Role of Intravascular Interventions in Simultaneous Pancreas and Kidney Transplantation - Almost 15 Years of Experience

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Abstract

Material and Methods

We performed a retrospective analysis of all cases of pancreas transplantations performed in our clinic and chose those, who required non-standard for the procedure and most challenging vascular interventions.

Results

In three cases we used intravascular procedure with implementing stent-grafts. In one retransplanted patient, there was acute extremity ischemia and narrowing in the iliac artery after previous transplantectomy.

Results

In other patient, the local inflammation after graftectomy lead to external iliac artery destruction at the side of former anastomosis and we observed acute severe bleeding. To perform hemostasis we had to implement a stent- graft to reconstruct the iliac artery wall. The third patient had a stent-graft implemented to femoral artery because of pseudoaneurysm of richt external iliac artery belowe pancreas graft vascular anastomoses.

Conclusions

Intravenous interventions in pancreas transplanted and retransplanted patients are safe and feasible. It is a technically demanding procedure but the risks of kidney graft function deterioration, as well as bleeding due to high dose of heparin are lower than vascular surgery. Nevertheless, a multidisciplinary and experienced in vascular surgery surgical team is required.

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