Department of General Surgery, Abdominal Transplant Service, Wake Forest Baptist Health, Winston-Salem, NC 27157, USA.
Curr Opin Organ Transplant. 2012 Feb;17(1):87-92. doi: 10.1097/MOT.0b013e32834ee717.
Pancreas graft thrombosis remains one of the most common reasons for pancreas transplant loss. Patients with a history of thrombotic events should be identified and evaluated for thrombophilia to identify transplant candidates at highest risk.
Early after transplant, vascular thrombosis is multifactorial, but beyond 2 weeks, inflammation or acute rejection predominate as the cause of thrombosis. Most pancreas transplant centers utilize some form of anticoagulation following transplantation. Aspirin is highly recommended. Unfractionated or low-molecular-weight heparin is often administered, but some centers use heparin selectively and typically at low dose to avoid postoperative bleeding. Warfarin is less frequently given and its use should probably be limited to patients with thrombophilia.
Thrombectomy, either surgical or percutaneous, may salvage the pancreas graft if performed early after the occurrence of thrombosis.
胰腺移植物血栓形成仍然是胰腺移植失败的最常见原因之一。有血栓形成史的患者应确定并评估血栓形成倾向，以确定风险最高的移植候选者。
移植后早期，血管血栓形成是多因素的，但超过 2 周后，炎症或急性排斥反应成为血栓形成的主要原因。大多数胰腺移植中心在移植后使用某种形式的抗凝治疗。强烈推荐使用阿司匹林。未分级或低分子量肝素通常给药，但一些中心选择性地且通常以低剂量使用肝素以避免术后出血。华法林的使用频率较低，其使用可能应限于血栓形成倾向的患者。
如果在血栓形成后早期进行，血栓切除术（无论是手术还是经皮）可能挽救胰腺移植物。
