[Thrombocytosis following pancreas transplantation--a retrospective clinical study]

Thrombosis of the pancreas transplant is one of the main causes for the lower success rate of this transplantation compared with other organ transplantations. Approximately one quarter of the pancreas transplantations discussed in this study were unsuccessful for this reason. This work is a retrospective study focussing on the blood platelet measurement from 19 patients with a postoperative combined pancreas and kidney transplant, functioning well for at least 1.5 months. In addition, the drug treatment (immunosuppressive agents, antibiotics, thrombosis prophylaxis), the transfusions and the body temperature were registered. 19 patients with only a kidney transplant, with similar distribution of sex, age and postoperative immunosuppressive treatment, were observed as a control group. After a pancreas transplantation the platelet number increases considerably and is found to be far above the normal level. There are no proven pathophysiological explanations for this thrombocytosis. Different factors such as postoperative infections, inflammations, acute blood losses, side effects of the drugs and the patients postoperative condition were taken into consideration. Other predisposing factors for the thrombosis tendency of the pancreas transplant vessels are its abnormal haemodynamic situation and the endothelial change caused by the preservation of the transplant, by mechanical or surgical traumas or by a possible pancreatitis of the transplant. Because of this increased risk of thrombosis, there are clear indications to use platelet inhibitors during the first two postoperative months.