Acute pancreatitis after renal transplantation

Abstract

Post-transplantation pancreatitis is an infrequent complication with a high risk of mortality. In a 7-year period, there were five patients who had documented pancreatitis out of a total of 488 renal homograft recipients, an incidence of 1 per cent. Two cases occurred in patients with an orthotopic transplant, one of them as a result of surgical injury of the pancreas and the other as a consequence of cytomegalovirus infection. The third case was an acute pancreatitis of hypercalcaemic origin, the fourth patient developed postoperative pancreatitis and acute acalculous cholecystitis, and the fifth had acute pancreatitis and sepsis associated with cytomegalovirus infection. Three patients died as a direct result of the complication. The mean incidence and mean mortality rate of post-transplantation pancreatitis, as determined from our review of the literature of the last 15 years, are 2.3 and 61.3 per cent, respectively; these are similar to the figures found up to 1970 of 1.7 and 52.2 per cent. A multiplicity of factors present in the uraemic patient may be responsible for the continued frequency of post-transplant pancreatitis despite advances in surgical technique and immunosuppressive therapy.

Acute pancreatitis with CMV papillitis and cholangiopathy in a renal transplant recipient

“…The incidence of acute pancreatitis following renal transplantation varies from 1 to 5% [1][2][3]. Renal transplant recipients have multiple risk factors for pancreatitis making identification of a single etiological agent difficult in clinical setting (Table 1).…”

Pancreatitis in adult orthotopic liver allograft recipients: Risk factors and outcome

“…2 In contrast, in a review of the literature of AP occurring in renal allograft recipients, both azathioprine and prednisone were documented to be etiologic factors. 20 Hagopian et al 21 have also suggested that increased doses of corticosteroids within 1 year of the episode can increase the mortality from AP in cardiac and renal allograft recipients.…”

“…22 This is in contrast to either no obvious cause or cytomegalovirus as precipitating factors for AP within the first 2 months after renal transplantation. 20,22 However, in the largest series reported of AP occurring in renal transplant recipients more than 2 months after allografting, immunosuppression was believed to be the most likely underlying factor because neither alcohol nor cholelithiasis were documented. 4 In conclusion, this study shows that the incidence of AP (3%) is low in stable adult transplant recipients post-OLT, and AP can occur many years after primary allografting.…”

Acute pancreatitis following adult liver transplantation: A systematic review

“…It can also have a more aggressive course, with mortality ranging from 37.5% to 63% (2,3,6,7) and is observed in both adult and pediatric populations (8). AP has been well documented in the setting of solid organ transplantation and has been described following kidney, bone marrow, intestinal, and heart transplantation (9)(10)(11)(12)(13)(14).…”