A prospective comparison of simultaneous kidney-pancreas transplantation with systemic-enteric versus portal-enteric drainage
To compare pancreas transplantation with systemic-enteric (SE) versus portal-enteric (PE) drainage in a prospective fashion. To improve the physiology of pancreas transplantation, the authors developed a new technique of portal venous delivery of insulin and enteric drainage of the exocrine secretio...
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| Veröffentlicht in: | Annals of surgery 2001-06, Vol.233 (6), p.740-751 |
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| creator | STRATTA, Robert J SHOKOUH-AMIRI, M. Hosein FRANCESCA EGIDI, M GREWAL, Hani P TARIK KIZILISIK, A NEZAKATGOO, Nosrat GABER, Lillian W OSAMA GABER, A |
| description | To compare pancreas transplantation with systemic-enteric (SE) versus portal-enteric (PE) drainage in a prospective fashion.
To improve the physiology of pancreas transplantation, the authors developed a new technique of portal venous delivery of insulin and enteric drainage of the exocrine secretions.
During a 26-month period, the authors prospectively alternated 54 consecutive simultaneous kidney and pancreas transplants to either SE (n = 27) or PE (n = 27) drainage. The two groups were well matched for numerous characteristics. Maintenance immunosuppression in both groups consisted of tacrolimus, mycophenolate mofetil, and steroids.
Patient survival rates were 93% SE versus 96% PE; kidney graft survival rates were 93% in both groups. Pancreas transplantation survival (complete insulin independence) was 74% after SE versus 85% after PE drainage with a mean follow-up of 17 months. The mean length of initial hospital stay was 12.4 days in the SE group and 12.8 days in the PE group. The SE group was characterized by a slight increase in the number of readmissions. The incidences of acute rejection (33%) and major infection (52%) were similar in both groups. The incidence of intraabdominal infection was slightly higher in the SE group. However, the early relaparotomy rate was similar between groups. The composite endpoint of no rejection, graft loss, or death was attained in 56% of SE versus 59% of PE patients.
These results suggest that simultaneous kidney and pancreas transplantation with SE or PE drainage can be performed with comparable short-term outcomes. |
| doi_str_mv | 10.1097/00000658-200106000-00003 |
| format | Article |
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To improve the physiology of pancreas transplantation, the authors developed a new technique of portal venous delivery of insulin and enteric drainage of the exocrine secretions.
During a 26-month period, the authors prospectively alternated 54 consecutive simultaneous kidney and pancreas transplants to either SE (n = 27) or PE (n = 27) drainage. The two groups were well matched for numerous characteristics. Maintenance immunosuppression in both groups consisted of tacrolimus, mycophenolate mofetil, and steroids.
Patient survival rates were 93% SE versus 96% PE; kidney graft survival rates were 93% in both groups. Pancreas transplantation survival (complete insulin independence) was 74% after SE versus 85% after PE drainage with a mean follow-up of 17 months. The mean length of initial hospital stay was 12.4 days in the SE group and 12.8 days in the PE group. The SE group was characterized by a slight increase in the number of readmissions. The incidences of acute rejection (33%) and major infection (52%) were similar in both groups. The incidence of intraabdominal infection was slightly higher in the SE group. However, the early relaparotomy rate was similar between groups. The composite endpoint of no rejection, graft loss, or death was attained in 56% of SE versus 59% of PE patients.
These results suggest that simultaneous kidney and pancreas transplantation with SE or PE drainage can be performed with comparable short-term outcomes.</description><identifier>ISSN: 0003-4932</identifier><identifier>EISSN: 1528-1140</identifier><identifier>DOI: 10.1097/00000658-200106000-00003</identifier><identifier>PMID: 11371732</identifier><identifier>CODEN: ANSUA5</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Adult ; Antibiotic Prophylaxis ; Biological and medical sciences ; Drainage - methods ; Female ; Humans ; Immunosuppressive Agents - administration & dosage ; Insulin - administration & dosage ; Kidney Transplantation ; Length of Stay ; Liver, biliary tract, pancreas, portal circulation, spleen ; Male ; Medical sciences ; Middle Aged ; Monitoring, Physiologic ; Pancreas Transplantation - methods ; Portal Vein ; Postoperative Complications ; Postoperative Period ; Prospective Studies ; Scientific Papers of the Southern Surgical Association ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Survival Rate ; Time Factors</subject><ispartof>Annals of surgery, 2001-06, Vol.233 (6), p.740-751</ispartof><rights>2001 INIST-CNRS</rights><rights>2001 Lippincott Williams & Wilkins, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c444t-4e4df5f5ff1e01ae0f07f16f51325da70df33bb7c4e3dfc47c5c4747b244a6b13</citedby><cites>FETCH-LOGICAL-c444t-4e4df5f5ff1e01ae0f07f16f51325da70df33bb7c4e3dfc47c5c4747b244a6b13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421316/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421316/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,309,310,314,727,780,784,789,790,885,23930,23931,25140,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=992692$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11371732$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>STRATTA, Robert J</creatorcontrib><creatorcontrib>SHOKOUH-AMIRI, M. Hosein</creatorcontrib><creatorcontrib>FRANCESCA EGIDI, M</creatorcontrib><creatorcontrib>GREWAL, Hani P</creatorcontrib><creatorcontrib>TARIK KIZILISIK, A</creatorcontrib><creatorcontrib>NEZAKATGOO, Nosrat</creatorcontrib><creatorcontrib>GABER, Lillian W</creatorcontrib><creatorcontrib>OSAMA GABER, A</creatorcontrib><title>A prospective comparison of simultaneous kidney-pancreas transplantation with systemic-enteric versus portal-enteric drainage</title><title>Annals of surgery</title><addtitle>Ann Surg</addtitle><description>To compare pancreas transplantation with systemic-enteric (SE) versus portal-enteric (PE) drainage in a prospective fashion.
