Repeat Pancreas Transplant Procedures: Recipient Selection and Surgical Techniques

Abstract

Pancreas retransplantation is not a common procedure but has been offered at experienced centers, and its application goes back to the late 1970s. In recent times, graft survival outcomes have become similar to that of primary transplants. Pancreas retransplantation can be challenging and is offered at a decreasing number of transplant centers. Success can hinge on recipient selection as well as technical aspects of the operation. We review the body of literature with attention to improved outcomes over time. This article highlights the existing literature on pancreas retransplant, and outlines key points regarding recipient selection and technical considerations that may be useful when offering pancreas retransplantation.

Medical and Surgical Management of the Failed Pancreas Transplant

“…Technical aspects are considerable and include prior vascular dissections, atherosclerotic disease, and the location of the failed pancreas (and possibly kidney). 63 The placement options for the new graft may be limited by any of these factors. A careful review of prior operative records and cross-sectional imaging is imperative, both in terms of prior vascular anastomoses and the method of enteric drainage used.…”