02 October 2018 : Original article
Fence Angioplasty Prevents Narrowing of Venous Anastomosis in Solitary Pancreas Transplant
Je Ho Ryu12ABEF, Tae Beom Lee1BCD, Kwang Ho Yang1BCEF, Taeun Kim3ACDE, Young Soo Chung4CDF, Byunghyun Choi12ABCEFG*DOI: 10.12659/AOT.911379
Ann Transplant 2018; 23:681-690
Abstract
BACKGROUND: Graft thrombosis is the leading cause of early graft failure in pancreas transplants. Direct anastomosis grafting of the portal vein to the iliac vein or vena cava generally appears narrowed on postoperative computed tomography (CT) scans. However, modification of surgical techniques may prevent venous narrowing, which also prevents thrombosis-related graft failure.
MATERIAL AND METHODS: We performed 31 solitary pancreas transplants since 2015. Retrospective analysis of these patients was performed.
RESULTS: Fence angioplasty was applied in the final 12 cases, and no technical failures or early graft losses occurred in these cases. Three graft losses, including 2 immunologic losses and 1 patient death with functioning graft, occurred after at least postoperative 4 months. The venous anastomoses were evaluated via intraoperative Doppler ultrasound and postoperative CT scans. Intraoperative Doppler ultrasound revealed improved spectral waves of venous anastomoses in the fence group (monophasic spectral wave, 42.9% vs. 0%, p=0.017). The fence-graft applied group had no cases of narrowing, whereas the non-fence group had high narrowing rates on CT scans (84.2% vs. 0%, p<0.001). Furthermore, with less use of postoperative heparin, postoperative bleeding rates were lower in the fence group (36% vs. 0%, p=0.026).
CONCLUSIONS: Fence angioplasty is a definitive method for avoiding venous anastomotic stenosis and preventing graft failure due to thrombosis.
Keywords: Anastomosis, Surgical, Pancreas Transplantation, Thrombosis
In Press
Original article
Simultaneous Liver and Kidney Transplant in a Middle-Income Country: A Single-Center ExperienceAnn Transplant In Press; DOI: 10.12659/AOT.947649
Original article
Outcomes of Combined Liver-Kidney Transplantation in Polycystic Liver and Kidney DiseaseAnn Transplant In Press; DOI: 10.12659/AOT.947639
Most Viewed Current Articles
03 Jan 2023 : Original article 6,881
Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and...DOI :10.12659/AOT.938467
Ann Transplant 2023; 28:e938467
15 Aug 2023 : Review article 6,826
Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ TransplantationDOI :10.12659/AOT.939750
Ann Transplant 2023; 28:e939750
16 May 2023 : Original article 6,569
Breaking Antimicrobial Resistance: High-Dose Amoxicillin with Clavulanic Acid for Urinary Tract Infections ...DOI :10.12659/AOT.939258
Ann Transplant 2023; 28:e939258
28 May 2024 : Original article 5,905
Effect of Dexmedetomidine Combined with Remifentanil on Emergence Agitation During Awakening from Sevoflura...DOI :10.12659/AOT.943281
Ann Transplant 2024; 29:e943281