Urological Complications After Simultaneous Pancreas-Kidney Transplantation

Polo, J. Medina; Morales, José; Blanco, Miguel Ángel Hidalgo; Aguirre, J.F.; Andrés, Amado; Díaz, Rafael; Jiménez, Carlos; Leiva, O; Meneu, J.C.; Moreno, Enrique; Pamplona, M.; Passas, J.; Rodríguez, Alfredo Nodarse; Rosa, Federico de la

doi:10.1016/j.transproceed.2009.06.065

Cited by 19 publications

(8 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Following the groundbreaking studies of Sollinger et al [65] and Nghiem et al [66] in the 1980s, bladder drainage with a donor duodenal segment became the preferred method of handling the pancreatic ductal secretions in pancreas transplantation until the mid-to late-1990s (Table 1) [67][68][69][70][71][72][73][74] . With this technique, the donor duodenum functions as an exocrine conduit and is anastomosed to the vesical dome either using a 2-layer hand sewn technique or a circular stapled anastomosis [75] ( Figure 1).…”

Section: Bladder Drainage Of the Exocrine Secretions (Systemicbladdermentioning

confidence: 99%

“…Hospital Universitario Spain, Medina Polo et al [73] , Retrospective, mean follow-up 52 mo n = 107, all SPK, bladder drainage in 58, enteric drainage in 49…”

Section: El-hennawy H Et Al Exocrine Drainage In Pancreas Transplantsmentioning

confidence: 99%

“…The incidence of surgical complications is also similar by type of transplant (SPK compared to solitary pancreas transplantation) [1][2][3] . Leaks from the allograft duodenum have been reported to occur in 5%-20% of bladder-drained and 5%-8% of bowel-drained pancreas transplants [9,[33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][67][68][69][70][71][72][73]80,[91][92][93][94][95] . Increasing experience with enteric exocrine drainage is likewise associated with a decreased rate of technical complications [9,38,80,[96][97][98][99][100][101][102][103] .…”

Section: El-hennawy H Et Al Exocrine Drainage In Pancreas Transplantsmentioning

confidence: 99%

See 2 more Smart Citations

Exocrine drainage in vascularized pancreas transplantation in the new millennium

El‐Hennawy¹,

Stratta²,

Smith³

2016

WJT

View full text Add to dashboard Cite

The history of vascularized pancreas transplantation largely parallels developments in immunosuppression and technical refinements in transplant surgery. From the late-1980s to 1995, most pancreas transplants were whole organ pancreatic grafts with insulin delivery to the iliac vein and diversion of the pancreatic ductal secretions to the urinary bladder (systemic-bladder technique). The advent of bladder drainage revolutionized the safety and improved the success of pancreas transplantation. However, starting in 1995, a seismic change occurred from bladder to bowel exocrine drainage coincident with improvements in immunosuppression, preservation techniques, diagnostic monitoring, general medical care, and the success and frequency of enteric conversion. In the new millennium, pancreas transplants are performed predominantly as pancreatico-duodenal grafts with enteric diversion of the pancreatic ductal secretions coupled with iliac vein provision of insulin (systemic-enteric technique) although the systemic-bladder technique endures as a preferred alternative in selected cases. In the early 1990s, a novel technique of venous drainage into the superior mesenteric vein combined with bowel exocrine diversion (portal-enteric technique) was designed and subsequently refined over the next ≥ 20 years to recreate the natural physiology of the pancreas with firstpass hepatic processing of insulin. Enteric drainage usually refers to jejunal or ileal diversion of the exocrine secretions either with a primary enteric anastomosis or with an additional Roux limb. The portal-enteric technique has spawned a number of newer and revisited techniques of enteric exocrine drainage including duodenal or gastric diversion. Reports in the literature suggest no differences in pancreas transplant outcomes irrespective of type of either venous or exocrine diversion. The purpose of this review is to examine the FIELD OF VISION

show abstract

Section: Bladder Drainage Of the Exocrine Secretions (Systemicbladdermentioning

confidence: 99%

“…Hospital Universitario Spain, Medina Polo et al [73] , Retrospective, mean follow-up 52 mo n = 107, all SPK, bladder drainage in 58, enteric drainage in 49…”

Section: El-hennawy H Et Al Exocrine Drainage In Pancreas Transplantsmentioning

confidence: 99%

Section: El-hennawy H Et Al Exocrine Drainage In Pancreas Transplantsmentioning

confidence: 99%

See 1 more Smart Citation

Exocrine drainage in vascularized pancreas transplantation in the new millennium

El‐Hennawy¹,

Stratta²,

Smith³

2016

WJT

View full text Add to dashboard Cite

show abstract

“…BD permits control of anastomotic complications by decompression with transurethral catheters, allows visualization of the anastomosis, gives access for cystoscopic biopsies of the graft, and permits urine amylase measurement for monitoring of rejection (22,(30)(31)(32). However, BD also exposes the recipient to a unique set of complications related to the relatively high bladder pressure, enzymatic digestion of the urinary mucosa, and fluid-and bicarbonate losses into the urine leading to alterations in the normally acidic environment (2,5,10,11,15,(33)(34)(35)(36). In most patients, those complications can be managed conservatively and usually resolve within six months after transplantation (13).…”

Section: Discussionmentioning

confidence: 99%

Enteric conversion after pancreatic transplantation: resolution of symptoms and long‐term results

Kleespies¹,

Mikhailov²,

Khalil³

et al. 2010

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

“…Las complicaciones urológicas (pancreatitis por reflujo de orina, infecciones, hematuria, cistitis, uretritis, etc.) están relacionadas con el TP cuando se realiza una derivación duodeno-vesical (32,33).…”

Section: Cuidados Perioperatorios Y Monitorización Del Injerto C0mplicaciones Pos-trasplanteunclassified

Update of pancreas transplantation. Experience of the Hospital Doce de Octubre

Jiménez¹,

Moreno²,

Manrique³

et al. 2021

an. ranm

Self Cite

View full text Add to dashboard Cite

Pancreas transplantation (PT) is considered as the only treatment that can convert a diabetic patient in a euglucemic state without the use of insulin or oral antidiabetic drugs. From 1996 to the end of 2016, more than 50,000 PT were performed in USA, and in Spain were performed 1.730 PT during the last 10 years. In this review we will perform an update of PT considering the introduction of several advances in the last years, adding our accumulated experience from the beginning of our program in the year 1995. The first PT was carried out in the Hospital of the University of Minnesota, and from that date several significant improvements have been introduced along the time due to advances in surgical technique in pancreas donors and recipients, perioperative management of patients, and introduction of more potent immunosuppressors able to reduce the rejection rate under 20%. Although PT is a therapy associated with a higher morbidity (pancreas graft thrombosis, systemic and intraabdominal infections, anastomotic leakages, etc.), currently most of the PT teams have obtained a rate of 93% of patient survival at 3-years, and between 78% and 83% of graft survival at 3-years. Additionally, the normal pancreas graft function is associated with an improvement of quality of life and most of complications related to diabetes, without the necessity to treat with antidiabetics drugs or insulin.

show abstract

Urological Complications After Simultaneous Pancreas-Kidney Transplantation

Cited by 19 publications

References 10 publications

Exocrine drainage in vascularized pancreas transplantation in the new millennium

Exocrine drainage in vascularized pancreas transplantation in the new millennium

Enteric conversion after pancreatic transplantation: resolution of symptoms and long‐term results

Update of pancreas transplantation. Experience of the Hospital Doce de Octubre

Contact Info

Product

Resources

About