Early detection of complications in pancreas transplants by microdialysis catheters, an observational feasibility study.
<h4>Background</h4>Despite advances in immunosuppression and surgical technique, pancreas transplantation is encumbered with a high rate of complication and graft losses. Particularly, venous graft thrombi occur relatively frequently and are rarely detected before the transplant is irrev...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0247615 |
| _version_ | 1818740669554884608 |
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| author | Gisle Kjøsen Kristina Rydenfelt Rune Horneland Einar Martin Aandahl Pål-Dag Line Eric Dorenberg Audun Elnæs Berstad Knut Brabrand Gaute Hagen Sören Erik Pischke Gisli Björn Bergmann Espen Nordheim Trond Geir Jenssen Tor Inge Tønnessen Håkon Haugaa |
| author_facet | Gisle Kjøsen Kristina Rydenfelt Rune Horneland Einar Martin Aandahl Pål-Dag Line Eric Dorenberg Audun Elnæs Berstad Knut Brabrand Gaute Hagen Sören Erik Pischke Gisli Björn Bergmann Espen Nordheim Trond Geir Jenssen Tor Inge Tønnessen Håkon Haugaa |
| author_sort | Gisle Kjøsen |
| collection | DOAJ |
| description | <h4>Background</h4>Despite advances in immunosuppression and surgical technique, pancreas transplantation is encumbered with a high rate of complication and graft losses. Particularly, venous graft thrombi occur relatively frequently and are rarely detected before the transplant is irreversibly damaged.<h4>Methods</h4>To detect complications early, when the grafts are potentially salvageable, we placed microdialysis catheters anteriorly and posteriorly to the graft in a cohort of 34 consecutive patients. Glucose, lactate, pyruvate, and glycerol were measured at the bedside every 1-2 hours.<h4>Results</h4>Nine patients with graft venous thrombosis had significant lactate and lactate-to-pyruvate-ratio increases without concomitant rise in blood glucose or clinical symptoms. The median lactate in these patients was significantly higher in both catheters compared to non-events (n = 15). Out of the nine thrombi, four grafts underwent successful angiographic extraction, one did not require intervention and four grafts were irreversibly damaged and explanted. Four patients with enteric anastomosis leakages had significantly higher glycerol measurements compared to non-events. As with the venous thrombi, lactate and lactate-to-pyruvate ratio were also increased in six patients with graft surrounding hematomas.<h4>Conclusions</h4>Bedside monitoring with microdialysis catheters is a promising surveillance modality of pancreatic grafts, but differentiating between the various pathologies proves challenging. |
| first_indexed | 2024-12-18T01:44:24Z |
| format | Article |
| id | doaj.art-86aa0067bbaa428e82b3406436c4d66e |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-18T01:44:24Z |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-86aa0067bbaa428e82b3406436c4d66e2022-12-21T21:25:14ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01163e024761510.1371/journal.pone.0247615Early detection of complications in pancreas transplants by microdialysis catheters, an observational feasibility study.Gisle KjøsenKristina RydenfeltRune HornelandEinar Martin AandahlPål-Dag LineEric DorenbergAudun Elnæs BerstadKnut BrabrandGaute HagenSören Erik PischkeGisli Björn BergmannEspen NordheimTrond Geir JenssenTor Inge TønnessenHåkon Haugaa<h4>Background</h4>Despite advances in immunosuppression and surgical technique, pancreas transplantation is encumbered with a high rate of complication and graft losses. Particularly, venous graft thrombi occur relatively frequently and are rarely detected before the transplant is irreversibly damaged.<h4>Methods</h4>To detect complications early, when the grafts are potentially salvageable, we placed microdialysis catheters anteriorly and posteriorly to the graft in a cohort of 34 consecutive patients. Glucose, lactate, pyruvate, and glycerol were measured at the bedside every 1-2 hours.<h4>Results</h4>Nine patients with graft venous thrombosis had significant lactate and lactate-to-pyruvate-ratio increases without concomitant rise in blood glucose or clinical symptoms. The median lactate in these patients was significantly higher in both catheters compared to non-events (n = 15). Out of the nine thrombi, four grafts underwent successful angiographic extraction, one did not require intervention and four grafts were irreversibly damaged and explanted. Four patients with enteric anastomosis leakages had significantly higher glycerol measurements compared to non-events. As with the venous thrombi, lactate and lactate-to-pyruvate ratio were also increased in six patients with graft surrounding hematomas.<h4>Conclusions</h4>Bedside monitoring with microdialysis catheters is a promising surveillance modality of pancreatic grafts, but differentiating between the various pathologies proves challenging.https://doi.org/10.1371/journal.pone.0247615 |
| spellingShingle | Gisle Kjøsen Kristina Rydenfelt Rune Horneland Einar Martin Aandahl Pål-Dag Line Eric Dorenberg Audun Elnæs Berstad Knut Brabrand Gaute Hagen Sören Erik Pischke Gisli Björn Bergmann Espen Nordheim Trond Geir Jenssen Tor Inge Tønnessen Håkon Haugaa Early detection of complications in pancreas transplants by microdialysis catheters, an observational feasibility study. PLoS ONE |
| title | Early detection of complications in pancreas transplants by microdialysis catheters, an observational feasibility study. |
| title_full | Early detection of complications in pancreas transplants by microdialysis catheters, an observational feasibility study. |
| title_fullStr | Early detection of complications in pancreas transplants by microdialysis catheters, an observational feasibility study. |
| title_full_unstemmed | Early detection of complications in pancreas transplants by microdialysis catheters, an observational feasibility study. |
| title_short | Early detection of complications in pancreas transplants by microdialysis catheters, an observational feasibility study. |
| title_sort | early detection of complications in pancreas transplants by microdialysis catheters an observational feasibility study |
| url | https://doi.org/10.1371/journal.pone.0247615 |
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