两次单纯胰腺移植术后动脉血栓形成1例

目的：总结1例两次单纯胰腺移植术后血栓形成的原因和诊治体会。 方法：广西中医学院附属瑞康医院器官移植中心于2006-12，2007-01为1例1型糖尿病患者先后两次施行单纯胰腺移植，观察分析移植后血栓形成经过、实验室检查和影像学检查结果。 结果：两次移植术后血糖未能恢复正常，初次移植术后12 d，患者腹痛、发热、白细胞增加，CT血管三维成像证实移植胰动脉栓塞，遂行移植物切除，并行再次移植手术，术后第11天，患者无症状，血管三维成像提示移植胰动脉部分栓塞，抗凝治疗无效，2 d后移植胰动脉完全栓塞，行移植胰切除。 结论：血栓形成易导致单纯胰腺移植失败，其临床征象缺乏特异性，影像学检查有助于诊断，保守治疗效果不佳。

Graft artery thrombosis following repeating pancreas transplantation alone in 1 case

OBJECTIVE: To summarize the mechanism, diagnosis and treatment of graft thrombosis following pancreas transplantation alone (PTA). METHODS: One patient with type 1 insulin-dependent diabetes mellitus and performed twice PTA in December 2006 and January 2007 at the Department of Organ Transplantation, Affiliated Ruikang Hospital of Guangxi Chinese Traditional Medicine College was selected. The clinical manifestations, laboratory and radiology results of thrombosis were analyzed. RESULTS: The blood glucose did not recover normal level after operation. The patient had abdominal pain, fever, complicated with leucocyte increasing at day 12 after primary transplantation. Complete artery graft embolism and intestinal fistula were found by multi-slice spiral CT angiography 3D imaging (CTA), therefore, the pancreatectomy and pancreas retransplantation were performed. No asymptomatic postoperatively, but the partial artery graft thrombosis was discovered by CTA at day 11 after the pancreas retransplantation, which ineffective to anticoagulation therapeutic, progressed to complete artery graft thrombosis 2 days later. Therefore, a second pancreatectomy had to be performed. CONCLUSION: Graft thrombosis, which lack of specific clinical sign, is easily result in pancreas transplantation failure. Imaging examination can facilitate the diagnosis, but the effect of conservative treatment is disappointing. Wu PZ, Gao HJ, Luo XD, Liang FF, Luo H, Yang H, Liang TS, Tan Z, Yang J. Graft artery thrombosis following repeating pancreas transplantation alone in 1 case. Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu. 2009;13(44): 8767-8770. http://www.crter.cn http://en.zglckf.com]