Incidence, Risk Factors and Associated Clinical Outcomes of Surgical Complications Following Pancreas Transplantation

Lin, Zilan; Kee, Mee Kyung; Taber, David J.; McGillicuddy, John W.; Chavin, Kenneth D.; Baliga, Prabhakar K.; Bratton, C. B.

doi:10.1016/j.jss.2012.10.278

Cited by 1 publication

(5 citation statements)

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“…The 63 included articles comprised of 2 meta-analyses, 47 39 cohort studies, 3 , 6 , 8 , 12 - 20 , 23 – 28 , 30 , 32 – 37 , 39 , 41 – 43 , 45 , 46 , 48 and 22 conference abstracts. 4 , 7 , 49 – 64 All studies reported thrombosis in pancreas allograft transplantation. The number of pancreas transplants per study ranged from 9 to 10 253; characteristics of each study are provided in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“…While amylase level defining hyperamylasemia and posttransplant time frames varied between citations, 3 different studies identified postreperfusion pancreatitis as an independent risk factor for graft thrombosis. 21 , 34 , 45 , 57 Montiel-Casado et al 34 employed a hyperamylasemia threshold of >745 mg/dL (1 standard deviation above mean) within 3 days of transplantation. Three of 8 thromboses and 4 of 50 nonthromboses cases had pancreatitis, conferring an 8.6 times greater risk for vascular thrombosis ( P = .032).…”

Section: Resultsmentioning

confidence: 99%

“…The 63 included articles comprised of 2 meta-analyses, 47 39 cohort studies, 3,6,8,[12][13][14][15][16][17][18][19][20][23][24][25][26][27][28]30,[32][33][34][35][36][37]39,[41][42][43]45,46,48 and 22 conference abstracts. 4,7,[49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] All studies reported thrombosis in pancreas allograft transplantation. The number of pancreas transplants per study ranged from 9 to 1...…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In several studies, donor age was associated with increased pancreas allograft thrombosis 6,20,25,45,68 and early technical failure. 50,57,67 Humar et al 25 Donor and recipient obesity, measured clinically as a BMI > 30 kg/m2, are both widely considered as risk factors for pancreatic allograft thrombosis. 8,39 Findings of this review corroborate this, 8,20,26,50 rather, more importantly, one publication even identified an increased thrombotic risk with a donor or recipient BMI 25 kg/m2 (P < .05).…”

Section: Donor and Recipient Factorsmentioning

confidence: 99%

“…In several studies, donor age was associated with increased pancreas allograft thrombosis 6,20,25,45,68 and early technical failure. 50,57,67 Humar et al 25 described a thrombosis incidence of 1.8% with donors younger than 20 years, 3.7% with 20-to 40-year-old donors, and 16.2% with donors older than 40 (P ¼ .009). A donor age older than 44 years (vs 30-44) trended toward increased thrombus formation in all 3 types of pancreas transplants included, reaching significant relative risk of 2.03 for PAK (P ¼ .007).…”

Section: Donor and Recipient Factorsmentioning

confidence: 99%

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Risk Factors for Early Pancreatic Allograft Thrombosis Following Simultaneous Pancreas-Kidney Transplantation: A Systematic Review

Blundell

Shahrestani

Lendzion

et al. 2020

Clin Appl Thromb Hemost

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Simultaneous pancreas-kidney (SPK) transplantation remains the most effective treatment for providing consistent and long-term euglycemia in patients having type 1 diabetes with renal failure. Thrombosis of the pancreatic vasculature continues to contribute significantly to early graft failure and loss. We compared the rate of thrombosis to graft loss and systematically reviewed risk factors impacting early thrombosis of the pancreas allograft following SPK transplantation. We searched the MEDLINE, EMBASE, The Cochrane Library, and PREMEDLINE databases for studies reporting thrombosis following pancreas transplantation. Identified publications were screened for inclusion and synthesized into a data extraction sheet. Sixty-three studies satisfied eligibility criteria: 39 cohort studies, 22 conference abstracts, and 2 meta-analyses. Newcastle-Ottawa Scale appraisal of included studies demonstrated cohort studies of low bias risk; 1127 thrombi were identified in 15 936 deceased donor, whole pancreas transplants, conferring a 7.07% overall thrombosis rate. Thrombosis resulted in pancreatic allograft loss in 83.3% of reported cases. This review has established significant associations between donor and recipient characteristics, procurement and preservation methodology, transplantation technique, postoperative management, and increased risk of early thrombosis in the pancreas allograft. Further studies examining the type of organ preservation fluid, prophylactic heparin protocol, and exocrine drainage method and early thrombosis should also be performed.

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