Τίτλος:
Vascular complications of pancreas transplantation
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective: The purpose of our study was to focus on the early diagnosis
and treatment of vascular complications after simultaneous
pancreas-kidney (SPK) transplantation. Description of the technique for
salvage of the graft after venous thrombosis (VT) is also provided.
Methods: From July 1994 to December 2002, 14 patients of 206 SPK
transplant recipients had partial VT. Partial splenic VT (PSVT) was
documented in 10 patients (4.8%), two had complete thrombosis of the
splenic vein, one partial superior mesenteric thrombosis, and one
developed partial thrombosis of the splenic and superior mesenteric
vein. Four patients developed complete VT of the pancreas allograft and
one superior mesenteric artery thrombosis. Our experience with four
arteriovenous fistulae is also reported. The immunosuppression included
tacrolimus, steroids, and monoclonal antibody to the IL-2 receptor.
Thymoglobulin was introduced in June 2000 in our protocol combined with
rapamycin or mycophenolate mofetil. These cases were identified
following the intravenous (iv) use of tacrolimus with or without
anti-IL-2R therapy. One case of complete VT is also reported one month
following transplantation in a recipient with high rapamycin levels.
Diagnosis was established during routine color Doppler ultrasonography.
Results: Partial VT was effectively treated with anticoagulation.
Complete VT required surgical thrombectomy. In our series, the pancreas
was salvaged successfully in all patients with the technique described
here.
Conclusion: Early diagnosis of vascular complications after pancreas
transplantation is of paramount importance for the appropriate treatment
with organ salvage. Based on our experience, we suggest that VT can be
effectively treated with anticoagulation. Aspirin is sufficient for
PSVT.
Συγγραφείς:
Spiros, D
Christos, D
John, B
Burke, GW
Miller, J and
Ciancio, G
Περιοδικό:
Journal of the Pancreas
Εκδότης:
Lippincott, Williams & Wilkins
Λέξεις-κλειδιά:
pancreas transplantation; vascular thrombosis; vascular complications
DOI:
10.1097/00006676-200405000-00010
