Significant arterial complications after pancreas transplantation—A single-center experience and review of literature

Kunal Yadav, Shamar J Young, Erik B Finger, Raja Kandaswamy, David E.R. Sutherland, Jafar Golzarian, Ty B Dunn

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Arterial fistulas and pseudoaneurysms are rarely described significant arterial complications associated with pancreas transplantation that sometimes present with herald or catastrophic bleeding. We herein describe our institutional case series with a focus on management and outcomes. Of 2256 pancreas transplants, 24 arterial complications were identified in 23 recipients. Chart review was performed to describe the clinical characteristics, treatments, and outcomes of the complications (pseudoaneurysm, arterial enteric/cystic/ureteric fistula, or arteriovenous fistula). Of these 23 patients, 57% had a failed allograft at the time of the complication. Nine patients underwent primary surgical repair of 10 complications, 13 were treated by endovascular methods, and one patient by medical management. In total, 3 embolized patients rebled, 2 of which had failed allografts prior to treatment. Of those with graft function that were treated by embolization alone, all retained graft function. Diagnosis of arterial complications requires a high degree of suspicion and should involve early systemic angiography to evaluate the pancreatic vasculature. Management can be endovascular or surgical and should be individualized. We report our center's evolution from a predominantly surgical to endovascular approach as a definitive vs stabilizing therapy, with selective coiling mostly reserved for well-defined peripheral lesions in patients with a functioning allograft.

Original languageEnglish (US)
Article numbere13070
JournalClinical Transplantation
Issue number10
StatePublished - Oct 2017

Bibliographical note

Publisher Copyright:
© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd


  • arteriovenous fistula
  • fistula
  • hemorrhage
  • pancreas transplantation
  • pseudoaneurysm


Dive into the research topics of 'Significant arterial complications after pancreas transplantation—A single-center experience and review of literature'. Together they form a unique fingerprint.

Cite this