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Updated: May 13, 2026
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Normothermic Ex Vivo Pancreas Perfusion for the Preservation of Pancreas Allografts before Transplantation
Published on: July 27, 2022
Early pancreas allograft thrombosis
Sharmila Ramessur Chandran1, John Kanellis, Kevan R Polkinghorne
1Department of Nephrology, Monash Medical Centre, Clayton, Vic, Australia. bill.mulley@southernhealth.org.au
Clinical Transplantation
|March 19, 2013
Summary
Early pancreatic allograft thrombosis (EPAT) is a serious complication. Vasopressor use, indicating perioperative hypotension, significantly increases EPAT risk, suggesting improved perfusion pressure management may prevent it.
Area of Science:
- Transplantation immunology
- Vascular surgery
- Nephrology
Background:
- Early pancreatic allograft thrombosis (EPAT) is the primary non-immunological cause of graft failure.
- Several risk factors for EPAT have been proposed.
- Recipient perioperative hypotension is hypothesized as a significant contributor.
Purpose of the Study:
- To identify factors associated with early pancreatic allograft thrombosis (EPAT).
- To evaluate the correlation between recipient perioperative hypotension and EPAT.
- To analyze other donor and recipient parameters linked to EPAT.
Main Methods:
- Retrospective review of 118 pancreatic allograft recipients from October 1992 to January 2010.
- Univariate and multivariate analyses of donor and recipient parameters.
- Statistical correction for age, sex, and peripheral vascular disease.
Main Results:
- The incidence of EPAT was 10.2% (12 episodes).
- Univariate analysis linked EPAT to perioperative hypotension, vasopressor use, and recipient neuropathy (p ≤ 0.04).
- Multivariate analysis revealed vasopressor use as the sole significant predictor of EPAT (HR 8.74, p = 0.04), associated with various recipient comorbidities and surgical complications.
Conclusions:
- Perioperative vasopressor use, indicative of significant hypotension, is strongly associated with EPAT.
- Maintaining adequate perfusion pressures during the perioperative period may be crucial in preventing EPAT.
- Further research into hemodynamic management strategies is warranted.
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