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Title: | Early pancreas allograft thrombosis. | Authors: | Saunder A.C.;Mulley W.R.;Ramessur Chandran S.;Kanellis J.;Polkinghorne K.R. | Institution: | (Ramessur Chandran, Kanellis, Polkinghorne, Saunder, Mulley) Department of Nephrology, Monash Medical Centre, Clayton, VIC, Australia (Kanellis, Polkinghorne, Mulley) Department of Medicine, Monash University, Clayton, VIC, Australia (Saunder) Department of Surgery, Monash Medical Centre, Clayton, VIC, Australia | Issue Date: | 18-Jun-2013 | Copyright year: | 2013 | Publisher: | Blackwell Publishing Ltd (E-mail: customerservices@oxonblackwellpublishing.com) | Place of publication: | United Kingdom | Publication information: | Clinical Transplantation. 27 (3) (pp 410-416), 2013. Date of Publication: May/June 2013. | Journal: | Clinical Transplantation | 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. Method(s): 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. Result(s): 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. Conclusion(s): 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. © 2013 John Wiley & Sons A/S. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1111/ctr.12105 | PubMed URL: | 23495654 [http://www.ncbi.nlm.nih.gov/pubmed/?term=23495654] | ISSN: | 0902-0063 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/42598 | Type: | Article | Subjects: | major clinical study male morbidity neuropathy *pancreas transplantation peripheral vascular disease postoperative complication priority journal retinopathy retrospective study risk factor *thrombosis azathioprine/cb [Drug Combination] azathioprine/dt [Drug Therapy] basiliximab/cb [Drug Combination] basiliximab/dt [Drug Therapy] cyclosporin/cb [Drug Combination] cyclosporin/dt [Drug Therapy] hypertensive factor/dt [Drug Therapy] mycophenolic acid 2 morpholinoethyl ester/cb [Drug Combination] mycophenolic acid 2 morpholinoethyl ester/dt [Drug Therapy] OKT 3/cb [Drug Combination] OKT 3/dt [Drug Therapy] prednisolone/cb [Drug Combination] prednisolone/dt [Drug Therapy] tacrolimus/cb [Drug Combination] tacrolimus/dt [Drug Therapy] perioperative period adult *allotransplantation article correlation analysis disease association donor drug use female graft failure graft recipient graft rejection/dt [Drug Therapy] graft rejection/pc [Prevention] human hypotension/dt [Drug Therapy] immunosuppressive treatment ischemic heart disease maintenance therapy graft recipient graft rejection / drug therapy / prevention human hypotension / drug therapy immunosuppressive treatment ischemic heart disease maintenance therapy major clinical study male morbidity neuropathy *pancreas transplantation perioperative period peripheral vascular disease postoperative complication priority journal retinopathy adult risk factor *thrombosis retrospective study *allotransplantation article correlation analysis disease association donor drug use female graft failure |
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