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Pancreatico-renal composite transplant: a new technique designed to decrease pancreatic graft thrombosis.

Donald C Dafoe1, Lloyd E Ratner

  • 1Division of Kidney and Pancreas Transplantation, Department of Surgery, Thomas Jefferson Medical College, Philadelphia, PA 90048, USA. donald.dafoe@cshs.org

Clinical Transplantation
|September 9, 2005
PubMed
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Pancreas graft thrombosis is a common issue. Anastoming a donor kidney to splenic vessels improved pancreas graft blood flow, potentially reducing thrombosis and graft loss.

Area of Science:

  • Transplantation immunology
  • Vascular surgery
  • Nephrology

Background:

  • Pancreas graft thrombosis is a significant cause of graft failure after transplantation.
  • Donor spleen removal often leads to reduced pancreatic graft blood flow, increasing thrombosis risk.

Observation:

  • A novel technique involved anastomosing a donor kidney to the splenic vessels of a pancreas graft during simultaneous pancreas and dual kidney transplantation.
  • This pancreatico-renal composite graft placement improved pancreatic graft portal vein blood flow by approximately 33% compared to standard methods.

Findings:

  • Intraoperative ultrasonic flow probe measurements confirmed a substantial increase in pancreatic graft blood flow.
  • Postoperative radionuclide scans showed comparable and brisk perfusion in both transplanted kidneys.

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  • The patient experienced an uneventful recovery with normal glucose and creatinine levels.

    • Implications:

    • This pancreatico-renal composite graft strategy may mitigate pancreas graft thrombosis by enhancing vascular perfusion.
    • Improving pancreatic graft blood flow is crucial for long-term graft survival and function.
    • This approach offers a potential solution to reduce graft loss in pancreas transplantation.