Incidence of pancreas graft thrombosis using low-molecular-weight heparin.
BACKGROUND
Simultaneous pancreas-kidney transplantation is the current treatment of choice for patients with type I diabetes and end stage renal disease. Vascular graft thrombosis (VGT) after pancreas transplantation is the main cause of early graft loss.


METHODS
A total of 188 consecutive pancreas transplantations were performed between January 2000 and December 2006. A retrospective study was carried out in order to compare incidence of VGT and relaparotomy-for-bleeding rate of once daily fixed dose low-molecular-weight-heparin (LMWH) to dose-adjusted intravenous unfractionated heparin (UFH).


RESULTS
Fifty-eight patients receiving LMWH and 129 receiving UFH were identified. There were 7% (4/58) VGTs in the LMWH and 17% (22/129) in the UFH group (p = 0.047). The frequency of major bleeding requiring relaparatomy was not significantly different in the groups related to LMWH and UFH, respectively (6.9% vs. 7.8%). One yr patient and pancreas graft survival was 98.9/89.6% in the LMWH and 97.8/74.4% in the UFH group. Donor and recipient characteristics were similar.


CONCLUSIONS
In our experience once daily fixed dose LMWH might not be inferior to dose-adjusted intravenous heparin in preventing pancreas graft thrombosis.
Schenker
Peter
P
Department of Surgery, Knappschafts-Hospital, Ruhr-University Bochum, Germany. Peter.Schenker@rub.de
Vonend
Oliver
O
Ertas
Neslihan
N
Wunsch
Andreas
A
Schaeffer
Michael
M
Rump
Lars-Christian
LC
Viebahn
Richard
R
D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006493:Heparin / Q000009:adverse effects; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage*; D006801:Humans; D007279:Injections, Subcutaneous; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects*; D011182:Postoperative Care; D012189:Retrospective Studies; D013927:Thrombosis / Q000517:prevention & control*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D006493:Heparin