Pancreatic allograft thrombosis: diagnostic and therapeutic importance of splenic venous flow velocity.

Thrombosis of pancreatic transplant is usually diagnosed so late that graft pancreatectomy is the only possible operative recourse. We report 3 patients with portal vein thrombosis which was diagnosed by the triad decreased splenic vein velocity, decreased urinary amylase and slowly rising glycemia. Thrombosis was confirmed at the time of surgery. Thrombectomy was performed in 2 patients. One patient achieved long-term insulin independence while the other graft was lost to recurrent thrombosis and failure of thrombectomies. The third graft was removed primarily. This experience led us to assess the role of Duplex Color Doppler in five normal volunteers and 11 insulin-independent pancreatic transplant recipients.