Unexplained fever after pancreas transplantation

Area of Science:

• Nephrology
• Transplantation Immunology
• Clinical Medicine

Background:

• Fever is a frequent early complication following pancreas transplantation.
• The precise cause of fever is often undetermined, with limited data on noninfectious, unexplained fever (UF).
• Understanding UF in pancreas recipients is crucial for managing patient and graft outcomes.

Purpose of the Study:

• To characterize unexplained fever (UF) in pancreas transplant recipients.
• To evaluate the impact of UF on patient and graft outcomes within the first year post-transplant.

Main Methods:

• A retrospective cohort study was conducted on pancreas or simultaneous pancreas-kidney transplant recipients.
• Unexplained fever (UF) was defined by the absence of positive cultures, radiologic findings, or other indicators of infection or rejection.
• Data were collected from January 1, 2011, to August 31, 2015.

Main Results:

• Twenty-three out of 92 (25%) patients experienced UF, with the first episode occurring at a mean of 31 days post-transplant.
• UF episodes led to 34 admissions with an average length of stay of 5.1 days.
• Corticosteroid treatment resolved fever in all patients who received it, and no significant differences in rejection, graft loss, death, or infection rates were observed compared to UF-free patients in the first year.

Conclusions:

• Unexplained fever (UF) is a common reason for readmission after pancreas transplantation.
• Despite diagnostic challenges in identifying UF etiology, its occurrence was not linked to adverse patient or graft outcomes within the first year post-transplant.