SURGICAL COMPLICATIONS IN BLADDER VS. ENTERIC DRAINED SIMULTANEOUS PANCREAS KIDNEY (SPK) TRANSPLANTS

Abstract

339 Background: Recently there has been increased popularity for enteric drainage of pancreas grafts due to the long-term complications seen with bladder drainage. We compared a cohort of SPK transplant recipients with enteric vs. bladder drainage to determine if the incidence of early surgical complications (<3 months posttransplant) were significantly different between the two groups. Method: Between January 1, 1994 and September 30, 1998, 128 cadaver SPK transplants were performed. Of these, 107 were bladder drained and 21 enteric drained. Demographic data and incidence of surgical complications for the two groups is presented in the table. Overall, surgical complications were not significantly different between the two groups. Bleeding and thrombosis were slightly higher with enteric drainage, but this was not statistically significant. Leaks and intraabdominal infections seemed to be lower with enteric drainage. The incidence of acute rejection, CMV disease, and pancreatitis were similar. Patient and graft survival rates were equivalent.TableConclusions: Enteric drainage in the setting of SPK transplants, does not seem to increase significantly the incidence of early surgical complications. Given the increased urologic morbidity associated with bladder drainage, and the ability to monitor for acute rejection using the serum creatinine, SPK transplants should preferentially be drained enterally.