To improve the physiology of pancreas transplantation, the authors developed a new technique of portal venous delivery of insulin and enteric drainage of the exocrine secretions.
During a 26-month period, the authors prospectively alternated 54 consecutive simultaneous kidney and pancreas transplants to either SE (n = 27) or PE (n = 27) drainage. The two groups were well matched for numerous characteristics. Maintenance immunosuppression in both groups consisted of tacrolimus, mycophenolate mofetil, and steroids.
Patient survival rates were 93% SE versus 96% PE; kidney graft survival rates were 93% in both groups. Pancreas transplantation survival (complete insulin independence) was 74% after SE versus 85% after PE drainage with a mean follow-up of 17 months. The mean length of initial hospital stay was 12.4 days in the SE group and 12.8 days in the PE group. The SE group was characterized by a slight increase in the number of readmissions. The incidences of acute rejection (33%) and major infection (52%) were similar in both groups. The incidence of intraabdominal infection was slightly higher in the SE group. However, the early relaparotomy rate was similar between groups. The composite endpoint of no rejection, graft loss, or death was attained in 56% of SE versus 59% of PE patients.
These results suggest that simultaneous kidney and pancreas transplantation with SE or PE drainage can be performed with comparable short-term outcomes.</description><subject>Adult</subject><subject>Antibiotic Prophylaxis</subject><subject>Biological and medical sciences</subject><subject>Drainage - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Immunosuppressive Agents - administration & dosage</subject><subject>Insulin - administration & dosage</subject><subject>Kidney Transplantation</subject><subject>Length of Stay</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Monitoring, Physiologic</subject><subject>Pancreas Transplantation - methods</subject><subject>Portal Vein</subject><subject>Postoperative Complications</subject><subject>Postoperative Period</subject><subject>Prospective Studies</subject><subject>Scientific Papers of the Southern Surgical Association</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Survival Rate</subject><subject>Time Factors</subject><issn>0003-4932</issn><issn>1528-1140</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkU2LFDEQhoMo7uzqX5CA4C1rvrrTfRGWxS9Y8KLnUJ2u7Ea7022SGZmD_92MM46aQIq8eapS1EsIFfxa8N685ofVNh2TnAve1gs7KOoR2YhGdkwIzR-TzUFiulfyglzm_LWyuuPmKbkQQhlhlNyQnzd0TUte0ZWwQ-qWeYUU8hLp4mkO83YqEHHZZvotjBH3bIXoEkKmJUHM6wSxQAmV_xHKA837XHAOjmEsmIKjO0y5Jq9LKjCd1TFBiHCPz8gTD1PG56d4Rb68e_v59gO7-_T-4-3NHXNa68I06tE3dXuBXAByz40XrW-Eks0Iho9eqWEwTqMavdPGNfXQZpBaQzsIdUXeHOuu22HG0dU-Ekx2TWGGtLcLBPv_SwwP9n7ZWaGlUKKtBV6dCqTl-xZzsXPIDqfpOBxreNf2bd9UsDuCrk41J_TnTwS3B-_sH-_s2bvfkqqpL_5t8m_iyawKvDwBkB1MvhrgQj5zfS_bXqpfA3mm5A</recordid><startdate>20010601</startdate><enddate>20010601</enddate><creator>STRATTA, Robert J</creator><creator>SHOKOUH-AMIRI, M. Hosein</creator><creator>FRANCESCA EGIDI, M</creator><creator>GREWAL, Hani P</creator><creator>TARIK KIZILISIK, A</creator><creator>NEZAKATGOO, Nosrat</creator><creator>GABER, Lillian W</creator><creator>OSAMA GABER, A</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20010601</creationdate><title>A prospective comparison of simultaneous kidney-pancreas transplantation with systemic-enteric versus portal-enteric drainage</title><author>STRATTA, Robert J ; SHOKOUH-AMIRI, M. Hosein ; FRANCESCA EGIDI, M ; GREWAL, Hani P ; TARIK KIZILISIK, A ; NEZAKATGOO, Nosrat ; GABER, Lillian W ; OSAMA GABER, A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c444t-4e4df5f5ff1e01ae0f07f16f51325da70df33bb7c4e3dfc47c5c4747b244a6b13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Antibiotic Prophylaxis</topic><topic>Biological and medical sciences</topic><topic>Drainage - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Immunosuppressive Agents - administration & dosage</topic><topic>Insulin - administration & dosage</topic><topic>Kidney Transplantation</topic><topic>Length of