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Transplantation. 2014 Mar 27;97(6):681-5. doi: 10.1097/01.TP.0000437790.26255.5d.

Clinical outcomes associated with the early postoperative use of heparin in pancreas transplantation.

Author information

  • 11 Department of Pharmacy, New York-Presbyterian Hospital, New York, NY. 2 Department of Surgery, Division of Transplant Surgery, Medical University of South Carolina, Charleston, SC. 3 Department of Pharmacy Services, Medical University of South Carolina, Charleston, SC. 4 Address correspondence to: David J. Taber, PharmD, Department of Surgery, Division of Transplant Surgery, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 611/CSB 409, Charleston, SC 29425.

Abstract

BACKGROUND:

Graft thrombosis following pancreas transplantation is the leading non-immunologic cause of graft loss. Routine systemic anticoagulation is controversial because of an increased bleeding risk.

METHODS:

This was a retrospective, single-center analysis including all pancreas transplants performed over 9 years evaluating the use of low-dose heparin in the early postoperative period. Clinical outcomes were partial and complete graft thrombosis within 30 days, bleeding events, relaparotomy rates, and 30-day graft and patient survival. Multivariate regression analysis was performed to identify risk factors for early graft loss resulting from thrombosis.

RESULTS:

One hundred fifty-two patients were included, 52 in the heparin group. The overall complete thrombosis rate was 13.1%, 10% in those who received heparin, and 15% in those who did not. Partial thrombosis was higher in the heparin group (10% vs. 3%). Higher relaparotomy rates were seen in the heparin group (29% vs. 22%); however, bleeding events were similar between groups. Graft and patient survival at 30 days were similar between groups; however, there was a trend toward higher graft survival in the heparin group. Heparin showed a trend toward a protective benefit for early graft loss resulting from thrombosis in all multivariate regression models.

CONCLUSION:

These data suggest low-dose heparin early in the postoperative period may provide a protective benefit in the prevention of early graft loss resulting from thrombosis, without an increased risk of bleeding.

PMID:
24285337
[PubMed - indexed for MEDLINE]
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