Procurement and workbench procedures in preparation of pancreatic allografts. Factors essential for a successful pancreas transplant.

The rapidly developing field of pancreas allotransplantation can be regarded as an excellent school of surgery in which the topics of meticulous surgical technique and attention to detail by virtue of their significance strongly outweigh all other topics. The growing experience of the rather grave complications after pancreas transplantation points to the need for consistent use of meticulous techniques during organ procurement and application of workbench procedures just prior to transplantation. In addition, with the further development of the extra-renal transplant programs, the procurement of multiple organs from the same donor is becoming more common and the pancreatic team is more frequently faced with a less than optimal situation in regard to the vascular supply of the pancreatic graft. It, therefore, becomes imperative to carefully evaluate the vasculature and to make the necessary modifications prior to transplantation, since the best surgical techniques will not outweigh the consequences of a suboptimal blood supply, which will compromise the viability of any segment of the delicate pancreaticoduodenal graft.