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ECR 2018 / C-1657
evaluation of CT factors of transplantectomy in pancreatic graft trombosis : proposal of a radiological reading table
Congress: ECR 2018
Poster No.: C-1657
Type: Scientific Exhibit
Keywords: Abdomen, Pancreas, Vascular, CT, CT-Angiography, Complications, Transplantation, Grafts
Authors: N. ROUSSEL; TOULOUSE/FR
DOI:10.1594/ecr2018/C-1657

Aims and objectives

Pancreatic transplantation is currently the gold standard for the restoration of the endocrine function (1).

The simultaneous pancreas-kidney transplant (SPK) is currently considered as the best pre-terminal renal disease treatment for type 1 diabetic patients aged up to 55 and represents the main indication of pancreatic graft. Literature data show constant improvement of patient and graft survival, as well as the superiority of this combined transplant to dialysis or to single kidney transplant, particularly regarding the long-term complications of diabetes (2-6).

Despite important advances in the selection of recipients and donors, surgical techniques and post-operative treatment, the rate of post-surgical complications remains high compared to other solid organ transplants. Namely, 8 to 9% of early graft failures are registered on an international scale versus 10 to 15 % in France. 30% of patients require post-transplant relaparotomy (7-9). Graft loss clinically implies resuming insulinotherapy. It may have an immunological origin, but early graft failure is mainly related to vascular thrombotic complications (3). Despite an appropriate medical treatment, these thrombotic complications unfortunately often end in transplantectomy, which means ultimate graft loss. (10).

Computed tomography (CT) has shown its superiority to other imaging techniques in the understanding of anatomy and the visualization of complications following pancreas transplant, including thrombosis (11,12) (Fig 1).

 

The purpose of our study is to search prognostic factors of transplantectomy in a pancreatic transplant population who had early vascular thrombotic complications.

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