The advantages of an extraperitoneal pancreatic transplant, without enteric anastomoses, prompted us to reappraise the procedure in the juvenile diabetic requiring kidney transplantation for end stage renal failure. Experimentally pancreatic duct to ureter anastomoses have allowed exocrine drainage through the canine urinary tract without apparent damage for over one year. Five juvenile onset diabetics with renal failure have received segmental pancreatic transplants with ureter to pancreatic duct anastomoses. Four are alive; two with functioning grafts at 12 and 7 months. Both also have functioning renal transplants. A third graft, which had provided normal endocrine function, was removed after one month because of bleeding. There has been no apparent damage to the urinary tract despite urinary amylase up to 350,000 Somogyi units/24 hours. Blood glucose and urinary amylase have served as indices of graft function and rejection. Asynchronous transplantation of the pancreas and kidney appears best since simultaneous renal and pancreatic implantation was associated with immediate poor function of one of the two grafts.
|Original language||English (US)|
|Number of pages||6|
|State||Published - Dec 1 1975|
ASJC Scopus subject areas