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

Early pancreas allograft thrombosis.

Author information

1
Department of Nephrology, Monash Medical Centre, Clayton, Vic, Australia. bill.mulley@southernhealth.org.au

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.

PMID:
23495654
DOI:
10.1111/ctr.12105
[Indexed for MEDLINE]

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