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Purpose <p>Bleeding after graft reperfusion is a significant challenge in pancreas transplantation (PTx). To reduce post-reperfusion bleeding, we developed a modified bench surgery technique, combining a vessel-sealing system (LigaSure™) with indigo carmine (IC) leak testing. This study evaluates the clinical efficacy and safety of this method.</p> Methods <p>We reviewed, retrospectively, 54 consecutive PTx procedures, with (<i>n</i> = 25) or without (<i>n</i> = 29) the novel LigaSure™ plus IC (L + IC) method, performed between 2010 and 2024. Surgical outcomes, postoperative complications, graft loss, and glucose tolerance were compared between the control and L + IC groups. The safety of IC (9.0&#xa0;µg/mL) for pancreatic islet cells was assessed through in vitro AO/PI staining and glucose-stimulated insulin secretion (GSIS) assays.</p> Results <p>The L + IC group showed significantly less post-reperfusion bleeding than the control group (715 mL vs. 360 mL; <i>p</i> = 0.0122). Multivariate analysis identified that L + IC was independently associated with reduced post-reperfusion bleeding (odds ratio 0.2171, <i>p</i> = 0.0171). IC exposure did not impair islet cell viability or function. The HbA1c and C-peptide levels were comparable between the groups.</p> Conclusion <p>Our novel L + IC bench surgery technique proved safe and effective for reducing bleeding after pancreas graft reperfusion. Further prospective multicenter studies should be carried out to confirm its impact on long-term surgical outcomes.</p>

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Graft trimming with LigaSure™ and leak testing with Indigo carmine reduces blood loss significantly after reperfusion in pancreas transplantation

  • 期刊论文

  • 发表日期：

    2025年11月20日

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  • Hiroki Imamura,
  • Yoshito Tomimaru,
  • Hirofumi Akita,
  • Toshinori Ito,
  • Yosuke Mukai,
  • Kazuki Sasaki,
  • Shinichiro Hasegawa,
  • Daisaku Yamada,
  • Takehiro Noda,
  • Hidenori Takahashi,
  • Shogo Kobayashi,
  • Yuichiro Doki,
  • Hidetoshi Eguchi

摘要

Purpose

Bleeding after graft reperfusion is a significant challenge in pancreas transplantation (PTx). To reduce post-reperfusion bleeding, we developed a modified bench surgery technique, combining a vessel-sealing system (LigaSure™) with indigo carmine (IC) leak testing. This study evaluates the clinical efficacy and safety of this method.

Methods

We reviewed, retrospectively, 54 consecutive PTx procedures, with (n = 25) or without (n = 29) the novel LigaSure™ plus IC (L + IC) method, performed between 2010 and 2024. Surgical outcomes, postoperative complications, graft loss, and glucose tolerance were compared between the control and L + IC groups. The safety of IC (9.0 µg/mL) for pancreatic islet cells was assessed through in vitro AO/PI staining and glucose-stimulated insulin secretion (GSIS) assays.

Results

The L + IC group showed significantly less post-reperfusion bleeding than the control group (715 mL vs. 360 mL; p = 0.0122). Multivariate analysis identified that L + IC was independently associated with reduced post-reperfusion bleeding (odds ratio 0.2171, p = 0.0171). IC exposure did not impair islet cell viability or function. The HbA1c and C-peptide levels were comparable between the groups.

Conclusion

Our novel L + IC bench surgery technique proved safe and effective for reducing bleeding after pancreas graft reperfusion. Further prospective multicenter studies should be carried out to confirm its impact on long-term surgical outcomes.