PANCREAS GRAFT THROMBOSIS - PROMPT DIAGNOSIS AND IMMEDIATE THROMBECTOMY OR RETRANSPLANTATION

The cause of venous thrombosis in pancreas transplantation is generall y not known and usually requires urgent pancreatectomy. In this report we describe 2 patients with pancreas graft thrombosis that occurred 2 and 6 days posttransplant in which surgical treatment was successful with immediate retransplantation in 1 case and portal venous thrombect omy in the other. When venous thrombosis is suspected, duplex-Doppler ultrasonography should be performed and, with findings of well-localiz ed thrombi with absent venous flow in the presence of well-preserved a rterial supply, a thrombectomy should be attempted as the first choice ; this operation should be performed in the presence of a suitable don or to offer retransplantation. Complication in the patient with pancre as retransplantation was one episode of kidney rejection; a urinary fi stula arose in the patient in whom venous thrombectomy was performed. Both patients have kidney and pancreas grafts functioning after more t han 1 and 2 years.