Bladder drainage, although no longer the most commonly performed method for exocrine drainage of the pancreas, remains an option for patients undergoing simultaneous pancreas- kidney (SPK), solitary pancreas, and pancreas after kidney transplantation. The purpose of our study is to examine kidney allograft survival in patients with enteric drained, bladder drained, or enterically converted pancreas allografts. Our study was a single center retrospective data analysis of 160 adult, first-time recipients who underwent a SPK between 1989 and 2012 at the University Of Nebraska Medical Center. We excluded patients who had previous transplants or who had transplants with acute vascular graft loss. Recipients with bladder drained pancreas allografts had the highest rate of kidney retransplant at 35%, while enteric drained pancreas allograft had the lowest rate at 4.5% (p<0.0001). Organ rejection and method of pancreas drainage had no significant association (p=0.6457). Additionally there was no association between organ rejection and kidney graft survival (p=0.8600). When comparing three groups; enteric drained, bladder drained, and enterically converted pancreas grafts, the difference in kidney graft survival was found to be significant with p=0.0149. Long term kidney graft survival in patients with a bladder drained pancreas was 83% at 5 years, 68% at 10 years and 55% at 15 years where patients with an enteric drained pancreas had 93% 5 year, 87% 10 year and 68% 15 year kidney graft survival. There was no significant difference in pancreas retransplant rate, or pancreas graft survival. These findings may be attributed to difficulty in managing metabolic acidosis and dehydration in bladder drained pancreas recipients.

CITATION INFORMATION: McCormick M, Luo J, Hoffman A. Kidney Re-Transplant Rate in Simultaneous Kidney Pancreas Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).

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