USA Technical Failure

Technical failure (TF) in 1996-2002 US cadaver primary PTA transplants did not significantly differ for BD vs. ED, but in SPK and PAK TF was significantly lower with BD than ED (Table 1). There were no significant differences for TF in ED systemic vs. portal drainage. By Roux-en-Y loop of recipient bowel, there were no significant differences in TF rates for ED pancreas transplants, except within the PTA group, where TF was higher with a Roux-en-Y.

Table 1

Graft thrombosis was the most common cause of TF for 1996-2002 US primary cadaveric pancreas transplants, > 70%, whether by duct management or transplant. The incidence of remaining TF reasons - infection/pancreatitis, anastomotic leak, bleed - was <30%; any of these as a cause of graft failure was<2% in each transplant category. For SPK and PTA categories, graft thrombosis was significantly lower for BD vs ED (Table 2). For ED in PTA, some early thrombosis may be early rejection since the diagnosis of early rejection is more difficult in the ED PTA group without markers such as urine amylase, leading to secondary thrombosis.

Table 2