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dc.date.accessioned2018-05-24T09:14:20Z
dc.date.available2018-05-24T09:14:20Z
dc.date.created2018-01-03T14:46:10Z
dc.date.issued2018
dc.identifier.citationLindahl, Jørn Petter Hanto Horneland, Rune Nordheim, Espen Hartmann, Anders Aandahl, Einar Martin Grzyb, Krzysztof Haugaa, Håkon Kjøsen, Gisle Åsberg, Anders Jenssen, Trond Geir . Outcomes in pancreas transplantation with exocrine drainage through a duodenoduodenostomy versus duodenojejunostomy. American Journal of Transplantation. 2018, 18(1), 154-162
dc.identifier.urihttp://hdl.handle.net/10852/61711
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 [SPKDD] and 55 pancreas transplantation alone [PTADD] with median follow‐up 2.2 years) were compared with DJ patients (n = 179; 167 SPKDJ and 12 PTADJ) 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 PTADD patients versus SPKDD patients (p = 0.003). Hazard ratio (HR) for graft loss was 2.25 (95% CI 1.00, 5.05; p = 0.049) in PTADD versus SPKDD 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. This research has been accepted and published in the American Journal of Transplantation. © 2018 Wileyen_US
dc.languageEN
dc.publisherBlackwell Publishing
dc.relation.ispartofHorneland, Rune (2019) Benefits and Challenges with Exocrine Drainage Through Native Duodenum in Whole Organ Pancreas Transpolantation. Doctoral thesis http://hdl.handle.net/10852/70671
dc.relation.urihttp://hdl.handle.net/10852/70671
dc.titleOutcomes in pancreas transplantation with exocrine drainage through a duodenoduodenostomy versus duodenojejunostomyen_US
dc.typeJournal articleen_US
dc.creator.authorLindahl, Jørn Petter Hanto
dc.creator.authorHorneland, Rune
dc.creator.authorNordheim, Espen
dc.creator.authorHartmann, Anders
dc.creator.authorAandahl, Einar Martin
dc.creator.authorGrzyb, Krzysztof
dc.creator.authorHaugaa, Håkon
dc.creator.authorKjøsen, Gisle
dc.creator.authorÅsberg, Anders
dc.creator.authorJenssen, Trond Geir
cristin.unitcode185,50,0,0
cristin.unitnameDet medisinske fakultet
cristin.ispublishedtrue
cristin.fulltextpreprint
cristin.qualitycode1
dc.identifier.cristin1535031
dc.identifier.bibliographiccitationinfo:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=American Journal of Transplantation&rft.volume=18&rft.spage=154&rft.date=2018
dc.identifier.jtitleAmerican Journal of Transplantation
dc.identifier.volume18
dc.identifier.issue1
dc.identifier.startpage154
dc.identifier.endpage162
dc.identifier.doihttp://dx.doi.org/10.1111/ajt.14420
dc.identifier.urnURN:NBN:no-64315
dc.type.documentTidsskriftartikkelen_US
dc.source.issn1600-6135
dc.identifier.fulltextFulltext https://www.duo.uio.no/bitstream/handle/10852/61711/4/Lindahl%2BAJT2018_PostScript.pdf
dc.type.versionSubmittedVersion


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