Pancreas Allograft Thrombosis as a Post-COVID-19 Complication in a Diabetic Patient After Pancreas Transplantation

Abstract

ABSTRACT: Arterial and venous thrombosis of pancreatic allografts is a rare complication in the late post-transplantation period. In addition to traditional thrombosis risk factors, SARS-CoV-2 infection predisposes patients to thrombotic diseases in both arterial and venous vessels. Transplant patients with a history of COVID-19 should be carefully monitored for arterial embolism and graft vein thrombosis. Early detection of this complication in patients after transplantation allows a chance to save the organ. Thromboprophylaxis with low molecular weight heparin is of great importance.

Keywords: COVID-19, Embolism and Thrombosis, Pancreas Transplantation, Allografts, Diabetes Mellitus, Type 1, Humans, Pancreas, Thrombosis

Figures

Figure 1. (A–C) 3D vascular reconstructions of Computed Tomography. A, B – Arterial phase. C – Venous phase. The marks show the localization of pancreatic graft. It is not visible because of the absence of blood flow. (D–G) Images from gastroduodenoscopy. Marks show the necrosis of the mucosa of transplanted duodenum with central ulceration.

References

1. Haldane V, De Foo C, Abdalla SM, Health systems resilience in managing the COVID-19 pandemic: Lessons from 28 countries: Nat Med, 2021; 27; 964-80

2. https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/

3. Goldman IA, Ye K, Scheinfeld MH, Lower-extremity arterial thrombosis associated with COVID-19 is characterized by greater thrombus burden and increased rate of amputation and death: Radiology, 2020; 297; E263-69

4. Wang T, Chen R, Liu C, Attention should be paid to venous thromboembolism prophylaxis in the management of COVID-19: Lancet Haematol, 2020; 7; e362-63

5. Kędzierska-Kapuza K, Zielińska D, Matejak-Górska M, Durlik M, The course of SARS-CoV-2 in a patient after a recent kidney transplant: A literature review on COVID-19 therapy: Transplant Proc, 2021; 53; 1194-201

6. Tantisattamo E, Dafoe DC, Ferrey AJ, Kidney allograft infarction associated with transplant renal artery stenosis in a COVID-19 kidney transplant recipient: Clin Nephrol Case Stud, 2021; 26(9); 93-104

7. Xu JJ, Samaha D, Mondhe S, Renal infarct in a COVID-19-positive kidney-pancreas transplant recipient: Am J Transplant, 2020; 20; 3221-24