title: Role of color Doppler sonography in post-transplant surveillance of vascular complications involving pancreatic allografts().
abstract: OBJECTIVE
  To evaluate the role of color Doppler ultrasonography in the postoperative surveillance of the vascular complications involving pancreas allografts.
  
  
  METHODS
  A retrospective analysis of a consecutive series of 223 pancreas transplantations was performed. All recipients received antithrombotic prophylaxis, which was tailored to the individual's estimated risk of thrombosis. All patients were monitored with daily color Doppler ultrasonography during the first post-transplant week and thereafter whenever clinically indicated. Vascular complications were defined as all thrombotic events requiring: increased anticoagulant therapy, angiography with fibrinolytic therapy, or repeat surgery.
  
  
  RESULTS
  The overall patient survival rates at one, three, and five years after transplantation were 94.7%, 93.3%, and 91%, respectively. The overall graft survival rates at the same time points were 87.4%, 79.6%, and 75.6%, respectively. In 28 of the 223 cases (12.5%) graft thromboses were diagnosed with Doppler ultrasound within the first 10 days after transplantation. In 3 cases, graft pancreatectomies were performed because of a complete loss of blood flow in the parenchyma. An attempt to rescue the graft was made in 18 patients. Fourteen of these grafts were saved and are still functioning (77.7%); and 4 rescue attempts failed and the grafts were subsequently explanted (32.3%).
  
  
  CONCLUSIONS
  Color Doppler ultrasound is a suitable tool for postoperative surveillance of pancreas transplant recipients. Its use can lead to early diagnosis and timely treatment of vascular complications.
authors: General and Transplantation Surgery, University of Pisa, Cisanello Hospital, Pisa, Italy.
authors: L
authors: L
authors: Morelli
authors: G
authors: G
authors: Di Candio
authors: A
authors: A
authors: Campatelli
authors: F
authors: F
authors: Vistoli
authors: M
authors: M
authors: Del Chiaro
authors: E
authors: E
authors: Balzano
authors: C
authors: C
authors: Croce
authors: C
authors: C
authors: Moretto
authors: S
authors: S
authors: Signori
authors: U
authors: U
authors: Boggi
authors: F
authors: F
authors: Mosca
keywords: Color Doppler ultrasonography; Complications; Pancreas; Transplantation; Vascular
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