There are several operative techniques in pancreas transplantation (PT) and controversy over the superiority of some of them. This study presents experience with 4 different techniques performed by the same team in more than 700 cases.

There were 727 TP performed between 1996 and 2016, being 395 Simultaneous Pancreas-Kidney Transplantation(SPK) and 332 solitary PT (pancreas after kidney and pancreas transplant alone). The techniques were distributed in Systemic-Vesical (SV), Systemic-Enteric (SE), Portal-Enteric (PE) and Portal-Duodenal (PD). Among the SPK, 137 were SV, 176 SE, 44 PE and 38 PD; among the solitary PT, 182 were SV, 32 SE, 47 PE and 71 PD. A statistical analysis was performed with significance for p <0.05.

In the SPK, there was similarity in gender, donor and recipient age, and use of donors with cerebrovascular disease (CVA) in the 4 groups. There was greater use of induction and fewer preemptive transplants in the PD group compared to the other groups. The 1-year patient , kidney and pancreatic survival was similar between the 4 techniques, as well as the incidence of technical or immunological loss of the pancreas. Although statistically non-significant, the success of the pancreas was 71% in the SV technique and 84% in the PD, as well as the success of the kidney that was 78% in the SV and 89% in the PD.

In solitary PT, there was similarity in gender, age of recipient and use of donors with CVA; donor age was significantly lower in the PD group and more retransplants were performed in the SE group (37.5% of the cases in this group). The ischemia time was higher in the SV group and the distribution between PAK and PTA was similar in the groups.One year patient was similar among techniques ranging from 93% in SV to 97% in PD; The 1-year pancreatic survival was also similar among the techniques, but with greater technical loss in the SE group.

It was concluded that the 4 techniques achieved similar patient and graft survival, but with a tendency to superior result of pancreatic and kidney grafts in SPK group and better patient survival in the solitary PT when PD technique was used.

CITATION INFORMATION: Perosa M, Branez J, Mota L, Zeballos B, Noujaim H, Ianhez L, Machado D, Alvim L, Paredes M, Genzini T. Comparative Analysis of Four Surgical Techniques in More Than 700 Pancreas Transplantes in a Single Center. Am J Transplant. 2017;17 (suppl 3).

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