SELECTIVE USE OF SANDOSTATIN IN VASCULARIZED PANCREAS TRANSPLANTATION

Despite improving results, the management of exocrine complications af ter pancreas transplantation remains problematic. During a 30-month pe riod, we performed 65 pancreas transplants with bladder drainage. A to tal of 23 patients (35%) were managed with a long-acting somatostatin analogue (Sandostatin) for persistent hyperamylasemia or allograft pan creatitis. Sandostatin was begun at a mean of 29 days after transplant with a mean duration of therapy of 13 days. Sandostatin therapy was a ssociated with significant reductions in the serum, urine, and periton eal fluid amylase levels (p<0.05). Sandostatin also caused a decrease in cyclosporine levels during oral cyclosporine use. In patients recei ving Sandostatin, pancreas allograft survival was 83%. We conclude tha t pancreatitis remains a major cause of morbidity after pancreas trans plantation. The selective use or Sandostatin can result in excellent g raft salvage with low morbidity. Sandostatin appears to be safe and ef fective in reducing the exocrine output of the denervated pancreas all ograft but also reduces cyclosporine levels.