Pancreas graft thrombosis: causes, prevention, diagnosis, and intervention

Curr Opin Organ Transplant. 2012 Feb;17(1):87-92. doi: 10.1097/MOT.0b013e32834ee717.


Purpose of review: Pancreas graft thrombosis remains one of the most common reasons for pancreas transplant loss. Patients with a history of thrombotic events should be identified and evaluated for thrombophilia to identify transplant candidates at highest risk.

Recent findings: Early after transplant, vascular thrombosis is multifactorial, but beyond 2 weeks, inflammation or acute rejection predominate as the cause of thrombosis. Most pancreas transplant centers utilize some form of anticoagulation following transplantation. Aspirin is highly recommended. Unfractionated or low-molecular-weight heparin is often administered, but some centers use heparin selectively and typically at low dose to avoid postoperative bleeding. Warfarin is less frequently given and its use should probably be limited to patients with thrombophilia.

Summary: Thrombectomy, either surgical or percutaneous, may salvage the pancreas graft if performed early after the occurrence of thrombosis.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Anticoagulants / therapeutic use*
  • Aspirin / administration & dosage
  • Fibrinolytic Agents / therapeutic use*
  • Graft Rejection / complications
  • Heparin / administration & dosage
  • Humans
  • Incidence
  • Inflammation
  • Pancreas Transplantation / adverse effects*
  • Postoperative Hemorrhage / etiology
  • Postoperative Hemorrhage / prevention & control
  • Risk Factors
  • Thrombectomy*
  • Thrombosis / diagnosis
  • Thrombosis / drug therapy
  • Thrombosis / etiology*
  • Thrombosis / prevention & control
  • Thrombosis / surgery
  • Thrombosis / therapy*
  • Warfarin / administration & dosage


  • Anticoagulants
  • Fibrinolytic Agents
  • Warfarin
  • Heparin
  • Aspirin