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doi: 10.1097/TP.0b013e31823e46d1
Clinical and Translational Research

Preservation of Pancreas Graft Function After Complete Venous Thrombosis: Report of Four Cases Treated Conservatively

Garcia-Roca, Raquel1,6; Samamé, Julia2; Garcia-Criado, Maria Angeles3; Real, Maria Isabel4; Gilabert, Rosa4; Ricart, Maria Jose5



In the January 27, 2012 issue of Transplantation, for the article by Garcia-Roca et al, “Preservation of Pancreas Graft Function After Complete Venous Thrombosis: Report of Four Cases Treated Conservatively”, the author Rosa Gilabert should no longer be considered an author. The new author list should read: Raquel Garcia-Roca, Julia Samame, Maria Angeles Garcia-Criado, Maria Isabel Real, and Maria Jose Ricart.

Transplantation. 93(9):e38, May 15, 2012.

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Background. Pancreas graft thrombosis is the most common cause of technical graft failure, with an incidence of up to 20% is some series. In most instances, vascular thrombosis of the graft will require immediate removal to avoid further abdominal complications. We present a total of four cases of complete venous thrombosis with preservation of function that were managed conservatively, resulting in long-term graft function.

Methods. Retrospective analysis of our case series over 10 years was carried out, obtaining patients with complete graft thrombosis by Doppler ultrasound. We included in the study only those patients who remained asymptomatic with preserved graft function. The clinical status of the patients, radiological findings, and therapeutic approach are evaluated. Patient and graft outcomes are analyzed.

Results. Retrospective evaluation of 227 transplants, a total of four patients were found to have complete thrombosis of the graft, remaining asymptomatic and preserving function without complications. Graft thrombosis was found on routine Doppler ultrasound evaluation of the transplanted organs at a median time of 19 days (range, 11–28 days), angiographic confirmation was obtained in all cases. The clinical condition and the presence of collateral flow allowed for conservative treatment. Median hospital stay was 29 days (range, 16–38 days), with a median follow-up of 106 months (range, 24–110 months), all patients are alive with a functioning graft.

Conclusions. In rare instances with complete thrombosis of the pancreas transplant in absence of clinical manifestations, the grafts can be closely monitored and treated with systemic anticoagulation, allowing long-term patient and graft survival.

© 2012 Lippincott Williams & Wilkins, Inc.



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