student research day - Case Western Reserve University School of ...

Daniel Oberlin
The Effect of Systemic Versus Portal Venous Drainage in Pancreas Transplantation on Metabolic Outcomes
Introduction:
Daniel Oberlin, Emilio Poggio, M.D., Titte Srinivas, M.D., Venkatesh Krishnamurthi, M.D.
Transplantation Center and Glickman Urological Kidney Institute
The Cleveland Clinic Foundation
Pancreas transplantation is a therapeutic option for patient with end-stage diabetic nephropathy or diabetes
mellitus with the inability to properly control blood glucose levels with insulin. Our objective is to compare portal
and systemic venous drainage of pancreas transplants and assess the metabolic profiles and survival differences
between the two groups.
Methods:
We performed a retrospective chart review of 110 pancreas transplant recipients—77 simultaneous pancreas-
kidney transplants, 50 pancreas-after-kidney transplants, and 19 pancreas transplant alone—who underwent
transplantation within the period of January 2002 to August 2007 and who received induction therapy with
thymoglobulin followed by maintenance immunosuppression with tacrolimus and mycophenolate mofetil. The
venous effluent of these patients was managed by either portal drainage (n=72) or systemic drainage (n=38). The
two groups were analyzed for matching baseline characteristics and managed with equivalent immunosuppression
regimens.
Results will portray:
The results will reflect comparisons of recipient characteristics and HLA matching
Comparison of change in body mass index (BMI), blood hematocrit, blood glucose level, lipid profiles, and
creatinine between the two populations at 6 months, 12 months, 3 years, and 5 years.
Survival analysis will be performed with possible analysis as to the grade of rejection.
Multivariate analysis to determine which parameters affected rejection.
Conclusions:
Significant difference in graft survival and metabolic profiles between the two groups will allow for a comparison of
clinical outcomes and influence surgical decision-making with respect to location of venous drainage. Conclusions
will address observed differences from published reports and determine if significant clinical outcomes are different
between portal and systemic venous drainage of pancreas allografts.
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