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Late complications of pancreas transplant

World Journal of Transplantation 2020年第12期10卷 404-414页

作者： Javier Maupoey Ibáñez Andrea BoscàRobledo Rafael López-Andujar Hepato-Pancreatico-Biliary Surgery and Transplant Unit La Fe University HospitalValencia 46026Spain

To summarize the long-term complications after pancreas transplantation that affect graft function,a literature search was carried out on the long-term complications of pancreatic transplantation,namely,complications from postoperative 3rd mo onwards,in terms of loss of graft function,late infection and vascular complications as *** most relevant reviews and studies were selected to obtain the current evidence on these *** definition of graft failure varies among different studies,so it is difficult to evaluate,a standardized definition is of utmost importance to know the magnitude of the problem in all worldwide *** rejection is the main cause of long-term graft failure,occurring in 10%of *** the 3rd mo of transplantation onwards,the main risk factor for late infections is immunosuppression,and patients have opportunistic infections like:Cytomegalovirus,hepatitis B and C viruses,Epstein-Barr virus and varicella-zoster virus;opportunistic bacteria,reactivation of latent infections as tuberculosis or fungal *** preoperative studies and serological tests should be made in all recipients to avoid these infections,adding perioperative prophylactic treatments when *** are uncommon,but one of the main causes of late bleeding,which can be *** treatment should be performed with radiological endovascular approaches or open surgery in case of *** all therapeutic options for the complications mentioned above,transplantectomy is a necessary option in approximately 50%of relaparotomies,especially in lifethreatening *** complications in pancreatic transplantation threatens long-term graft *** exhaustive follow-up as well as a correct immunosuppression protocol are necessary for prevention.

关键词： Pancreas transplantation Pancreas allograft failure Pancreas transplant rejection Pseudoaneurysm allograft pancreatectomy

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