Abstract | OBJECTIVE: To define the incidence, clinical presentation, radiologic findings and principles of diagnosis, and management of acute graft pancreatitis occurring more than 3 months after transplantation. SUMMARY BACKGROUND DATA: METHODS: We performed a retrospective analysis of data from patients who underwent SPKT with enteric drainage at our institution. All recipients who experienced episodes that met the clinical criteria for late graft pancreatitis were included. We excluded events proven to be anastomotic or duodenal stump leaks. Clinical presentation, laboratory findings, radiologic imaging, course of management, and graft and patient outcome were evaluated and analyzed. RESULTS: Of 79 SPKTs (1995-2007), 11 (14%) recipients experienced 31 episodes of late graft pancreatitis (average number per patient, 3; range, 1-13), occurring an average of 28 months after transplantation (range, 3 months to 8 years). All patients presented with right lower quadrant abdominal peritonitis, fever, and findings compatible with pancreas graft inflammation on computed tomography or ultrasound imaging. Mild hyperamylasemia (>110 IU/L) was found in 82% of cases. Treatment was conservative, including bowel rest, antibiotics, and percutaneous sampling and drainage of abscesses as necessary. Excellent graft and patient survival were achieved. CONCLUSION:
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Authors | Risa M Small, Ilanit Shetzigovski, Arye Blachar, Jacob Sosna, Joseph M Klausner, Richard Nakache, Menahem Ben-Haim |
Journal | Annals of surgery
(Ann Surg)
Vol. 247
Issue 6
Pg. 1058-63
(Jun 2008)
ISSN: 1528-1140 [Electronic] United States |
PMID | 18520235
(Publication Type: Journal Article)
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Topics |
- Acute Disease
- Adult
- Diabetes Mellitus, Type 1
(surgery)
- Female
- Graft Survival
- Humans
- Kidney Transplantation
- Male
- Middle Aged
- Pancreas Transplantation
- Pancreatitis
(diagnosis, therapy)
- Postoperative Complications
(diagnosis, therapy)
- Prognosis
- Renal Insufficiency
(surgery)
- Retrospective Studies
- Survival Rate
- Tomography, X-Ray Computed
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