Pancreas transplantation: towards minimization of technical graft loss

The objective of the study is to determine whether evolution in surgical techniques results in minimization of technical graft loss after simultaneous pancreas-kidney transplantation (SPKTx). Eighty consecutive patients with insulin-dependent diabetes mellitus and end-stage nephropathy, and who received SPKTx, were studied. Patient, pancreas and kidney survival at 5 years were 89, 84 and 84% respectively. The porto-systemic venous anastomosis laterally to the arterial vessels resulted in exclusion of technical graft loss due to venous thrombosis. The switch from exocrine bladder drainage to enteric drainage lowered significantly the posttransplant surgical morbidity. This series indicates that excellent short- and long-term survival can be obtained after SPKTx and this with a low perioperative surgical morbidity.