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

Objective: To present our experience with conversion from bladder to enteri c 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 transplant s for insulin-dependent diabetes and who subsequently developed complicatio ns of bladder drainage including recurrent episodes of dehydration and meta bolic 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 oe dema, 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 patient s with refractory metabolic or urological complications of bladder drainage after simultaneous pancreatic and renal transplantation.