Late recurrent bleeding episodes from duodenojejunostomy after pancreas transplantation

Clinical Transplantation
Franka MessnerChristian Margreiter

Abstract

In response to a number of late, repetitive bleeding episodes from the site of the enteric anastomosis, we herein analyze the clinical courses and etiologies of 379 consecutively performed pancreas transplants between January 2000 and December 2016. Duodenojejunostomies for enteric drainage were performed at the upper jejunum in a side to side, double layer fashion. Five patients (1.3%) developed recurrent late hemorrhagic episodes originating from the graft duodenal anastomosis. Bleeding from the anastomotic site was associated with hematochezia, hemodynamic instability and decrease in serum hemoglobin. Mean onset was 6.4(±2.8) years after transplantation. Bleeding was recurrent (mean 5.2 ± 2.6) and required 9(±2.5) interventions. Hypervascularization, mucosal vulnerability, and bleeding at the site of the enteric anastomosis could be identified in all cases. In four patients, the enteric pancreas anastomosis was resected and a new duodenojejunostomy was performed. No pancreas graft loss occurred due to bleeding. In two patients, hepatic cirrhosis and portal hypertension were identified, one patient had a liver fibrosis as putative cause for the repetitive bleeding episodes. Late anastomotic hemorrhage is a rare but severe com...Continue Reading

References

Apr 17, 2001·Annals of Surgery·D E SutherlandJ S Najarian
Feb 26, 2005·Transplant International : Official Journal of the European Society for Organ Transplantation·Elena OrsenigoValerio Di Carlo
Nov 3, 2005·Nature Clinical Practice. Gastroenterology & Hepatology·Peter D R HigginsMatthew J DiMagno
Nov 15, 2006·Cardiovascular and Interventional Radiology·Aslihan Semiz-Oysu, Wojciech Cwikiel
May 26, 2009·Lancet·Steve A WhiteDavid E R Sutherland
Dec 17, 2009·Current Opinion in Organ Transplantation·Christoph Troppmann
Mar 23, 2010·Transplantation Proceedings·L MartinsM Teixeira
Dec 2, 2011·Clinical Transplantation·Jonathan A FridellJohn A Powelson
Apr 12, 2012·Vascular and Endovascular Surgery·Wael E A SaadKlaus D Hagspiel
Jun 26, 2012·Transplantation·Mathieu PageBernard Allaouchiche
Mar 5, 2013·World Journal of Surgery·Nir LubezkyMenahem Ben-Haim
Sep 3, 2013·Progress in Transplantation : Official Publication, North American Transplant Coordinators Organization ... [et Al.]·Antonio RíosPascual Parrilla
Oct 10, 2013·Transplant Infectious Disease : an Official Journal of the Transplantation Society·S IrtanC Chardot
Mar 15, 2014·The International Journal of Angiology : Official Publication of the International College of Angiology, Inc·Manuel VillaJeffrey Nicastro
Jul 6, 2014·Annals of Transplantation : Quarterly of the Polish Transplantation Society·Martin MontenovoJeffrey Halldorson
Jan 27, 2015·Transplant Infectious Disease : an Official Journal of the Transplantation Society·D PatronoM Mourad
Feb 25, 2017·The American Journal of Case Reports·Rubens Macedo ArantesLuiz Augusto Carneiro D'Albuquerque

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Citations

Feb 7, 2020·Transplant International : Official Journal of the European Society for Organ Transplantation·Franka MessnerChristian Margreiter
Feb 12, 2021·Transplant International : Official Journal of the European Society for Organ Transplantation·Franka MessnerChristian Margreiter

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