Effect of Venous Vascular Management on USA ED Pancreas Outcome 1999 - 2003 Cases

For primary DD pancreas transplants during 1999-2003, 78% SPK, 60% PAK, 49% PTA were enteric drained (ED). Of cases with complete records for analysis of systemic (SV) and portal (PV) venous vascular management (n=3635), about 25% used PV (n=920) vs. SV (n=2715).  Pancreas graft survival rates were similar for SPK (p>0.17) and PAK (p>0.8) PV vs. SV ED transplants: 1-year SPK 87% PV and 84% SV, 3-year 77% each (Figure 16a); 1-year PAK 74% PV and 77% SV, 3-year 53% and 54% respectively (Figure 16b). For ED PTA, pancreas PV (n=90) GSRs were higher than SV (n=99), but not significantly (p>0.11): 1-year 80% PV and 69% SV, 3-year 69% and 34% respectively (Figure 16c). Rejection loss accounted for this difference in the PTA ED GSRs. Even though there may be an immunological advantage with ED in PTA, the rejection rate is higher, possibly due to more prompt diagnosis of rejection episodes using urine amylase monitoring in BD cases (Figure 16d). 

Figure 16a

Figure 16b

Figure 16c

Figure 16d

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