Management of Severe Pancreatitis in Renal Transplant Recipients

Abstract

ObjectiveThe authors determine if any aspects of the treatment of renal transplant patients with pancreatitis were of particular benefit with regard to graft and patient survival.

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

“…CT scanning is believed to have an important role in the diagnosis. [4][5][6] Biliary tract problems have previously been documented to be a factor contributing to AP in stable liver transplant recipients 2,3 and emerged as the most common underlying factor in this study. Biliary tract manipulation, particularly ERCP, is associated with the development of pancreatitis in liver transplant recipients.…”

“…19 However, in our patients, as in immunosuppressed renal transplant recipients, the incidence of these complications was greater. 4 The only death in this series of patients occurred in the patient with diffuse malignancy. However, none of these patients had severe pancreatitis with pancreatic necrosis.…”

“…This contrasts with the 1.3% incidence of AP in stable adult renal transplant recipients. 4 The use of CT scanning to either confirm or diagnose AP in the immunosuppressed transplant recipient cannot be overstated. 2,4 Hyperamylasemia alone without significant AP can occur in liver transplant recipients and tends to have a benign course.…”

“…4 The use of CT scanning to either confirm or diagnose AP in the immunosuppressed transplant recipient cannot be overstated. 2,4 Hyperamylasemia alone without significant AP can occur in liver transplant recipients and tends to have a benign course. 2 The development of AP has implications for both initial patient management and subsequent clinical course.…”

“…Similarly, in renal transplant recipients, 6 of 11 of those who had severe AP combined with necrosis (54%) died. 4 It is unclear what effect the presence of immunosuppression has on the occurrence and outcome of AP in liver transplant recipients. In 1 large series of liver transplant recipients, no relationship between immunosuppression and AP could be shown.…”