Failure of pancreas transplantation from venous thrombosis of the graft - A case report
Journal
Journal of Surgical Association Republic of China
Journal Volume
29
Journal Issue
2
Pages
163-169
Date Issued
1996
Author(s)
Abstract
Successful pancreas transplantation (PT) can restore normal glucose metabolism in type I diabetic patients. However, the incidence of pancreas graft thrombosis remains high (10-30%); it accounts for a major cause of technical failure in PT. In the initial trial of PT at National Taiwan University Hospital, a 37-year-old female, insulin-dependent diabetes mellitus (IDDM) patient who had been uremic for two years and under treatment by continuous ambulatory peritoneal dialysis (CAPD), received a simultaneous pancreas-kidney transplantation in November 1994. In spite of transient function of the pancreas graft proved by an adequate output of urine amylase and reduced requirement of insulin to maintain normoglycemia, from the second postoperative day the pancreas graft demonstrated a picture of venous thrombosis, including progressive hematuria, decreased urine amylase and an increment of insulin requirement. Doppler sonography revealed in the pancreas graft a dilated splenic vein filled with thrombi; and the venous flow of the graft became undetectable on the 5th postoperative day. The pancreas graft was removed in a laparotomy. Histological examination of the graft revealed diffuse thrombosis in the veins and hemorrhagic necrosis. Contrary to the pancreas graft, the kidney graft maintained satisfactory function after recovering from two episodes of rejection. The patient wad discharged without azotemia, but still with insulin-dependence.
SDGs
Other Subjects
adult; article; case report; glucose metabolism; graft failure; histopathology; human; human cell; human tissue; insulin dependence; insulin dependent diabetes mellitus; kidney graft; male; pancreas transplantation; uremia; vein thrombosis
Type
journal article