Exocrine drainage in vascularized pancreas transplantation in the new millennium

Table 7 Portal-enteric drainage: Literature review

Center, authors, year, ref., study design and follow-up	Number and type of transplant	Complications	Readmissions, reoperation, length of stay	1 yr patient survival	1 yr kidney and pancreas graft survival
University of Tennessee, Stratta et al[122], Retrospective, mean follow-up 3 yr	PE 126; 90 SPK; 18 PAK; 18 PTA; Era 1 (10/90-6/95); Era 2 (7/95-5/98); Era 3 (6/98-12/99)	In 3 successive eras, rates of acute rejection were 63%, 33%, and 39%, respectively; rates of major infection were 60%, 43%, and 44%, respectively	In 3 successive eras, rates of relaparotomy were 47%, 31%, and 33%, respectively; rates of thrombosis were 20%, 7%, and 6%, respectively. Mean length of stay: 12.5 d	In 3 successive eras, patient survival was 77%, 93%, and 100%, respectively	In 3 successive eras, kidney graft survival was 77%, 93%, and 94%, respectively; pancreas graft survival was 60%, 83%, and 83%, respectively
Università di Pisa, Italy, Boggi et al[17], Retrospective, mean follow-up 21 ± 20 mo	PE 110	10 grafts were lost; 3 acute rejection, 2 chronic rejection, 2 venous thrombosis, 2 deaths, 1 late thrombosis (6 mo). Incidence of pancreas acute rejection was 6%	Relaparotomy rate was 13.6%; Mean length of stay was 26 ± 14 d; One month readmission rate was 13%	98%	Pancreas graft survival was 91%
University of Chicago, Bruce et al[116], Retrospective, mean follow-up 16 mo	PE 70	Pancreas graft losses: Thrombosis (3), acute rejection (5), late duodenal perforation (2)	Total 1st year hospitalization: 37 ± 28 d; Relaparotomy in 14 (70%)	88%	Kidney 78%; Pancreas 79%
Louisiana State University, Zibari et al[23], Retrospective, mean follow-up 25 mo	PE 21	Postoperative Bleeding in 4, wound infections in 4, acute rejection in 9, pancreas graft loss in 2	Mean length of stay was 16 d	100%	Kidney 90%; Pancreas 90%
Wake Forest Baptist Medical Center, Rogers et al[4], Retrospective, mean follow-up 6 ± 3 yr	202; SPK 162, PAK 35, PTA 5; PE 179; SE 23	Thrombosis rate was 8%; acute rejection rate was 28%; major infection rate was 50%	Mean length of stay was 13 d; Relaparotomy rate was 38%	Overall patient survival was 87%; one-year patient survival was 97%	Overall kidney and pancreas graft survival rates are 76% and 65%; death-censored graft survival rates are 84% and 72%, and one year graft survival rates are 94% and 88%, respectively
Monash Medical Centre, Victoria, Australia, Kave et al[118], Retrospective, mean follow-up 2 yr	SB 37; PE 27	Pancreas graft thrombosis rates SB 10.8%, PE 7.4% (P = NS)		Two-year patient survival was SB 94.3% vs PE 96.0%	Two year kidney (SB 89.2% vs PE 85.2%); pancreas (SB 77.9% vs PE 71.4%)

SB: Systemic-bladder; SE: Systemic-enteric; PE: Portal-enteric.