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Management of Complications Occurring After Pancreas Transplantation

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Textbook of Emergency General Surgery

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Abstract

In this chapter are analyzed the postoperative complication after the transplant of pancreas and kidney and their management. Some complications, especially with respect to the pancreas, could be insidious and catastrophic because affecting patients with a long history of diabetes. The prompt diagnosis and management are fundamental for the life of the patients. Complications are listed for each organ, and it explains the diagnosis and management. The complications, considered in the chapter, after pancreas transplantation are vascular thrombosis, pseudoaneurysm, arteriovenous fistula, arterio-enteric fistula, and duodenal graft complications. In case of kidney transplantation, we analyzed vascular thrombosis, graft rupture, lymphocele, and vesicoureteral complications.

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References

  1. Humar A, Kandaswamy R, Granger D, et al. Decreased surgical risk of pancreas transplantation in the modern era. Ann Surg. 2000;231:269–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Gruessner AC, Sutherland DE. Pancreas transplant outcomes for United States (US) cases as reported to the United Network of Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR). Clin Transpl. 2008:45–56.

    Google Scholar 

  3. Kandaswamy R, Stock PG, Miller J, et al. OPTN/SRTR 2019 Annual Data Report: pancreas. Am J Transplant. 2021;21(Suppl 2):138–207.

    Article  PubMed  Google Scholar 

  4. Humar A, Ramcharan T, Kandaswamy R, et al. Technical failures after pancreas transplants: why grafts fail and the risk factors—a multivariate analysis. Transplantation. 2004;78(8):1188–92.

    Article  PubMed  Google Scholar 

  5. Cornejo-Carrasco CE, Fernández-Cruz L. Re-operation in pancreas transplantation. Transplant Proc. 2014;46:3050–3.

    Article  CAS  PubMed  Google Scholar 

  6. Yales A, Parry C, Stephens M, Eynon A. Imaging pancreas transplants. Br J Radiol. 2013;86:20130428.

    Article  Google Scholar 

  7. Neri E, Cappelli C, Boggi U, et al. Multirow CT in the follow-up of pancreas transplantation. Transplant Proc. 2004;36:507–600.

    Article  Google Scholar 

  8. Boggi U, Amorese G, Marchetti P. Surgical techniques for pancreas transplantation. Curr Opin Organ Transplant. 2010;15(1):102–11.

    Article  PubMed  Google Scholar 

  9. Pieroni E, Napoli N, Lombardo C, et al. Duodenal graft complications requiring duodenectomy after pancreas and pancreas-kidney transplantation. Am J Transplant. 2018;18(6):1388–96.

    Article  PubMed  Google Scholar 

  10. Sansalone CV, Maione G, Aseni P, et al. Surgical complications are the main cause of pancreatic allograft loss in pancreas-kidney transplant recipients. Transplant Proc. 2005;37(6):2651–3.

    Article  CAS  PubMed  Google Scholar 

  11. O’Malley RB, Moshiri M, Osman S, et al. Imaging of pancreas transplantation and its complications. Radiol Clin N Am. 2016;54:251–26.

    Article  PubMed  Google Scholar 

  12. Laurencea JM, Cattral MS. Techniques of pancreas graft salvage/indications for allograft pancreatectomy. Curr Opin Organ Transplant. 2016;21:405–11.

    Article  Google Scholar 

  13. Stockland AH, Willingham DL, Paz-Fumagalli R, et al. Pancreas transplant venous thrombosis: role of endovascular interventions for graft salvage. Cardiovasc Intervent Radiol. 2009;32:279–83.

    Article  PubMed  Google Scholar 

  14. Fernandez-Cruz L, Gilabert R, Sabater L, et al. Pancreas graft thrombosis: prompt diagnosis and immediate thrombectomy or retransplantation. Clin Transpl. 1993;7:230–23.

    Google Scholar 

  15. Sörelius K, Wanhainen A, Furebring M, et al. Nationwide study of the treatment of mycotic abdominal aortic aneurysms comparing open and endovascular repair. Circulation. 2016;134:1822–32.

