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dc.contributor.authorLindahl, Jørn Petter Hanto
dc.contributor.authorHorneland, Rune
dc.contributor.authorNordheim, Espen
dc.contributor.authorHartmann, Anders
dc.contributor.authorAandahl, Einar Martin
dc.contributor.authorGrzyb, Krzysztof
dc.contributor.authorHaugaa, Håkon
dc.contributor.authorKjøsen, Gisle
dc.contributor.authorÅsberg, Anders
dc.contributor.authorJenssen, Trond Geir
dc.date.accessioned2018-03-13T09:21:44Z
dc.date.available2018-03-13T09:21:44Z
dc.date.issued2017-08-23
dc.description.abstractUntil recently, pancreas transplantation has mostly been performed with exocrine drainage via duodenojejunostomy (DJ). Since 2012, DJ was substituted with duodenoduodenostomy (DD) in our hospital, allowing endoscopic access for biopsies. This study assessed safety profiles with DD versus DJ procedures and clinical outcomes with the DD technique in pancreas transplantation. DD patients (n = 117; 62 simultaneous pancreas–kidney [SPK<sub>DD</sub>] and 55 pancreas transplantation alone [PTA<sub>DD</sub>] with median follow-up 2.2 years) were compared with DJ patients (n = 179; 167 SPK<sub>DJ</sub> and 12 PTA<sub>DJ</sub>) transplanted in the period 1998–2012 (pre-DD era). Postoperative bleeding and pancreas graft vein thrombosis requiring relaparotomy occurred in 17% and 9% of DD patients versus 10% (p = 0.077) and 6% (p = 0.21) in DJ patients, respectively. Pancreas graft rejection rates were still higher in PTA<sub>DD</sub> patients versus SPK<sub>DD</sub> patients (p = 0.003). Hazard ratio (HR) for graft loss was 2.25 (95% CI 1.00, 5.05; p = 0.049) in PTA<sub>DD</sub> versus SPK<sub>DD</sub> recipients. In conclusion, compared with the DJ procedure, the DD procedure did not reduce postoperative surgical complications requiring relaparatomy or improve clinical outcomes after pancreas transplantation despite serial pancreatic biopsies for rejection surveillance. It remains to be seen whether better rejection monitoring in DD patients translates into improved long-term pancreas graft survival.en_US
dc.descriptionSubmitted manuscript version. Published version available in <a href=http://dx.doi.org/10.1111/ajt.14420> American Journal of Transplantation 2018, 18(1):154-162. </a>en_US
dc.identifier.citationLindahl, P., Horneland, R., Nordheim, E., Hartmann, A., Aandahl, E. M., Grzyb, K. ... Jenssen, T. G. (2018). Outcomes in pancreas transplantation with exocrine drainage through a duodenoduodenostomy versus duodenojejunostomy. American Journal of Transplantation. 18(1):154-162en_US
dc.identifier.cristinIDFRIDAID 1535031
dc.identifier.doi10.1111/ajt.14420
dc.identifier.issn1600-6135
dc.identifier.issn1600-6143
dc.identifier.urihttps://hdl.handle.net/10037/12305
dc.language.isoengen_US
dc.publisherWileyen_US
dc.relation.journalAmerican Journal of Transplantation
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Gasteroenterologi: 773en_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Gastroenterology: 773en_US
dc.titleOutcomes in pancreas transplantation with exocrine drainage through a duodenoduodenostomy versus duodenojejunostomyen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US


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