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Vascular Complications of Transplantation: Part 2: Pancreatic Transplants

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Abstract

Vascular complications after solid organ transplantation are not uncommon and may lead to graft dysfunction and ultimately graft loss. A thorough understanding of the surgical anatomy, etiologies, and types of vascular complications, their presentation and the options for management are important for managing these complex patients. This article reviews the basic surgical anatomy, the vascular complications, and endovascular management options of vascular complications in patients with pancreas transplants.

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References

  1. Neri E, Cappelli C, Boggi U et al (2004) Multirow CT in the follow-up of pancreas transplantation. Transplant Proc 36:597–600

    Article  CAS  PubMed  Google Scholar 

  2. Hagspiel KD, Nandalur K, Pruett TL et al (2007) Evaluation of vascular complications of pancreas transplantation with high special-resolution contrast-enhanced MR angiography. Radiology 242:590–599

    Article  PubMed  Google Scholar 

  3. Gruessner AC, Sutherland DER (2005) Pancreas transplant outcomes for United States (US) and non-US cases as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR) as of June 2004. Clin Transplant 19:433–455

    Article  PubMed  Google Scholar 

  4. Hagspiel KD, Nadular K, Burkholder B et al (2005) Contrast-enhanced MR angiography after pancreas transplantation: normal appearance and vascular complications. AJR Am J Roentgenol 184:465–473

    Article  PubMed  Google Scholar 

  5. Bloom RD, Olivares M, Rehman L, Raja RM, Yang S, Badosa F (1997) Long-term pancreas allograft outcome in simultaneous pancreas-kidney transplantation: a comparison of enteric and bladder drainage. Transplantation 64:1689–1695

    Article  CAS  PubMed  Google Scholar 

  6. Krebs TL, Daly B, Wong-You-Cheong JJ, Carroll K, Bartlett ST (1999) Acute pancreatic transplant rejection: evaluation with dynamic contrast-enhanced MR imaging compared with histopathologic analysis. Radiology 210:437–442

    Article  CAS  PubMed  Google Scholar 

  7. Saad WEA, Darwish WM, Turba UC et al (2012) Endovascular management of vascular complications in pancreatic transplants. Vasc Endovasc Surg 46:262–268

    Article  Google Scholar 

  8. Eubank WB, Schmiedl UP, Levy AE, Marsh CL (2000) Venous thrombosis and occlusion after pancreas transplantation: evaluation with breath-hold gadolinium-enhanced three-dimensional MR imaging. AJR Am J Roentgenol 175:381–385

    Article  CAS  PubMed  Google Scholar 

  9. Woo EY, Milner R, Brayman KL, Fairman RM (2003) Successful PTA and stenting for acute iliac arterial injury following pancreas transplantation. Am J Transplant 3:85–87

    Article  PubMed  Google Scholar 

  10. Kimura T, Saito T, Tsuchiya A et al (2005) Treatment of external iliac artery dissection with endovascular stent placement in a patient with simultaneous pancreas and kidney transplantation. Transpl Proc 37:3572–3573

    Article  CAS  Google Scholar 

  11. Phillips BJ, Fabrega AJ (2000) Embolization of a mesenteric arteriovenous fistula following pancreatic allograft: the steal effect. Transplantation 70:1529–1539

    Article  CAS  PubMed  Google Scholar 

  12. Angle JF, Matsumoto AH, McGraw JK, Hagspiel KD, Spinosa DJ, McCullough CS (1999) Percutaneous embolization of a high-flow pancreatic transplant arteriovenous fistula. Cardiovasc Intervent Radiol 22:147–149

    Article  CAS  PubMed  Google Scholar 

  13. Barth MM, Khwaja K, Faintuch S, Rabkin D (2008) Transarterial and transvenous embolotherapy of arteriovenous fistulas in the transplanted pancreas. J Vasc Interv Radiol 19:1231–1235

    Article  PubMed  Google Scholar 

  14. Tan M, Di Carlo A, Stein LA, Cantarovich M, Tchervenkov JI, Metrakos P (2001) Pseudoaneurysm of the superior mesenteric artery after pancreas transplantation treated by endovascular stenting. Transplantation 72:336–338

    Article  CAS  PubMed  Google Scholar 

  15. Orsenigo E, De Cobelli F, Salvioni M et al (2003) Successful endovascular treatment for gastroduodenal artery pseudoaneurysm with an arteriovenous fistula after pancreas transplantation. Transpl Int 16:694–696

    Article  PubMed  Google Scholar 

  16. McBeth BD, Stern SA (2003) Lower gastrointestinal hemorrhage from an arterioenteric fistula in a pancreatorenal transplant patient. Ann Emerg Med 42:587–591

