OBJECTIVE: To present our experience with conversion from bladder to enteric drainage after simultaneous pancreatic and renal transplants, so that new transplant centres know that it is both safe and effective. DESIGN: Retrospective study. SETTINGS: Teaching hospital, Republic of Ireland. SUBJECTS: Six patients who had simultaneous pancreatic and renal transplants for insulin-dependent diabetes and who subsequently developed complications of bladder drainage including recurrent episodes of dehydration and metabolic acidosis (n = 3), haematuria (n = 2), and urinary tract infections (n = 1). INTERVENTION: Conversion to enteric drainage. MAIN OUTCOME MEASURE: Resolution of symptoms. RESULTS: All symptoms resolved, but one patient each developed pulmonary oedema, haematuria, and prolonged ileus. All three complications resolved on conservative treatment. All patients are well with surviving grafts a mean of 40 months later (range 19-50). CONCLUSION: Conversion to enteric drainage is safe and effective in patients with refractory metabolic or urological complications of bladder drainage after simultaneous pancreatic and renal transplantation.
OBJECTIVE: To present our experience with conversion from bladder to enteric drainage after simultaneous pancreatic and renal transplants, so that new transplant centres know that it is both safe and effective. DESIGN: Retrospective study. SETTINGS: Teaching hospital, Republic of Ireland. SUBJECTS: Six patients who had simultaneous pancreatic and renal transplants for insulin-dependent diabetes and who subsequently developed complications of bladder drainage including recurrent episodes of dehydration and metabolic acidosis (n = 3), haematuria (n = 2), and urinary tract infections (n = 1). INTERVENTION: Conversion to enteric drainage. MAIN OUTCOME MEASURE: Resolution of symptoms. RESULTS: All symptoms resolved, but one patient each developed pulmonary oedema, haematuria, and prolonged ileus. All three complications resolved on conservative treatment. All patients are well with surviving grafts a mean of 40 months later (range 19-50). CONCLUSION: Conversion to enteric drainage is safe and effective in patients with refractory metabolic or urological complications of bladder drainage after simultaneous pancreatic and renal transplantation.
Authors: Samy M Riad; Daniel O Keys; Scott Jackson; Viral Vakil; Danielle Berglund; Arthur Matas; Erik B Finger; Raja Kandaswamy Journal: Transplant Direct Date: 2020-04-22