Complications after pancreas transplantation

Research output: Contribution to journalArticle

77 Scopus citations

Abstract

Purpose of review: The history of transplantation of the pancreas, unlike that of transplantation of other abdominal organs, has largely been shaped by the associated surgical complications. After more than three decades of progress, surgical-technical pancreas graft failure rates have decreased to approximately 8%. The most recent developments in this area are systematically reviewed in this article. Recent findings: Vascular graft thrombosis remains, by far, the most common cause of technical graft failure. Recent reports suggested that pancreas preservation with histidine-tryptophan-ketoglutarate solution (HTK) might be a risk factor for reperfusion pancreatitis, graft thrombosis and decreased short- and long-term graft survival. It remains unclear whether these results are, at least in part, related to HTK flush volumes and extended preservation (e.g.,>12 h). For selected thrombosed pancreas grafts, there has been renewed interest in pharmacological, interventional, and surgical salvage. For selected recipients with early pancreas graft thrombosis not amenable to a salvage intervention, transplant pancreatectomy in conjunction with immediate retransplantation has emerged as a viable option. For graft thrombosis prevention, the enhanced backtable pancreas vascular reconstruction techniques (e.g., gastroduodenal artery revascularization) proposed by some authors await more formal study. For prevention of native vascular complications in high-risk recipients, several technical modifications have been reported. Developments with respect to other surgical complications (wound infection, pancreatitis, leak, and bleeding) have been more incremental. Conclusion: Recent evidence underscores the importance of judicious donor and recipient selection and of optimization of preservation and surgical factors for excellent short- and long-term pancreas transplant outcomes.

Original languageEnglish (US)
Pages (from-to)112-118
Number of pages7
JournalCurrent Opinion in Organ Transplantation
Volume15
Issue number1
DOIs
StatePublished - Feb 2010

Keywords

  • Graft pancreatitis
  • Intraabdominal abscess
  • Pancreas graft thrombosis
  • Pancreas transplantation
  • Surgical complication

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation

Fingerprint Dive into the research topics of 'Complications after pancreas transplantation'. Together they form a unique fingerprint.

  • Cite this