    Article  PubMed  Google Scholar 

  16. Tobben PJ, Zajko AB, Sumkin JH, et al. Pseudoaneurysms complicating organ transplantation: roles of CT, duplex sonography and angiography. Radiology. 1988;169(1):65–70.

    Article  CAS  PubMed  Google Scholar 

  17. White SA, Shaw JA, Sutherland DE. Pancreas transplantation. Lancet. 2009;373:1808–17.

    Article  CAS  PubMed  Google Scholar 

  18. Gorey TF, Bulkley GB, Spees EK Jr, et al. Iliac artery ligation: the relative paucity of ischemic sequelae in renal transplant patients. Ann Surg. 1979;190:753–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Yiannoulloua P, van Dellena D, Khambalia H, et al. Successful management of a ruptured mycotic pseudoaneurysm following pancreas transplantation using bovine pericardial patch: a case report. Transplant Proc. 2014;46:2023–5.

    Article  Google Scholar 

  20. McMillan WD, Leville CD, Hile CN. Bovine pericardial patch repair in infected fields. J Vasc Surg. 2012;55(6):1712–5.

    Article  PubMed  Google Scholar 

  21. Khan TF, Ciancio G, Burke GW III, et al. Pseudoaneurysm of the superior mesenteric artery with an arteriovenous fistula after simultaneous kidney pancreas transplantation. Clin Transpl. 1999;13(277–279):65.

    Google Scholar 

  22. Lowell JA, Stratta RJ, Taylor RJ, et al. Mesenteric arteriovenous fistula after vascularized pancreas transplantation resulting in graft dysfunction. Clin Transpl. 1996;10:278–81.

    CAS  Google Scholar 

  23. Fridell JA, Powelson JA, Kubal CA, et al. Retrieval of the pancreas allograft for whole-organ transplantation. Clin Transpl. 2014;28:1313–30.

    Article  Google Scholar 

  24. Bratton CF, Hamid A, Selby JB, et al. Case report: gastrointestinal hemorrhage caused by a pancreas transplant arteriovenous fistula with large pseudoaneurysm 9 years after transplantation. Transplant Proc. 2011;43:4039–43.

    Article  CAS  PubMed  Google Scholar 

  25. Dalla Valle R, Capocasale E, Mazzoni MP, et al. Embolization of a ruptured pseudoaneurysm with massive hemorrhage following pancreas transplantation: a case report. Transplant Proc. 2005;37:2275–7.

    Article  CAS  PubMed  Google Scholar 

  26. Maupoey Ibáñez J, Boscà Robledo A, López-Andujar R. Late complications of pancreas transplant. World J Transplant. 2020;10(12):404–14.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Parajuli S, Odorico J, Astor BC, et al. Incidence and indications for late allograft pancreatectomy while on continued immunosuppression. Transplantation. 2017;101:2228–34.

    Article  PubMed  Google Scholar 

  28. Zhao J, Gao Z, Wang K. The transplantation operation and its surgical complications, understanding the complexities of kidney transplantation; 2011. Ortiz J, editor, ISBN: 978-953-307-819-9.

    Google Scholar 

  29. Grochowiecki T, Gałązka Z, Madej K, et al. Early complications related to the transplanted kidney after simultaneous pancreas and kidney transplantation. Transplant Proc. 2014;46(8):2815–7.

    Article  CAS  PubMed  Google Scholar 

  30. Shahrokh H, Rasouli H, Zargar MA, et al. Spontaneous kidney allograft rupture. Transplant Proc. 2005;37(7):3079–80.

    Article  CAS  PubMed  Google Scholar 

  31. Salomon L, Saporta F, Amsellem D, et al. Results of pyeloureterostomy after ureterovesical anastomosis complications in renal transplantation. Urology. 1999;53(5):908–12.

