Perez Daga Jose Antonio, Perez Rodriguez Rosa, Santoyo Julio
Department of Surgery, Hospital Regional de Málaga, Malaga 29010, Spain.
World J Transplant. 2020 Dec 28;10(12):415-421. doi: 10.5500/wjt.v10.i12.415.
Simultaneous pancreas-kidney transplantation is the treatment of choice for insulin-dependent diabetes that associates end-stage diabetic nephropathy, since it achieves not only a clear improvement in the quality of life, but also provides a long-term survival advantage over isolated kidney transplant. However, pancreas transplantation still has the highest rate of surgical complications among organ transplants. More than 70% of early graft losses are attributed to technical failures, that is, to a non-immunological cause. The so-called technical failures include graft thrombosis, bleeding, infection, pancreatitis, anastomotic leak and pancreatic fistula. Pancreatic graft thrombosis leads these technical complications as the most frequent cause of early graft loss. Currently most recipients receive postoperative anticoagulation with the aim of reducing the rate of thrombosis. Hemoperitoneum in the early postoperative period is a frequent cause of relaparotomy, but it is not usually associated with graft loss. The incidence of hemoperitoneum is clearly related to the use of anticoagulation in the postoperative period. Post-transplant pancreatitis is another cause of early postoperative complications, less frequent than the previous. In this review, we analyze the most common surgical complications that determine pancreatic graft losses.
胰肾联合移植是伴有终末期糖尿病肾病的胰岛素依赖型糖尿病的首选治疗方法，因为它不仅能显著改善生活质量，而且与单纯肾移植相比还具有长期生存优势。然而，胰腺移植在器官移植中手术并发症发生率仍然最高。超过70%的早期移植物丢失归因于技术失败，即非免疫性原因。所谓的技术失败包括移植物血栓形成、出血、感染、胰腺炎、吻合口漏和胰瘘。胰腺移植物血栓形成是导致这些技术并发症的最常见原因，也是早期移植物丢失的最常见原因。目前，大多数受者术后接受抗凝治疗，目的是降低血栓形成率。术后早期腹腔积血是再次剖腹手术的常见原因，但通常与移植物丢失无关。腹腔积血的发生率与术后抗凝治疗的使用明显相关。移植后胰腺炎是术后早期并发症的另一个原因，但其发生率低于前者。在本综述中，我们分析了导致胰腺移植物丢失的最常见手术并发症。
