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Outcomes of Portal Vein Extension Grafts in Pancreas Transplantation: A Single-Centre Analysis

S. R. Punjala, B. L. Phillips, N. Karydis, F. Calder, C. J. Callaghan

Department of Nephrology, Renal Transplantation and Urology, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom

Meeting: 2019 American Transplant Congress

Abstract number: D298

Keywords: Pancreas transplantation, Portal veins

Session Information

Date: Tuesday, June 4, 2019

Session Name: Poster Session D: Pancreas and Islet: All Topics

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

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*Purpose: Surgical dogma suggests that portal vein extension grafts (PVEGs) in pancreas transplantation should be strenuously avoided, though the evidence-base is lacking. In our unit, at least one surgeon routinely uses a PVEG, while all surgeons will use a PVEG for major technical issues where a transplant could not otherwise be performed. A single-centre retrospective analysis of outcomes was performed to determine if PVEGs were associated with worse outcomes.

*Methods: All pancreases transplanted between 1.1.13-31.5.18 were included. PVEGs were retrospectively coded as routine (rPVEG) or ‘indicated’ (iPVEG). Outcome measures included pancreas PNF, DGF, pancreas death-censored graft survival (DCGS; graft pancreatectomy or return to insulin), and presence of graft thrombosis (combined clinical and radiological, arterial and venous). Standard univariate statistical analyses were applied.

*Results: 156 pancreas transplants were performed (151 SPK), with 52 from DCD donors (33%). PVEG use was common (42 patients (27%)); 31 (74%) were rPVEG and 11 (26%) were iPVEG. There were no significant differences in donor or recipient baseline variables between PVEG and non-PVEG groups, but median pancreas CIT and mean anastomosis times were longer in the PVEG group (730 vs 641 mins, p=0.002; 44 vs 38 mins, p=0.03). There were no significant differences in rates of pancreas PNF (0% vs 2.6%, p=0.29), DGF (2.4% vs 1.8%, p=0.80), or graft thromboses (9.5% vs 7.9%, p=0.74) between the PVEG and non-PVEG groups, respectively. There were no venous thromboses leading to pancreas graft loss in the PVEG group; 5 occurred in the non-PVEG group (p=0.32). There were no statistically significant differences in DCGS between the PVEG and non-PVEG groups (p=0.59) or between non-PVEG, iPVEG and rPVEG groups (p=0.726, see figure).

*Conclusions: The presence of a PVEG makes no clinically relevant difference in graft outcomes after pancreas transplantation in our unit.

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To cite this abstract in AMA style:

Punjala SR, Phillips BL, Karydis N, Calder F, Callaghan CJ. Outcomes of Portal Vein Extension Grafts in Pancreas Transplantation: A Single-Centre Analysis [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/outcomes-of-portal-vein-extension-grafts-in-pancreas-transplantation-a-single-centre-analysis/. Accessed March 7, 2021.

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