Successful surgical salvage of pancreas allograft

Background. Early and late complications related to the pancreas after simultaneous kidney-pancreas transplantation (SKPT) frequently result in graft loss. The authors describe a surgical rescue technique that allows salvage of the pancreatic graft when surgical complications appear after the transplant. Methods. Of 158 patients who underwent SKPT, 7 were identified with posttransplant complications that required surgical salvage of the pancreas allograft. The surgical salvage technique consisted of the following: pancreatoduodenectomy with conversion from whole-pancreas transplant with bladder or enteric diversion to segmental graft with duct injection (three cases) and conversion from whole-pancreas transplant with duct injection (four cases). Results. Five of seven pancreas allografts are still functioning, with a mean follow-up of 28 months (range, 6-42 months). Conclusion. The described surgical treatment may be useful for surgical salvage of the pancreatic allograft, without major impairment of endocrine function.