Enteric conversion after bladder-drained pancreatic transplantation; a simple and safe salvage procedure.

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.