title: Antithrombin therapy in pancreas retransplantation and pancreas-after-kidney/pancreas-transplantation-alone patients.
abstract: Antithrombin (AT) is a coagulatory inhibitor with pleiotropic activities. AT reduces ischemia/reperfusion injury and has been successfully used in patients with simultaneous pancreas kidney transplantation. This study retrospectively analyzes prophylactic high-dose AT application in patients with solitary pancreas transplantation traditionally related to suboptimal results. In our center, 31 patients received solitary pancreas transplantation between 7/1994 and 7/2005 (pancreas retransplantation, PAK/PTA). The perioperative treatment protocol was modified in 5/2002 now including application of 3000 IU. AT was given intravenously before pancreatic reperfusion (AT, n = 18). Patients receiving standard therapy served as controls (n = 13). Daily blood sampling was performed during five postoperative days. Standard coagulatory parameters and number of transfused red blood cell units were not altered by AT. In AT patients serum amylase (p < 0.01) and lipase (p < 0.01) on postoperative days 1, 2 and 3 were significantly reduced. Our actual perioperative management protocol including high dose AT application in human solitary pancreas transplantation reduced postoperative liberation of pancreatic enzymes in this pilot study. Prophylactic AT application should deserve further clinical testing in a randomized controlled trial.
authors: Department of Surgery, University of Munich-Grosshadern, Munich, Germany.
authors: Jan M
authors: JM
authors: Fertmann
authors: Helmut P
authors: HP
authors: Arbogast
authors: Wolf-Dieter
authors: WD
authors: Illner
authors: Anwar
authors: A
authors: Tarabichi
authors: Christoph
authors: C
authors: Dieterle
authors: Walter
authors: W
authors: Land
authors: Karl-Walter
authors: KW
authors: Jauch
authors: Johannes N
authors: JN
authors: Hoffmann
mesh_terms: D000328:Adult; D000368:Aged; D000991:Antithrombins / Q000627:therapeutic use*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects* / Q000401:mortality; D010195:Pancreatitis / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D011183:Postoperative Complications; D012086:Reoperation; D015427:Reperfusion Injury / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000991:Antithrombins