OBJECTIVES: To simplify the @entity1681 ( @entity1681 ) procedure and to decrease surgical and metabolic complications in simultaneous pancreas-kidney transplantation (SPK) @entity1 . METHODS: Between June 2000 and June 2002, nine @entity1 with @entity1723 ( @entity1723 ) and @entity5507 underwent simultaneous pancreas-kidney transplantation. The arterial inflow of the pancreas was based upon the right external iliac artery, while venous drainage was systemic via the external iliac vein. The allografts' exocrine secretions were drained into the proximal jejunum via a two-layer hand sewn, side-to-side donor duodenum to proximal small bowel @entity254 after reperfusion. No Roux-en-Y an astomosis of the jejunum was performed. The kidney graft was placed in the left iliac fossa. Quadruple immunosuppressive therapy with antilymphocyte globulin or anti- @entity2902 monoclonal antibody (Zenapax), @entity1140 , @entity618 and @entity230 was standard treatment in all @entity1 . RESULTS: This procedure was successfully applied in all 9 @entity1 without complication referable to the technique. All @entity1 had achieved euglycemia and excellent renal function, and stopped being dependent on an external insulin source. Fasting serum @entity413 fell from 9.5 preoperatively to 4.8 mmol/L and remained stable thereafter. At the time this paper was written, the grafts from eight @entity1 were functioning well. CONCLUSIONS: Our primary experience suggests that SPK with @entity1681 without Roux-en-Y @entity254 represents a more physiologic milieu, and a viable alternation to replace the bladder (BD) as the primary route of drainage for exocrine secretions of the pancreas. It is a feasible and safer procedure.

Simultaneous pancreas-kidney transplantation with XXXX of exocrine secretions.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5507 :: ('MESH:D014511', 'Disease') :: ['uremia'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity1723 :: ('MESH:D003922', 'Disease') :: ['IDDM', 'insulin-dependent diabetes mellitus'] @entity618 :: ('MESH:C063008', 'Chemical') :: ['mycophenolate mofetil'] @entity2902 :: ('3559', 'Gene') :: ['CD25'] @entity230 :: ('MESH:D013256', 'Chemical') :: ['steroids'] @entity1140 :: ('MESH:D016559', 'Chemical') :: ['tacrolimus'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose'] @entity1681 :: ('MESH:D004751', 'Disease') :: ['ED', 'enteric drainage']
@entity1681 :: (MESH:D004751,Disease) :: ['enteric drainage']