    Article  PubMed  Google Scholar 

  17. Semiz-Oysu A, Cwikiel W (2007) Endovascular management of acute enteric bleeding from pancreas transplant. Cardiovasc Intervent Radiol 30:313–316

    Article  PubMed  Google Scholar 

  18. Decker E, Coimbra C, Weekers L et al (2009) A retrospective monocenter review of simultaneous pancreas-kidney transplantation. Transplant Proc 41:3389–3392

    Article  CAS  PubMed  Google Scholar 

  19. Martins L, Pedroso S, Henriques AC et al (2006) Simultaneous pancreas-kidney transplantation: five-year results from a single center. Transplant Proc 38:1929–1932

    Article  CAS  PubMed  Google Scholar 

  20. Michalak G, Kwiatkowski A, Czerwinski J et al (2005) Surgical complications of simultaneous pancreas-kidney transplantation: a 16-year experience at one center. Transplant Proc 37:3555–3557

    Article  CAS  PubMed  Google Scholar 

  21. Sansalone CV, Maione G, Aseni P et al (2005) Surgical complications are the main cause of pancreatic allograft loss in pancreas-kidney transplant recipients. Transplant Proc 37:2651–2653

    Article  CAS  PubMed  Google Scholar 

  22. Reddy KS, Stratta RJ, Shokouh-Amici MH, Alloway R, Edidi MF, Gager AO (1999) Surgical complications after pancreas transplantation with portal-enteric drainage. J Am Coll Surg 189(3):305–313

    Article  CAS  PubMed  Google Scholar 

  23. Vandermeer FQ, Manning MA, Frazier AA (2012) Imaging of whole-organ pancreas transplants. Radiographics 32:411–435

    Article  PubMed  Google Scholar 

  24. Fernandez MP, Bernardino ME, Neylan JF, Olson RA (1991) Diagnosis of pancreatic transplant dysfunction: value of gadopentetate dimeglumine-enhanced MR imaging. AJR Am J Roentgenol 156:1171–1176

    Article  CAS  PubMed  Google Scholar 

  25. Ozak CF, Stratta RJ, Taylor RJ, Largnas AN, Byron JS, Shaw BW (1992) Surgical complications in solitary pancreas and combined pancreas-kidney transplantation. Am J Surg 164:546–551

    Article  Google Scholar 

  26. Douzdjian V, Abecassis MM, Cooper JL et al (1993) Incidence, management and significance of surgical complications after pancreatic transplantation. Surg Gynecol Obstet 177:451–456

    CAS  PubMed  Google Scholar 

  27. Gruessner AC, Sutherland DER, Troppman C et al (1997) The risk of pancreas transplantation in the cyclosporine era: an overview. J Am Coll Surg 185:128–144

    Article  CAS  PubMed  Google Scholar 

  28. Bruce DS, Newell KA, Woodle ED et al (1998) Synchronous pancreas-kidney transplantation with portal venous and enteric exocrine drainage: outcome in 70 consecutive cases. Transplant Proc 30:270–271

    Article  CAS  PubMed  Google Scholar 

  29. Norton PT, Hagspiel KH (2012) Vascular MR imaging. Essentials of body MRI. Oxford University Press, New York

    Google Scholar 

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Conflict of interest

Wael E. Saad: Compensated speaker for Atrium. Grant recipient from Siemens Medical. Consultant for Siemens Medical and Boston Scientific Corp. Expert Panelist for Merit Medical. Minhaj S. Khaja: No conflicts of interest. Alan H. Matsumoto: Data Safety Monitoring Board for Trivascular, Bolton Medical, Boston Scientific, and Medicines Company. Institutional grants with W.L. Gore, Medtronic, Cook Medical, and InSightec. Personal stock or stock options of Crux Medical. Other travel/accommodations/meeting expenses from Siemens Medical. None of these are relevant to this manuscript.

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Authors and Affiliations

  1. Department of Radiology & Medical Imaging, University of Virginia Health System, 1215 Lee St., Box 800170, Charlottesville, VA, 22908, USA

    Minhaj S. Khaja & Alan H. Matsumoto

  2. Department of Radiology, University of Michigan Medical Center, 1500 E. Medical Drive, SPC 5868; Cardiovascular Center #5588, Ann Arbor, MI, 48109, USA

    Wael E. Saad

Authors
  1. Minhaj S. Khaja
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  2. Alan H. Matsumoto
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  3. Wael E. Saad
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Correspondence to Minhaj S. Khaja.

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Khaja, M.S., Matsumoto, A.H. & Saad, W.E. Vascular Complications of Transplantation: Part 2: Pancreatic Transplants. Cardiovasc Intervent Radiol 37, 1415–1419 (2014). https://doi.org/10.1007/s00270-014-0867-4

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  • DOI: https://doi.org/10.1007/s00270-014-0867-4

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