Clinical segmental pancreatic transplantation with ureter-pancreatic duct anastomosis for exocrine drainage

Five segmental pancreatic transplants with pancreatic duct-ureter anastomoses are reported. The technique for segmental pancreatic transplantation with pancreatic duct-ureter anastomosis in man is described. The synchronous transplanation of the kidney and a segmental pancreatic graft is contrasted with the staged transplantation of the pancreatic segment and subsequent renal allografting. The pancreatic duct-ureter anastomosis is a relatively simple effective technique which provides exocrine drainage for a pancreatic segment. Of the five patients with juvenile-onset diabetes who received pancreatic transplants by this technique, four are alive. Two have functioning pancreatic grafts; the survivor of 15 months has impaired pancreatic function but appears to be improving. The other surviving patient has a functioning pancreatic graft eight months after pancreatic transplantation. These latter two patients also have functioning renal transplants. The asynchronous transplantation of a pancreatic segment and kidney appears superior at this time.