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Chapter-69 Complications

BOOK TITLE: Kidney & Pancreas Transplantation

Author
1. Nicastro Jeffrey M.
2. Coppa Gene F.
3. Molmenti Ernesto P
4. Molmenti Christine Sardo
5. Gruessner Angelika
6. Gruessner Christine E
7. Gruessner Stefan A
8. Rilo Horacio
9. Gruessner Rainer
ISBN
9789351523390
DOI
10.5005/jp/books/12547_70
Edition
1/e
Publishing Year
2015
Pages
4
Author Affiliations
1. Hofstra North Shore – LIJ School of Medicine and North Shore – Long Island Jewish Health System, New York, USA
2. Hofstra North Shore – LIJ School of Medicine, New York, USA
3. Hofstra Northwell School of Medicine, Long Island, New York, USA, North Shore-LIJ Health System, Long Island, New York, USA; Hofstra North Shore–LIJ School of Medicine, Long Island, New York, USA
4. Mailman School of Public Health, Herbert Irving Comprehensive Cancer Center, New York-Presbyterian Columbia University Medical Center, New York, USA
5. Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
6. University of Arizona, Tucson, Arizona, USA
7. University of Arizona, Tucson, Arizona, USA
8. Cell Transplant Institute; Arizona Diabetes Center, University of Arizona School of Medicine, Tucson, Arizona, USA
9. University of Arizona, Tucson, Arizona, USA
Chapter keywords
graft injury, acute rejection, parenchyma, vascular complication, thrombosis, pancreatic allografts, arterioenteric fistula, graft pancreatectomy, urinary tract infection

Abstract

Every possible effort should be made to minimize cold (preservation) and warm (implantation) ischemic times to prevent unnecessary graft injury. Recipients can also develop complications that represent exacerbations of preexisting comorbidities rather than complications associated with the transplant itself. Acute rejection is characterized by the presence of activated inflammatory cells in the parenchyma, in association with vascular and glandular injury. Thrombosis of the pancreas allograft is a feared vascular complication. Thrombosis results in pancreatic graft necrosis and usually requires graft pancreatectomy. In rare circumstances, and especially in instances of failed pancreatic allografts, an arterioenteric fistula may develop. Pancreas transplants with bladder drainage feature a variety of urological complications such as urinary tract infection and cystitis.

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