This paper was in part presented at the 12th Congress of the European Society for Organ Transplantation (ESOT) in Geneva, Switzerland from October 16–19, 2005.
Single-shot antithrombin in human pancreas–kidney transplantation: reduction of reperfusion pancreatitis and prevention of graft thrombosis*
Article first published online: 15 MAY 2006
Volume 19, Issue 6, pages 458–465, June 2006
How to Cite
Fertmann, J. M., Wimmer, C. D., Arbogast, H. P., Illner, W.-D., Tarabichi, A., Calasan, I., Dieterle, C., Land, W., Jauch, K.-W. and Johannes, N. H. (2006), Single-shot antithrombin in human pancreas–kidney transplantation: reduction of reperfusion pancreatitis and prevention of graft thrombosis. Transplant International, 19: 458–465. doi: 10.1111/j.1432-2277.2006.00325.x
- Issue published online: 15 MAY 2006
- Article first published online: 15 MAY 2006
- Received: 20 September 2005 Revision requested: 13 October 2005 Accepted: 17 March 2006
Vol. 19, Issue 10, 859, Article first published online: 6 SEP 2006
- graft thrombosis;
- pancreas transplantation;
Reperfusion pancreatitis and graft thrombosis often induce early graft loss in simultaneous pancreas–kidney (SPK) transplantation. Antithrombin (AT) is a coagulatory inhibitor with pleiotropic activities that reduces experimental ischemia/reperfusion injury. This study retrospectively analyses prophylactic high-dose AT application in patients with first SPK. In an university transplantation center, 53 consecutive patients with SPK were studied without randomization. In one group, 3000 IU of AT was given intravenously before pancreatic reperfusion (AT, n = 24). Patients receiving standard therapy including postoperative AT supplementation (controls, n = 29) served as controls. Daily blood sampling was performed as a part of the clinical routine during four postoperative days. There were no differences in demographic and laboratory parameters [donor/recipient age, ischemia time, perfusion solution, body weight, mismatches] between both groups. Baseline creatinine values were lower in the control group versus AT group (P < 0.05). Coagulatory parameters and bleeding incidence were not influenced by AT, while incidence of graft thrombosis was reduced (control: 7/29; AT: 4/24; relative reduction of risk: −33%; P < 0.05). Single-shot AT application during SPK modulated serum lipase activity on postoperative days 2 and 3, and minimized risk for graft thromboses without increasing perioperative bleeding. This new concept should deserve testing in a prospective clinical trial.