[Acute pancreatitis after kidney transplantation]

Area of Science:

• Nephrology
• Gastroenterology
• Transplantation Medicine

Background:

• Pancreatitis post-kidney transplant is a serious complication with a high mortality rate (53-60%) compared to non-transplant patients.
• Risk factors include uremia, lipid metabolism disorders, polycystic kidney disease, immunosuppressive drugs, and cytomegalovirus infection.
• The incidence of severe pancreatitis in kidney transplant recipients ranges from 1.2% to 6.8%.

Purpose of the Study:

• To analyze the prognosis of acute pancreatitis in kidney transplant patients.
• To investigate the role of immunosuppression in the development and outcomes of pancreatitis after kidney transplantation.

Main Methods:

• Retrospective analysis of 9 cases of acute pancreatitis in 8 patients who underwent kidney transplantation between June 1991 and December 2000.
• Patients received various immunosuppressive regimens including Cyclosporin, Steroids, Azathioprine, and Mycophenolate Mofetil.
• Treatment involved jejunal nutrition, intensive care, antibiotics, CT monitoring, and surgical interventions when necessary.

Main Results:

• An incidence rate of 2.56% for acute pancreatitis was observed in 349 kidney transplant recipients.
• Multiorgan insufficiency (kidney, lung, liver) and peritonitis were present in 6 and 3 cases, respectively.
• Despite intensive treatment, mortality was 33.3% (3 out of 9 patients) due to multiorgan failure, while 6 patients recovered.

Conclusions:

• The mortality rate of acute pancreatitis is significantly higher in immunosuppressed kidney transplant patients.
• While optimizing immunosuppression may reduce pancreatitis risk, prognosis remains poor even with advanced treatments.
• All potential risk factors must be considered during immunosuppressive treatment and follow-up of transplant patients.