder drainage. Ann Surg. 1991 Dec;214(6):703–711.

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

December 1991

Volume

214

Issue

6

Start / End Page

703 / 711

Location

United States

Related Subject Headings

  • Urinary Bladder
  • Tissue and Organ Procurement
  • Survival Rate
  • Surgery
  • Preoperative Care
  • Postoperative Complications
  • Postoperative Care
  • Pancreas Transplantation
  • Organ Preservation
  • Male