title: The use of venous jump grafts in pancreatic transplantation - no difference in patient or allograft outcomes - an update of the UNOS database.
abstract: Venous jump grafts are used in pancreas transplantation to salvage a pancreas with a short portal vein or to facilitate an easier anastomosis. There have been no large studies evaluating the safety of venous jump grafts in pancreas transplantation. We analyzed the UNOS database to determine whether venous jump grafts are associated with graft loss or patient death. Data from UNOS on all adult pancreas transplant recipients 1996-2012 were analyzed. Venous extension grafts were used in 2657 cases; they were not in 18 124. Kaplan-Meier/product-limit estimates analysis demonstrated similar patient survival (p < 0.641) and death-censored graft survival (p < 0.351) at one, three, five,10, and 15 yr between subjects with and without venous jump grafts. There was a statistically significant difference in one-yr unadjusted patient survival between the venous extension graft (94.9%) and the no-venous extension graft (95.8%) groups (p < 0.045) and a borderline difference in one-yr graft survival between the venous extension graft (84.1%) and the no-venous extension graft (82.6%) groups (p < 0.055). There was no significant difference in patient survival or allograft survival at the three-, five-, 10-, and 15-yr intervals. The use of venous jump grafts is not associated with increased graft loss or mortality.
authors.affiliation: Department of Transplantation, North Shore Long Island Jewish Health System, Hofstra University School of Medicine, Manhasset, NY, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Siskind
authors.forename: Caroline
authors.initials: C
authors.lastname: Maloney
authors.forename: Sarah
authors.initials: S
authors.lastname: Ashburn
authors.forename: Meredith
authors.initials: M
authors.lastname: Akerman
authors.forename: Tamar
authors.initials: T
authors.lastname: Siskind
authors.forename: Lauren
authors.initials: L
authors.lastname: Goldberg
authors.forename: Madhu
authors.initials: M
authors.lastname: Bhaskaran
authors.forename: Amit
authors.initials: A
authors.lastname: Basu
authors.forename: Ernesto
authors.initials: E
authors.lastname: Molmenti
authors.forename: Jorge
authors.initials: J
authors.lastname: Ortiz
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000401:mortality*; D006085:Graft Survival; D006801:Humans; D008297:Male; D016035:Pancreas Transplantation; D010182:Pancreatic Diseases / Q000401:mortality / Q000601:surgery*; D011169:Portal Vein / Q000637:transplantation*; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D014184:Transplantation, Homologous; D020246:Venous Thrombosis / Q000401:mortality*
keywords: graft failure; graft thrombosis; long-term outcomes; mortality; pancreas transplantation