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Enteric conversion after bladder-drained pancreatic transplantation; a simple and safe salvage procedure
E M Connolly1, R Baktavatsalam, K O'Malley
1Department of Urology and Transplantation, Beaumont Hospital, Dublin, Ireland. liz_connolly@hotmail.com
The European Journal of Surgery = Acta Chirurgica
|June 23, 2001
Summary
Converting bladder to enteric drainage after simultaneous pancreas and kidney transplants is safe and effective for managing complications. This approach resolves metabolic and urological issues, ensuring graft survival.
Area of Science:
- Transplantation immunology
- Gastroenterology
- Nephrology
Background:
- Simultaneous pancreas and kidney transplantation (SPKT) is a treatment for type 1 diabetes.
- Bladder drainage is common but can lead to complications.
- Complications include dehydration, metabolic acidosis, hematuria, and UTIs.
Purpose of the Study:
- To evaluate the safety and efficacy of converting from bladder to enteric drainage.
- To provide data for transplant centers considering this procedure.
Main Methods:
- Retrospective study at a teaching hospital.
- Six patients with SPKT and bladder drainage complications underwent conversion to enteric drainage.
- Outcomes assessed by symptom resolution and graft survival.
Main Results:
- All patients experienced symptom resolution post-conversion.
- Minor complications (pulmonary edema, hematuria, ileus) occurred in three patients, all resolved with conservative treatment.
- Grafts remained viable at a mean follow-up of 40 months.
Conclusions:
- Conversion to enteric drainage is a safe and effective strategy.
- This procedure successfully manages refractory metabolic or urological complications after SPKT.
- It offers a viable solution for improving patient outcomes.