title: Pancreas graft thrombosis:  causes, prevention, diagnosis, and intervention.
abstract: OBJECTIVE
  Pancreas graft thrombosis remains one of the most common reasons for pancreas transplant loss. Patients with a history of thrombotic events should be identified and evaluated for thrombophilia to identify transplant candidates at highest risk.
  
  
  RESULTS
  Early after transplant, vascular thrombosis is multifactorial, but beyond 2 weeks, inflammation or acute rejection predominate as the cause of thrombosis. Most pancreas transplant centers utilize some form of anticoagulation following transplantation. Aspirin is highly recommended. Unfractionated or low-molecular-weight heparin is often administered, but some centers use heparin selectively and typically at low dose to avoid postoperative bleeding. Warfarin is less frequently given and its use should probably be limited to patients with thrombophilia.
  
  
  CONCLUSIONS
  Thrombectomy, either surgical or percutaneous, may salvage the pancreas graft if performed early after the occurrence of thrombosis.
authors.affiliation: Department of General Surgery, Abdominal Transplant Service, Wake Forest Baptist Health, Winston-Salem, NC 27157, USA. afarney@wakehealth.edu
authors.forename: Alan C
authors.initials: AC
authors.lastname: Farney
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Rogers
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stratta
mesh_terms: D000208:Acute Disease; D000925:Anticoagulants / Q000627:therapeutic use*; D001241:Aspirin / Q000008:administration & dosage; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006084:Graft Rejection / Q000150:complications; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D007249:Inflammation; D016035:Pancreas Transplantation / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D017131:Thrombectomy; D013927:Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery / Q000628:therapy*; D014859:Warfarin / Q000008:administration & dosage
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D014859:Warfarin; D006493:Heparin; D001241:Aspirin