    Article  CAS  PubMed  Google Scholar 

  32. Lehner LJ, Hohberger A, Marschke L, et al. Analysis of risk factors and long-term outcomes in kidney transplant patients with identified lymphoceles. J Clin Med. 2020;9(9):2841.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Grochowiecki T, Madej K, Gałązka Z, et al. Usefulness of modified Dindo-Clavien scale to evaluate the correlation between the severity of surgical complications and complications related to the renal and pancreatic grafts after simultaneous kidney and pancreas transplantation. Transplant Proc. 2016;48(5):1677–80.

    Article  CAS  PubMed  Google Scholar 

  34. Boggi U, Signori S, Vistoli F, et al. Laparoscopic robot-assisted pancreas transplantation: first world experience. Transplantation. 2012;93(2):201–6.

    Article  PubMed  Google Scholar 

  35. Boggi U, Signori S, Vistoli F, et al. Current perspectives on laparoscopic robot-assisted pancreas and pancreas-kidney transplantation. Rev Diabet Stud. 2011;8(1):28–34.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Tzvetanov I, D’Amico G, Bejarano-Pineda L, et al. Robotic-assisted pancreas transplantation: where are we today? Curr Opin Organ Transplant. 2014;19(1):80–2.

    Article  PubMed  Google Scholar 

  37. Surowiecka-Pastewka A, Matejak-Górska M, Frączek M, et al. Endovascular interventions in vascular complications after simultaneous pancreas and kidney transplantations: a single-center experience. Ann Transplant. 2019;12(24):199–207.

    Article  Google Scholar 

Further Reading

  • Boggi U, Amorese G, Marchetti P. Surgical techniques for pancreas transplantation. Curr Opin Organ Transplant. 2010;15(1):102–11.

    Article  PubMed  Google Scholar 

  • Grochowiecki T, GaĹ‚Ä…zka Z, Madej K, et al. Early complications related to the transplanted kidney after simultaneous pancreas and kidney transplantation. Transplant Proc. 2014;46(8):2815–7.

    Article  CAS  PubMed  Google Scholar 

  • Pieroni E, Napoli N, Lombardo C, et al. Duodenal graft complications requiring duodenectomy after pancreas and pancreas-kidney transplantation. Am J Transplant. 2018;18(6):1388–96.

    Article  PubMed  Google Scholar 

  • Sansalone CV, Maione G, Aseni P, et al. Surgical complications are the main cause of pancreatic allograft loss in pancreas-kidney transplant recipients. Transplant Proc. 2005;37(6):2651–3.

    Article  CAS  PubMed  Google Scholar 

  • Zhao J, Gao Z, Wang K. The transplantation operation and its surgical complications, understanding the complexities of kidney transplantation; 2011. Ortiz J, editor, ISBN: 978-953-307-819-9.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Division of General and Transplant Surgery, University of Pisa, Pisa, Italy

    Fabio Vistoli, Emanuele Federico Kauffmann, Niccolò Napoli & Ugo Boggi

  2. Division of Anesthesia and Intensive Care, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy

    Gabriella Amorese

Authors
  1. Fabio Vistoli
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  2. Emanuele Federico Kauffmann
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  3. Niccolò Napoli
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  4. Gabriella Amorese
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  5. Ugo Boggi
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Corresponding author

Correspondence to Ugo Boggi .

Editor information

Editors and Affiliations

  1. General, Emergency and Trauma Surgery Dept., Pisa University Hospital, Pisa, Italy

    Federico Coccolini

  2. General and Emergency Surgery Dept., Bufalini Hospital, Cesena, Italy

    Fausto Catena

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Vistoli, F., Kauffmann, E.F., Napoli, N., Amorese, G., Boggi, U. (2023). Management of Complications Occurring After Pancreas Transplantation. In: Coccolini, F., Catena, F. (eds) Textbook of Emergency General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-22599-4_105

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  • DOI: https://doi.org/10.1007/978-3-031-22599-4_105

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-22598-7

  • Online ISBN: 978-3-031-22599-4

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