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Allograft Pancreatectomy: Indications and Outcomes
S Nagai1, J A Powelson1, T E Taber1
1Division of Transplant Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN.
Summary
Allograft pancreatectomy is a safe procedure for pancreas transplant recipients experiencing graft failure. It can be performed urgently or electively, does not prevent retransplantation, and can be lifesaving.
Area of Science:
- Transplantation surgery
- Gastroenterology
- Nephrology
Background:
- Pancreas allograft failure necessitates intervention to manage complications.
- Allograft pancreatectomy is a surgical option for failed pancreas transplants.
Purpose of the Study:
- To evaluate the indications, surgical techniques, and outcomes of allograft pancreatectomy.
- To assess the safety and impact of allograft pancreatectomy on subsequent transplantation.
Main Methods:
- Retrospective review of 47 patients undergoing allograft pancreatectomy between 2003 and 2013.
- Analysis of indications for early (within 14 days) and late graft loss.
- Documentation of surgical techniques, postoperative morbidity, and outcomes.
Main Results:
- Early graft loss (16 patients) invariably required pancreatectomy; late graft loss (31 patients) led to pancreatectomy in 61%.
- Indications included vascular thrombosis, pancreatitis, gastrointestinal hemorrhage, and graft failure symptoms.
- Postoperative morbidity was low, with one mortality from pulmonary embolism.
Conclusions:
- Allograft pancreatectomy is a safe and potentially lifesaving procedure for pancreas transplant recipients with graft failure.
- The procedure does not preclude future pancreas retransplantation.
- Careful patient selection and surgical technique are crucial for favorable outcomes.
