PANCREATICODUODENAL TRANSPLANTATION IN HUMANS

Abstract

Whole cadaveric pancreata were transplanted to the pelvic extraperitoneal location in 4 patients with diabetes who previously had undergone successful cadaveric renal transplantation. One graft was lost within a few hours from venous thrombosis but with patient survival. The other 3 are providing normal endocrine function after 2 1/2, 11 and 12 mo. The exocrine pancreatic secretions were drained into the recipient jejunum through enteric anastomoses. Because mucosal slough of the graft duodenum and jejunum in 2 patients caused a protein losing enteropathy and necessitated reoperations, the pancreatic transplantation is now done with only a blister of graft duodenum large enough for side-to-side enteroenterostomy. The spleen has been transplanted with the pancreas mainly for technical reasons, and this technique should have further trials in spite of the fact that delayed graft splenectomy became necessary in 2 recipients to treat graft-induced hematologic complications.