title: Early pancreas allograft thrombosis.
abstract: OBJECTIVE
  To determine factors associated with early pancreatic allograft thrombosis (EPAT). Thrombosis is the leading non-immunological cause of early pancreatic allograft failure. Multiple risk factors have been postulated. We hypothesized that recipient perioperative hypotension was a major risk factor and evaluated the correlation of this and other parameters with EPAT.
  
  
  METHODS
  We retrospectively reviewed the records of the 118 patients who received a pancreatic allograft at our center between October 1992 and January 2010. Multiple donor and recipient parameters were analyzed as associates of EPAT by univariate and multivariate analysis.
  
  
  RESULTS
  There were 12 episodes of EPAT, resulting in an incidence of 10.2%. On univariate analysis, EPAT was associated with perioperative hypotension, vasopressor use, and neuropathy in the recipient (p ≤ 0.04 for all). On multivariate analysis corrected for age, sex, and peripheral vascular disease, only vasopressor use retained a significant association with EPAT with a hazard ratio of 8.74 (CI 1.11-68.9, p = 0.04). Factors associated with vasopressor use included recipient ischemic heart disease, peripheral vascular disease, retinopathy or neuropathy, and any surgical complication.
  
  
  CONCLUSIONS
  Significant hypotension, measured by the need for perioperative vasopressor use was associated with EPAT, suggesting that maintenance of higher perfusion pressures may avoid this complication.
authors.affiliation: Department of Nephrology, Monash Medical Centre, Clayton, Vic, Australia. bill.mulley@southernhealth.org.au
authors.forename: Sharmila
authors.initials: S
authors.lastname: Ramessur Chandran
authors.forename: John
authors.initials: J
authors.lastname: Kanellis
authors.forename: Kevan R
authors.initials: KR
authors.lastname: Polkinghorne
authors.forename: Alan C
authors.initials: AC
authors.lastname: Saunder
authors.forename: William R
authors.initials: WR
authors.lastname: Mulley
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects*; D010182:Pancreatic Diseases / Q000150:complications* / Q000401:mortality / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D055815:Young Adult