INTRODUCTION: In the early experience of pancreas transplantation, bladder drainage was favored. However, this often caused metabolic and infectious complications that necessitated conversion to enteric drainage. Long-term graft survival and complications after enteric conversion of bladder drained pancreases is poorly understood.

METHODS: The University of Wisconsin allograft database was queried for all pancreas transplants performed from 1994 to 2015. Time to conversion was estimated with the Kaplan-Meier technique, while risk factors associated with conversion were estimated via a time-varying Cox proportional hazards model to account for the time that the pancreas was bladder drained.

RESULTS: Of 117 bladder drained pancreata, 63 (53.8%) eventually required enteric conversion. 29 (46.0%) occurred within the first year after transplantation. Kaplan-Meier estimates showed relatively similar graft survival (Figure). In time-varying Cox model adjusting for donor and recipient factors, enteric conversion did not affect the risk of graft loss (HR 1.54, P = 0.09). The most common complications after conversion were bowel obstruction and enteric leaks, most of which occurred in the first year after conversion.

CONCLUSIONS: When necessary due to symptoms or complications, enteric conversion of bladder drained pancreata is safe and does not affect overall graft survival. This relationship appears to be true no matter when the conversion is performed.

CITATION INFORMATION: Adler J., Redfield R., Kaufman D., Odorico J., Sollinger H. Enteric Conversion after Bladder-Drained Pancreas Transplantation: The Wisconsin Experience Am J Transplant. 2017;17 (suppl 3).

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