Gastrointestinal Bleeding During Anticoagulant Therapy for Deep Vein Thrombosis after Simultaneous Pancreas and Kidney Transplantation
Akihito Sannomiya*, Ichiro Nakajima, Yuichi Ogawa, Kotaro Kai, Toru Murakami, Ichiro Koyama, Kumiko Kitajima and Shohei Fuchinoue
Department of Surgery, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan
- *Corresponding Author:
- Dr. Akihito Sannomiya
Department of Surgery, Kidney Center
Tokyo Women’s Medical University, Japan
Tel: +81 3 3353 8111
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Received Date: April 21, 2017; Accepted Date: May 18, 2017; Published Date: May 24, 2017
Citation: Sannomiya A, Nakajima I, Ogawa Y, Kai K, Murakami T, et al. (2017) Gastrointestinal Bleeding During Anticoagulant Therapy for Deep Vein Thrombosis after Simultaneous Pancreas and Kidney Transplantation. J Clin Case Rep 7:957. doi: 10.4172/2165-7920.1000957
Copyright: © 2017 Sannomiya A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
A 46-year-old Japanese woman on dialysis for type 1 diabetes and chronic renal failure underwent simultaneous pancreas and kidney transplantation from a brain-dead donor. On postoperative day 3, ilio-femoral deep vein thrombosis on the side of pancreatic transplantation was diagnosed from swelling of the right leg, an increased D-dimer level, and imaging findings. Anticoagulant therapy was initiated to prevent proximal propagation of the thrombosis and pulmonary thromboembolism. However, gastrointestinal bleeding occurred, which was thought to be due to mucosal bleeding from the duodenal graft. Her anticoagulant therapy was adjusted and hemostasis was conducted, controlling the gastrointestinal bleeding without surgical intervention. Blood flow was maintained to both grafts and graft function was good. When gastrointestinal bleeding occurs during anticoagulant therapy for deep vein thrombosis after combined pancreas and kidney transplantation, bleeding can be controlled by adjusting anticoagulant therapy and other appropriate measures.