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World J Transplant. Dec 28, 2020; 10(12): 404-414
Published online Dec 28, 2020. doi: 10.5500/wjt.v10.i12.404
Late complications of pancreas transplant
Javier Maupoey Ibáñez, Andrea Boscà Robledo, Rafael López-Andujar
Javier Maupoey Ibáñez, Andrea Boscà Robledo, Rafael López-Andujar, Hepato-Pancreatico-Biliary Surgery and Transplant Unit, La Fe University Hospital, Valencia 46026, Spain
Author contributions: Maupoey Ibáñez J performed the literature search and wrote the manuscript; Boscà Robledo A contributed to the literature search and manuscript revisions; López-Andujar R revised the manuscript; All authors read and approved the final manuscript.
Conflict-of-interest statement: The authors confirm no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rafael López-Andujar, MD, PhD, Professor, Surgeon, Hepato-Pancreatico-Biliary Surgery and Transplant Unit, La Fe Universitario Hospital, C/ Fernando Abril Martorell nª 106 Planta 5 Torre F, Valencia 46026, Spain. rafaellopezandujar@gmail.com
Received: June 22, 2020
Peer-review started: June 22, 2020
First decision: July 25, 2020
Revised: August 18, 2020
Accepted: October 9, 2020
Article in press: October 9, 2020
Published online: December 28, 2020
Processing time: 184 Days and 9.6 Hours
Core Tip

Core Tip: Late complications after pancreas transplant (> 3 mo after surgery) may occur, endangering loss of graft function. Chronic rejection is the main cause of long-term graft failure, occurring in 10% of patients, so targeted immunosuppressive therapy is important to prevent it; however, it predisposes to opportunistic viral, bacterial and fungal infections, and even the reactivation of latent infections, which should be prevented with perioperative prophylaxis and treated when necessary. Pseudoaneurysm should be early diagnosed, and treated by endovascular approach when possible, to prevent bleeding. Nonetheless, in some late complications, transplantectomy is a necessary option, especially in life-threatening complications.