Simultaneous pancreas-kidney transplantation: portal versus systemic venous drainage of the pancreas allografts

Simultaneous pancreas-kidney (SPK) transplantation is considered a valid th erapeutic option for patient with type I diabetes mellitus and end-stage di abetic nephropathy. This study was performed to determine whether the techn ique of pancreas venous drainage affects patient survival as well as graft survival and function. From October 1996 to April 1999 34 uremic patients w ith type I diabetes mellitus were randomly assigned to two groups: the firs t group (SV group = 17) received SPK transplantation with systemic venous d rainage, and the second group (PV group = 17) received pancreas allograft w ith portal drainage. A Roux-en-Y loop was performed in all the patients. Pa tient follow-up included clinical course and metabolic studies. At 1 yr, pa tient survival rates were 88.2% in the SV group and 94.1% in the PV group w hile graft survival rate was 76.4% in both groups. Several surgical complic ations were attributed to the enteric drainage without any graft failure in both groups. One venous thrombosis occurred in each group. No significant differences have been evidenced in kidney and pancreas function. The prelim inary results of this randomized trial did not evidence any significant dif ferences between portal and systemic venous drainage of pancreas allograft.