Mechanical obstruction of the portal vein as a cause of vascular thrombosis after pancreatic transplantation in humans

P. Soon-Shiong, G. White, E. DeMayo, M. Koyle, G. Danovitch

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    5 Citations (Scopus)

    Abstract

    Venous thrombosis remains a significant problem that accounts for pancreatic allograft loss. The incidence of early graft loss due to vascular thrombosis has been estimated at 15% by Calne and as high as 20% by Groth et al. The exact mechanism of thrombosis is unknown. Various forms of therapy are instituted at different pancreas transplant centers in an attempt to prevent this complication. Indicative of our current lack of understanding of the basic mechanism underlying the cause of this complication is the finding that no single form of therapy consistently prevents venous thrombosis. Preventive regimens include vascular reconstruction techniques to improve blood flow through the pancreas, and prophylactic anticoagulant (heparin, dextran, aspirin, dipyridamole, Coumadin) therapy. In addition to the above regimens, pancreas transplant recipients are kept at bedrest three to four days postoperatively to prevent physical twisting or kinking of the portal vein, especially of the portal-external iliac venous anastomosis. Whether early mobilization and physical kinking of the portal vein truly attributed to venous thrombosis has not been documented. We report an instance of probable mechanical portal vein occlusion in an allograft recipient after early ambulation and mobilization.

    Original languageEnglish
    Pages (from-to)1059-1061
    Number of pages3
    JournalTransplantation Proceedings
    Volume20
    Issue number5
    Publication statusPublished - 1988

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