Advantages of bladder drainage in pancreas transplantation: A personal view

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Abstract
Excorine drainage of the pancreas into the bladder has become the most frequently used exocrine drainage procedure after pancreas transplantation since we described this technique in 1982. The advantages of bladder drainage are technical simplicity associated with a low infection rate and a low incidence of surgical complication. Selected centers around the world have reported 1‐year graft survival exceeding 80% with the use of bladder drainage. Disadvantages of this technique include urinary problems such as hematuria, dyauria, and urinary tract infections. The number of centers using bladder drainage as the preferred drainage technique has steadily increased since 1984, and now more than two‐thirds of all pancreas transplants are performed with exocrine drainage to the urinary bladder. A further advantage of bladder drainage is the fact that rejection episodes can be diagnosed by determination of urinary amylase, which seems to be particularly important in isolated pancreas transplantation in pre‐uremic patients or sequential pancreas transplantation in patients who have previously received a kidney transplant.