USA Technical Failure by Category and Duct Management 1999 - 2003 Cases

Technical failure (TF) rates in 1999-2003 US DD 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 1a). 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 1b). For ED systemic vs. ED portal vs. BD systemic, there were significant differences in SPK and PAK, but not PTA (Table 1c).  But PTA ED portal had the highest incidence of TF and the TF was significantly higher with (n=69) vs. without (n=21) Roux-en-Y: 17% vs. 2% respectively (p=0.02).

Table 1a

Table 1b

Table 1c

Graft thrombosis by duct management and transplant category was the most common cause of TF for 1999-2003 US primary DD pancreas transplants (Table 2), > 60% in each category. The TF incidence of remaining reasons – infection/pancreatitis, anastomotic leak, bleed – was <40%; any of these as a cause of graft failure was<2.5% in each transplant category. For SPK and PAK categories, graft thrombosis was significantly lower for BD vs. ED.  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

Previous page / Next page / Index