title: The unrecognized posterior gastric artery: a potential cause of surgical complications in pancreas transplantation.
abstract: BACKGROUND
  Our report describes, for the first time, a pre-transplant vascular complication in a pancreas graft related to the posterior gastric artery - a major, but relatively unknown side branch of the splenic artery. The posterior gastric artery that was overlooked by a surgical procurement team during donor pancreatectomy led to distortion of the peripancreatic vascular anatomy and set the stage for a splenic artery injury.
  
  
  METHODS
  We identified the transected, partially resected graft splenic artery during backtable preparation of the pancreas, and repaired it using standard vascular surgical techniques.
  
  
  RESULTS
  The recipient's post-operative course was uncomplicated. At 9-yr post-transplant, the recipient is alive with good pancreas graft function.
  
  
  CONCLUSIONS
  The relevance of the posterior gastric artery with regard to general surgical procedures was only recently recognized. Our case demonstrates that the posterior gastric artery is also important in transplant surgery. Awareness of this anatomical structure during organ procurement would help minimize pre-transplant vascular complications.
authors.affiliation: Department of Surgery, UC Davis Medical Center, University of California, Sacramento, CA, USA. christoph.troppmann@ucdmc.ucdavis.edu
authors.forename: Christoph
authors.initials: C
authors.lastname: Troppmann
authors.forename: Jacques
authors.initials: J
authors.lastname: Pirenne
authors.forename: Richard V
authors.initials: RV
authors.lastname: Perez
authors.forename: Rainer W G
authors.initials: RW
authors.lastname: Gruessner
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D001158:Arteries / Q000033:anatomy & histology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D013157:Splenic Artery / Q000033:anatomy & histology / Q000601:surgery; D013270:Stomach / Q000098:blood supply*; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting