title: Clinical outcomes associated with the early postoperative use of heparin in pancreas transplantation.
abstract: BACKGROUND
  Graft thrombosis following pancreas transplantation is the leading non-immunologic cause of graft loss. Routine systemic anticoagulation is controversial because of an increased bleeding risk.
  
  
  METHODS
  This was a retrospective, single-center analysis including all pancreas transplants performed over 9 years evaluating the use of low-dose heparin in the early postoperative period. Clinical outcomes were partial and complete graft thrombosis within 30 days, bleeding events, relaparotomy rates, and 30-day graft and patient survival. Multivariate regression analysis was performed to identify risk factors for early graft loss resulting from thrombosis.
  
  
  RESULTS
  One hundred fifty-two patients were included, 52 in the heparin group. The overall complete thrombosis rate was 13.1%, 10% in those who received heparin, and 15% in those who did not. Partial thrombosis was higher in the heparin group (10% vs. 3%). Higher relaparotomy rates were seen in the heparin group (29% vs. 22%); however, bleeding events were similar between groups. Graft and patient survival at 30 days were similar between groups; however, there was a trend toward higher graft survival in the heparin group. Heparin showed a trend toward a protective benefit for early graft loss resulting from thrombosis in all multivariate regression models.
  
  
  CONCLUSIONS
  These data suggest low-dose heparin early in the postoperative period may provide a protective benefit in the prevention of early graft loss resulting from thrombosis, without an increased risk of bleeding.
authors.affiliation: 1 Department of Pharmacy, New York-Presbyterian Hospital, New York, NY. 2 Department of Surgery, Division of Transplant Surgery, Medical University of South Carolina, Charleston, SC. 3 Department of Pharmacy Services, Medical University of South Carolina, Charleston, SC. 4 Address correspondence to: David J. Taber, PharmD, Department of Surgery, Division of Transplant Surgery, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 611/CSB 409, Charleston, SC 29425.
authors.forename: Jenna L
authors.initials: JL
authors.lastname: Scheffert
authors.forename: David J
authors.initials: DJ
authors.lastname: Taber
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Pilch
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Chavin
authors.forename: Prabhakar K
authors.initials: PK
authors.lastname: Baliga
authors.forename: Charles F
authors.initials: CF
authors.lastname: Bratton
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006085:Graft Survival / Q000187:drug effects; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016035:Pancreas Transplantation / Q000009:adverse effects* / Q000401:mortality; D011182:Postoperative Care; D019106:Postoperative Hemorrhage / Q000139:chemically induced; D016016:Proportional Hazards Models; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013022:South Carolina; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents; D006493:Heparin