Portal Vein Thrombosis After Total Pancreatectomy and Islet Autotransplant: Prophylaxis and Graft Impact. Pancreas 2019;48(10):1329-1333
Date
11/07/2019Pubmed ID
31688597Pubmed Central ID
PMC7181460DOI
10.1097/MPA.0000000000001421Scopus ID
2-s2.0-85074546053 (requires institutional sign-in at Scopus site) 14 CitationsAbstract
OBJECTIVES: To determine the rate of portal vein thrombosis (PVT) based on pharmacologic prophylaxis protocol and the impact of PVT on islet graft function after total pancreatectomy with islet autotransplantation (TPIAT).
METHODS: We compared the incidence of PVT, postsurgical bleeding, and thrombotic complications in patients undergoing TPIAT between 2001 and 2018 at the University of Minnesota who received either unfractionated heparin (UFH) or enoxaparin for postoperative PVT prophylaxis. Six-month and 1-year graft function was compared between patients who developed PVT and those who did not.
RESULTS: Twelve patients (6.6%) developed a PVT, which resolved by 6 months after TPIAT in 10 patients. There was no statistically significant difference in PVT rate between patients who received UFH or enoxaparin for prophylaxis (P = 0.54). Patients who received enoxaparin developed other thrombotic complications more often (6% vs 0%, P = 0.02). Islet graft function did not differ in patients who developed PVT versus those who did not.
CONCLUSIONS: There was no difference between enoxaparin or UFH prophylaxis in preventing PVT, but there may be a higher incidence of other thrombotic complications with enoxaparin. In the setting of routine screening and anticoagulation therapy, PVT is a self-limited process.
Author List
Robbins AJ, Skube ME, Bellin MD, Dunn TB, Chapman SA, Berry KL, Lusczek E, Beilman GJAuthor
Ty Blink Dunn MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultEnoxaparin
Female
Heparin
Humans
Islets of Langerhans Transplantation
Male
Middle Aged
Pancreatectomy
Portal Vein
Postoperative Complications
Retrospective Studies
Transplantation, Autologous
Venous Thrombosis