Incidence of pancreas graft thrombosis using low-molecular-weight heparin

Simultaneous pancreas-kidney transplantation is the current treatment of choice for patients with type I diabetes and end stage renal disease. Vascular graft thrombosis (VGT) after pancreas transplantation is the main cause of early graft loss.

A total of 188 consecutive pancreas transplantations were performed between January 2000 and December 2006. A retrospective study was carried out in order to compare incidence of VGT and relaparotomy-for-bleeding rate of once daily fixed dose low-molecular-weight-heparin (LMWH) to dose-adjusted intravenous unfractionated heparin (UFH).

Fifty-eight patients receiving LMWH and 129 receiving UFH were identified. There were 7% (4/58) VGTs in the LMWH and 17% (22/129) in the UFH group (p = 0.047). The frequency of major bleeding requiring relaparatomy was not significantly different in the groups related to LMWH and UFH, respectively (6.9% vs. 7.8%). One yr patient and pancreas graft survival was 98.9/89.6% in the LMWH and 97.8/74.4% in the UFH group. Donor and recipient characteristics were similar.

In our experience once daily fixed dose LMWH might not be inferior to dose-adjusted intravenous heparin in preventing pancreas graft thrombosis.