Does surgical technique influence outcomes after simultaneous kidney-pancreas transplantation?
Since 1995, many centers have switched from bladder to enteric drainage of the exocrine secretions in simultaneous kidney-pancreas transplantation (SKPT). Enteric exocrine drainage may be performed with either systemic (systemic-enteric [S-E]) or portal (portal-enteric [P-E]) venous delivery of insulin. Controversy exists regarding the optimal surgical technique. From March 1999 to May 2001, a total of 297 SKPT patients were enrolled into a prospective, multicenter, randomized, open-label, comparative trial of two daclizumab dosing strategies versus no-antibody induction in combination with tacrolimus, mycophenolate mofetil, and steroids in SKPT recipients. Surgical techniques were center specific. A total of 171 patients (58%) underwent SKPT with S-E drainage, 96 (32%) with P-E drainage, and 30 (10%) with systemic-bladder (S-B) drainage. The two groups randomized to daclizumab induction were similar with regard to surgical technique (64% S-E, 25% P-E, 11% S-B drainage). Demographic an
