| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 5729070 | Transplantation Proceedings | 2016 | 5 Pages |
â¢A 44-year-old male underwent pancreas alone transplantation.â¢The recipient's IVC was dissected for anastomosis with a graft portal vein. The graft duodenum was anastomosed with recipient duodenum using the side-to-side manner. Postoperatively, there was no evidence of graft thrombosis or rejection. We can do protocol biopsies of the graft duodenum through endoscopy two times. The IVC-duodenum drainage procedure was a feasible method for preventing thrombosis and providing an opportunity for direct graft monitoring through endoscopy.â¢To the best of our knowledge, this is the first reported case of IVC-duodenal drainage during pancreas transplantation among the Asian countries.
Enteric drainage has been the main trend in solitary pancreas transplantation. Compared with bladder drainage, it does not cause metabolic or urologic complications, but there is no way to perform immunologic monitoring, except by graft pancreas biopsy. Additionally, although portal drainage of the graft vein is considered physiological drainage, it has more of a risk for surgical complications. To overcome these disadvantages, we successfully performed inferior vena cava (IVC)-duodenal drainage in pancreas alone transplantation. A 44-year-old man underwent pancreas alone transplantation. He had insulin-dependent diabetes because of chronic pancreatitis, thus he had taken a pancreatic enzyme. After right-sided medial visceral rotation, the IVC was dissected for anastomosis with a graft portal vein. The right common iliac artery was anastomosed with a Y-graft in the pancreas graft. The graft duodenum was anastomosed with recipient duodenum using the side-to-side manner. Postoperatively, he underwent protocol biopsies of the graft duodenum through endoscopy two times. There was no evidence of graft thrombosis or rejection. He had a normal glucose level without any diabetic drugs, and he required no pancreatic enzyme for digestion. The IVC-duodenum drainage procedure was a feasible method for preventing thrombosis and providing an opportunity for direct graft monitoring through endoscopy.