Stay</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Monitoring, Physiologic</topic><topic>Pancreas Transplantation - methods</topic><topic>Portal Vein</topic><topic>Postoperative Complications</topic><topic>Postoperative Period</topic><topic>Prospective Studies</topic><topic>Scientific Papers of the Southern Surgical Association</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Survival Rate</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>STRATTA, Robert J</creatorcontrib><creatorcontrib>SHOKOUH-AMIRI, M. Hosein</creatorcontrib><creatorcontrib>FRANCESCA EGIDI, M</creatorcontrib><creatorcontrib>GREWAL, Hani P</creatorcontrib><creatorcontrib>TARIK KIZILISIK, A</creatorcontrib><creatorcontrib>NEZAKATGOO, Nosrat</creatorcontrib><creatorcontrib>GABER, Lillian W</creatorcontrib><creatorcontrib>OSAMA GABER, A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>STRATTA, Robert J</au><au>SHOKOUH-AMIRI, M. Hosein</au><au>FRANCESCA EGIDI, M</au><au>GREWAL, Hani P</au><au>TARIK KIZILISIK, A</au><au>NEZAKATGOO, Nosrat</au><au>GABER, Lillian W</au><au>OSAMA GABER, A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A prospective comparison of simultaneous kidney-pancreas transplantation with systemic-enteric versus portal-enteric drainage</atitle><jtitle>Annals of surgery</jtitle><addtitle>Ann Surg</addtitle><date>2001-06-01</date><risdate>2001</risdate><volume>233</volume><issue>6</issue><spage>740</spage><epage>751</epage><pages>740-751</pages><issn>0003-4932</issn><eissn>1528-1140</eissn><coden>ANSUA5</coden><abstract>To compare pancreas transplantation with systemic-enteric (SE) versus portal-enteric (PE) drainage in a prospective fashion.
To improve the physiology of pancreas transplantation, the authors developed a new technique of portal venous delivery of insulin and enteric drainage of the exocrine secretions.
During a 26-month period, the authors prospectively alternated 54 consecutive simultaneous kidney and pancreas transplants to either SE (n = 27) or PE (n = 27) drainage. The two groups were well matched for numerous characteristics. Maintenance immunosuppression in both groups consisted of tacrolimus, mycophenolate mofetil, and steroids.
Patient survival rates were 93% SE versus 96% PE; kidney graft survival rates were 93% in both groups. Pancreas transplantation survival (complete insulin independence) was 74% after SE versus 85% after PE drainage with a mean follow-up of 17 months. The mean length of initial hospital stay was 12.4 days in the SE group and 12.8 days in the PE group. The SE group was characterized by a slight increase in the number of readmissions. The incidences of acute rejection (33%) and major infection (52%) were similar in both groups. The incidence of intraabdominal infection was slightly higher in the SE group. However, the early relaparotomy rate was similar between groups. The composite endpoint of no rejection, graft loss, or death was attained in 56% of SE versus 59% of PE patients.
These results suggest that simultaneous kidney and pancreas transplantation with SE or PE drainage can be performed with comparable short-term outcomes.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>11371732</pmid><doi>10.1097/00000658-200106000-00003</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| source | MEDLINE; Journals@Ovid Complete; PubMed (Medline); EZB Electronic Journals Library |
| subjects | Adult Antibiotic Prophylaxis Biological and medical sciences Drainage - methods Female Humans Immunosuppressive Agents - administration & dosage Insulin - administration & dosage Kidney Transplantation Length of Stay Liver, biliary tract, pancreas, portal circulation, spleen Male Medical sciences Middle Aged Monitoring, Physiologic Pancreas Transplantation - methods Portal Vein Postoperative Complications Postoperative Period Prospective Studies Scientific Papers of the Southern Surgical Association Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Survival Rate Time Factors |
| title | A prospective comparison of simultaneous kidney-pancreas transplantation with systemic-enteric versus portal-enteric drainage |
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