Exocrine drainage in vascularized pancreas transplantation in the new millennium

Table 1 Bladder drainage: Literature review

Center, authors, year, ref., study design, and follow-up	Number and type of transplant	Complications	Enteric conversion	1 yr patient survival	1 yr pancreas graft survival
University of Minnesota, Hakim et al[67], Retrospective, mean follow-up 55 mo	n = 425 with bladder drainage, SPK - 53%; PAK - 23%; PTA - 24%	Duodenal stump complications - 20%; Duodenal leak - 10%; Recurrent UTI - 9%; Hematuria - 6% (19% required surgery); Bladder stone - 0.5%; CMV duodenitis - 1.5%; Graft loss - 9%	16%	ND	ND
University of Nebraska, Stratta et al[68], Retrospective, mean follow-up 44 mo	n = 201 with bladder drainage	Duodenal stump complications - 19%; Duodenal leak - 6% (all required surgery); Hematuria - 13% ( 30% required surgery); CMV duodenitis - 3%	13%	94%	80%
University of Wisconsin, Sollinger et al[69], Retrospective	n = 500; 338 with bladder drainage, 112 with enteric drainage	Duodenal leak - 15.4%; Graft Thrombosis - 0.7%; Hematuria - 3%; UTI - 52.5%; Graft loss - 13%; Death with a functioning graft - 8%	24%	96.4%	87.5%
The Ohio State University, Henry et al[70], Retrospective, mean follow-up 16 mo	n = 300 with bladder drainage	CMV - 2%; Intra-abdominal infection - 15%; Wound infection - 8%; Rejection - 55%; Hematuria - 14%; Bladder leak - 10%	4%	92%	82%
University of Maryland, Del Pizzo et al[71], Retrospective, mean follow-up 35 mo	n = 140; SPK - 68%, PAK - 25%, PTA - 7%	Urological complication - 50%; Bladder stone - 10%; Duodenitis - 11%; Retained foreign bodies - 12%; Bladder tumor - 2%	21%	ND	ND
Mayo Clinic Rochester, Gettman et al[72], Retrospective, mean follow-up 44 mo	n = 65	UTI - 59%; Hematuria - 26%; Allograft pancreatitis - 19%; Duodenal leaks 17%, (all required surgery); Ureteral lesions - 9%	ND	92%	86%
Hospital Universitario Spain, Medina Polo et al[73], Retrospective, mean follow-up 52 mo	n = 107, all SPK, bladder drainage in 58, enteric drainage in 49	UTI - 72%; Hematuria - 20%; Bladder stone - 8%; Reflux pancreatitis - 48%	10%	92.7%	78.1%
University of Nebraska, Sudan et al[74], Retrospective, mean follow-up 60 mo	n = 57, all with bladder drainage	UTI - 15%; Dehydration - 20%; Rejection - 1%	ND	95%	88%

SPK: Simultaneous pancreas-kidney; PAK: Pancreas after kidney; PTA: Pancreas transplantation alone; UTI: Urinary tract infection; CMV: Cytomegalovirus; ND: Not determined/no data.