title: Incidence of pancreas graft thrombosis in portoiliac and portocaval venous anastomosis.
abstract: BACKGROUND
  Pancreas graft thromboses represent more than 70% of all technical failures; multiple risk factors have been implicated. We analyzed the thrombosis rates using portoiliac versus portocaval vein anastomoses.
  
  
  METHODS
  The series includes 53 patients who underwent pancreas transplantation: 49 simultaneous pancreas-kidney and 4 pancreas after kidney. There were 27 men and 26 women, of mean age of 37.2 +/- 7.0 years. We compared two groups of recipients that were classified according to venous anastomosis: (A) portoiliac (n = 30), and (B) portocaval (n = 23).
  
  
  RESULTS
  The recipients did not show significant differences in age, gender, or duration of diabetes mellitus, but body mass index was significantly higher among the portocaval group. A bladder-drained pancreas technique was more frequently performed in the portoiliac group (93% of patients) versus an enteric-drained pancreas in the portocaval group (81%; P < .001). Heparinization was performed in 12 recipients: 11 (36.6%) in the portoiliac group and 1 (4.3%) in the portocaval group (P < .01). Vascular graft thrombosis (venous in six and arterial in one) developed in seven patients (13.2%) all in the portoiliac group (23%) (P < .02). Two-year patient survival was 93% in the portoiliac group and 94% in portocaval group (P = NS). Two-year graft survival was 66.6% in the portoiliac group and 85.9% in portocaval group (P = .07).
  
  
  CONCLUSIONS
  There was no graft thrombosis among patients with a portocaval vein anastomosis.
authors.affiliation: Servicio de Cirugía General, Ap. Digestivo y Trasplante de Organos Abdominales, Madrid, Spain. carlos.jimenez@inforboe.es
authors.forename: C
authors.initials: C
authors.lastname: Jiménez
authors.forename: A
authors.initials: A
authors.lastname: Manrique
authors.forename: M L
authors.initials: ML
authors.lastname: Herrero
authors.forename: J C
authors.initials: JC
authors.lastname: Meneu
authors.forename: M
authors.initials: M
authors.lastname: Abradelo
authors.forename: E
authors.initials: E
authors.lastname: Gutierrez
authors.forename: J M
authors.initials: JM
authors.lastname: Morales
authors.forename: T
authors.initials: T
authors.lastname: Ortuño
authors.forename: M
authors.initials: M
authors.lastname: Praga
authors.forename: A
authors.initials: A
authors.lastname: Andrés
authors.forename: E
authors.initials: E
authors.lastname: Morales
authors.forename: E
authors.initials: E
authors.lastname: Moreno
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000601:surgery; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D016035:Pancreas Transplantation / Q000379:methods* / Q000401:mortality; D011169:Portal Vein / Q000601:surgery*; D011170:Portasystemic Shunt, Surgical; D012189:Retrospective Studies; D016019:Survival Analysis; D013927:Thrombosis / Q000453:epidemiology; D016896:Treatment Outcome