Portal Vein Thrombosis after Total Pancreatectomy and Islet Autotransplant: Prophylaxis and Graft Impact

Alexandria J. Robbins, Mariya E. Skube, Melena D. Bellin, Ty B. Dunn, Scott A. Chapman, K. Louise Berry, Elizabeth Lusczek, Gregory J. Beilman

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objectives To determine the rate of portal vein thrombosis (PVT) based on pharmacologic prophylaxis protocol and the impact of PVT on islet graft function after total pancreatectomy with islet autotransplantation (TPIAT). Methods We compared the incidence of PVT, postsurgical bleeding, and thrombotic complications in patients undergoing TPIAT between 2001 and 2018 at the University of Minnesota who received either unfractionated heparin (UFH) or enoxaparin for postoperative PVT prophylaxis. Six-month and 1-year graft function was compared between patients who developed PVT and those who did not. Results Twelve patients (6.6%) developed a PVT, which resolved by 6 months after TPIAT in 10 patients. There was no statistically significant difference in PVT rate between patients who received UFH or enoxaparin for prophylaxis (P = 0.54). Patients who received enoxaparin developed other thrombotic complications more often (6% vs 0%, P = 0.02). Islet graft function did not differ in patients who developed PVT versus those who did not. Conclusions There was no difference between enoxaparin or UFH prophylaxis in preventing PVT, but there may be a higher incidence of other thrombotic complications with enoxaparin. In the setting of routine screening and anticoagulation therapy, PVT is a self-limited process.

Original languageEnglish (US)
Pages (from-to)1329-1333
Number of pages5
JournalPancreas
Volume48
Issue number10
DOIs
StatePublished - Nov 1 2019

Bibliographical note

Funding Information:
From the Departments of *Surgery, †Medicine, and ‡Pediatrics, University of Minnesota Medical School, Minneapolis, MN; §Department of Surgery, University of Pennsylvania, Philadelphia, PA; and ||Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, MN. Received for publication May 21, 2019; accepted September 13, 2019. Address correspondence to: Gregory J. Beilman, MD, Division of Critical Care and Acute Care Surgery, Department of Surgery, University of Minnesota, MMC 195, 420 Delaware St SE, Minneapolis, MN 55455 (e‐mail: beilman@umn.edu). Research by G.J.B. and M.E.S. is funded by the National Institutes of Health (T32DK108733). Research by G.J.B. and A.J.R. are funded by DOD (W81XWH18106872). The authors declare no conflict of interest. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/MPA.0000000000001421

Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • TPIAT
  • anticoagulation
  • islet graft function
  • portal vein thrombosis

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