Document Detail


Arterial reconstruction with donor iliac vessels during pancreas transplantation: an intraoperative approach to arterial injury or inadequate flow.
MedLine Citation:
PMID:  15740569     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Outcome of pancreas transplantation (PTX) has improved because of use of novel immunosuppression and advances in surgical technique. It is not uncommon for severe atherosclerosis in patients with type 1 insulin-dependent diabetes mellitus or the presence of a previously transplanted organ to limit the options for vascular anastomosis. Herein we report the novel application of donor iliac arterial interposition grafts for arterial reconstruction in patients with severe iliac artery arteriosclerosis, and/or previous transplant who develop an arterial injury or stenosis during surgery. METHODS: In five patients undergoing PTX, the external iliac artery was severely atherosclerotic and/or occupied by a previous vascular anastomosis. In four of the five patients, an arterial intimal dissection became apparent. The external iliac artery was excised and reconstructed with donor iliac artery interposition graft (end-to-end anastomosis). Pancreas or kidney was engrafted onto this arterial interposition graft (end-to-side anastomosis). RESULTS: There was no operative morbidity related to this surgical approach. All grafts functioned well after transplantation. Distal lower extremities have no evidence of vascular insufficiency with mean follow-up of 26 months (7-45 months). CONCLUSION: This surgical technique is an acceptable option during PTX for the patient with severe iliac artery arteriosclerosis with intraoperative intimal dissection or stenosis, or perhaps those with challenging arterial access.
Authors:
Jang Il Moon; Gaetano Ciancio; George W Burke
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical transplantation     Volume:  19     ISSN:  0902-0063     ISO Abbreviation:  Clin Transplant     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-03-02     Completed Date:  2005-07-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710240     Medline TA:  Clin Transplant     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  286-90     Citation Subset:  IM    
Affiliation:
Division of Transplantation, Department of Surgery, University of Miami School of Medicine, Miami, FL, USA. jmoon@med.miami.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Anastomosis, Surgical / methods*
Aneurysm, Dissecting / surgery
Arteriosclerosis / surgery
Constriction, Pathologic / surgery
Female
Follow-Up Studies
Humans
Iliac Artery / pathology,  surgery,  transplantation*
Intraoperative Complications / surgery
Kidney Transplantation
Male
Middle Aged
Pancreas Transplantation* / physiology
Reconstructive Surgical Procedures / methods*
Regional Blood Flow / physiology
Tunica Intima / pathology
Vascular Patency / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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