Early pancreas allograft thrombosis

Clin Transplant. May-Jun 2013;27(3):410-6. doi: 10.1111/ctr.12105. Epub 2013 Mar 17.

Abstract

Objectives: To determine factors associated with early pancreatic allograft thrombosis (EPAT). Thrombosis is the leading non-immunological cause of early pancreatic allograft failure. Multiple risk factors have been postulated. We hypothesized that recipient perioperative hypotension was a major risk factor and evaluated the correlation of this and other parameters with EPAT.

Methods: We retrospectively reviewed the records of the 118 patients who received a pancreatic allograft at our center between October 1992 and January 2010. Multiple donor and recipient parameters were analyzed as associates of EPAT by univariate and multivariate analysis.

Results: There were 12 episodes of EPAT, resulting in an incidence of 10.2%. On univariate analysis, EPAT was associated with perioperative hypotension, vasopressor use, and neuropathy in the recipient (p ≤ 0.04 for all). On multivariate analysis corrected for age, sex, and peripheral vascular disease, only vasopressor use retained a significant association with EPAT with a hazard ratio of 8.74 (CI 1.11-68.9, p = 0.04). Factors associated with vasopressor use included recipient ischemic heart disease, peripheral vascular disease, retinopathy or neuropathy, and any surgical complication.

Conclusions: Significant hypotension, measured by the need for perioperative vasopressor use was associated with EPAT, suggesting that maintenance of higher perfusion pressures may avoid this complication.

MeSH terms

  • Adolescent
  • Adult
  • Allografts
  • Child
  • Female
  • Follow-Up Studies
  • Graft Rejection / diagnosis
  • Graft Rejection / etiology*
  • Graft Rejection / mortality
  • Humans
  • Male
  • Middle Aged
  • Pancreas Transplantation / adverse effects*
  • Pancreatic Diseases / complications*
  • Pancreatic Diseases / mortality
  • Pancreatic Diseases / surgery
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Thrombosis / diagnosis
  • Thrombosis / etiology*
  • Thrombosis / mortality
  • Young Adult