{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T23:46:09Z","timestamp":1781739969874,"version":"3.54.5"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T00:00:00Z","timestamp":1568246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["DRF\u20102016\u201009\u2010132"],"award-info":[{"award-number":["DRF\u20102016\u201009\u2010132"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>\u201cTechnical failure\u201d is still perceived to be a frequent cause of graft loss after pancreas transplantation. However, some early graft losses currently attributed to technical failure could be due to unrecognized acute pancreas rejection (APR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We investigated the apparent incidence of APR in cases of early allograft pancreatectomy (EAP) that had previously been attributed to technical failure. We performed an analysis of 198 patients who underwent pancreas transplantation between January 2009 and January 2016 and identified all those with EAP within 90\u00a0days of transplantation. Explanted grafts of EAP recipients were re\u2010examined histologically to evaluate for evidence of APR using current Banff criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010three EAPs were identified (11.6%; 23\/198). APR was identified histologically in 9 out of the 15 recipients who lost their grafts due to duodenal leaks or recurrent peripancreatic collections, but was not identified in any of the patients whose grafts were lost due to thrombosis or ischemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Unsuspected APR appears common in the explanted grafts of recipients who have undergone EAP for apparently \u201ctechnical\u201d reasons. We suggest that EAP should be defined as a technical failure only when APR of the pancreas (or duodenum) has been excluded by histological analysis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.13702","type":"journal-article","created":{"date-parts":[[2019,8,27]],"date-time":"2019-08-27T06:58:38Z","timestamp":1566889118000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Early allograft pancreatectomy\u2014Technical failure or acute pancreatic rejection?"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8959-7741","authenticated-orcid":false,"given":"David F","family":"Wallace","sequence":"first","affiliation":[{"name":"Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine London UK"},{"name":"Department of Nephrology and Transplantation Guy's and St Thomas' NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Bunnett","sequence":"additional","affiliation":[{"name":"Statistics and Clinical Studies NHS Blood and Transplant Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eve","family":"Fryer","sequence":"additional","affiliation":[{"name":"Department of Cellular Pathology Oxford University Hospitals NHS Foundation Trust John Radcliffe Hospital Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Drage","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Transplantation Guy's and St Thomas' NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Horsfield","sequence":"additional","affiliation":[{"name":"Department of Histopathology Guy's and St Thomas' NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3334-4152","authenticated-orcid":false,"given":"Chris J","family":"Callaghan","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Transplantation Guy's and St Thomas' NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12269"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2013.138"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.2038"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000137198.09182.A2"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12624"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1900\/RDS.2011.8.6"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13890"},{"key":"e_1_2_8_9_1","unstructured":"NHS Blood and Transplant.Annual report on pancreas and islet transplantation.https:\/\/nhsbtdbe.blob.core.windows.net\/umbraco-assets-corp\/12251\/nhsbt-pancreas-and-islet-transplantation-annual-report-2017-2018.pdf. 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