Immediate post-operative complications (I): Post-operative bleeding; vascular origin: Thrombosis pancreatitis

• Published in: World journal of transplantation 2020-12, Vol.10 (12), p.415-421
• Main Authors: Perez Daga, Jose Antonio, Perez Rodriguez, Rosa, Santoyo, Julio
• Format: Article
• Language: English
• Subjects: Minireviews
• ISSN: 2220-3230; 2220-3230
• DOI: 10.5500/wjt.v10.i12.415

Simultaneous pancreas-kidney transplantation is the treatment of choice for insulin-dependent diabetes that associates end-stage diabetic nephropathy, since it achieves not only a clear improvement in the quality of life, but also provides a long-term survival advantage over isolated kidney transplant. However, pancreas transplantation still has the highest rate of surgical complications among organ transplants. More than 70% of early graft losses are attributed to technical failures, that is, to a non-immunological cause. The so-called technical failures include graft thrombosis, bleeding, infection, pancreatitis, anastomotic leak and pancreatic fistula. Pancreatic graft thrombosis leads these technical complications as the most frequent cause of early graft loss. Currently most recipients receive postoperative anticoagulation with the aim of reducing the rate of thrombosis. Hemoperitoneum in the early postoperative period is a frequent cause of relaparotomy, but it is not usually associated with graft loss. The incidence of hemoperitoneum is clearly related to the use of anticoagulation in the postoperative period. Post-transplant pancreatitis is another cause of early postoperative complications, less frequent than the previous. In this review, we analyze the most common surgical complications that determine pancreatic graft losses.