Effects of portal versus systemic venous drainage in kidney-pancreas recipients

A randomized study of combined kidney-pancreas transplantation was performe d on 30 insulin-dependent diabetic patients with end-stage renal disease to compare the consequences of pancreas transplantation with portal venous (P V) and systemic venous (SV) drainage. Fourteen patients (SV group) received systemically drained and sixteen (PV group) portally drained pancreas allo grafts. Enteric drainage was performed in both groups. The routine follow-u p included documentation of the clinical course and detailed endocrine stud ies. At 1 year after transplantation, the patient survival rate was 92% for the SV group and 96% for the PV group; the graft survival rate was 78% and 82%, respectively. Endocrine studies indicated no difference in fasting an d stimulated glucose or in glycosylated hemoglobin between the two groups. In addition, no hyperinsulinemia and lipidic abnormalities were evidenced i n either group Long-term studies are required to conclude whether PV and SV drainage in pancreas transplantation are equivalent in terms of patient an d graft survival as well as metabolic consequences.