THROMBOCYTOPENIA IN AN ESTABLISHED SOLITARY PANCREAS GRAFT RECIPIENT

Isolated, life-threatening thrombocytopenia from a previously well tol erated pancreas allograft has not been reported in the literature. Her ein we report such a case where a 31-year-old, Caucasian, Type I diabe tic male developed severe thrombocytopenia 6 months following isolated pancreas transplantation and 2 wk after enteric conversion of the gra ft. Despite extensive diagnostic work-up, the cause remained unclear a nd his thrombocytopenia did not remit with standard treatment, but did resolve upon explantation. Pathologic examination of the pancreatic g raft showed evidence of chronic rejection along with CMV pancreatitis. We conclude that unremitting isolated thrombocytopenia in solitary pa ncreas grafts may reflect a localized DIC phenomenon that requires gra ft explantation.