Clinical analysis of acute pancreatitis after kidney transplantation: a single-center retrospective observational study

Abstract

Abstract Object The aim of this single-center study was to summarize the diagnosis and treatment experience of acute pancreatitis after kidney transplantation. To explore the etiology of acute pancreatitis in kidney transplant recipients and provide reference for the prevention and diagnosis. Methods We retrospectively collected the clinical data of patients who suffered acute pancreatitis after kidney transplant in our hospital from 2019 to 2023, clinical data of patients with the chronic kidney disease who suffered acute pancreatitis were also collected at the same time. We summarized the diagnosis and treatment process of acute pancreatitis after kidney transplantation; and the differences in the pathogenesis, clinical manifestations, complications and mortality of acute pancreatitis between the two types of patients were analyzed. Results A total of 10 cases of acute pancreatitis of kidney transplant recipients and 11 cases of acute pancreatitis in patients with chronic kidney disease were included in this study. The most common causes of acute pancreatitis in kidney transplant recipients was drug (50.0%), of which tigecycline accounted for 100.0%, one of these cases was considered acute pancreatitis caused by a combination of tacrolimus and tigecycline. The common causes of acute pancreatitis in patients with chronic kidney disease was idiopathic (50.0%). The complication rates of acute pancreatitis in two groups were 30.0% and 9.1%, and the mortality rate were 0% and 18.2%, respectively, and there was no significant difference in complications and mortality rate. There were 10 cases of kidney transplant recipients in our center, 6 cases had acute pancreatitis within 1 month after surgery, 4 cases had acute pancreatitis over 1 month after surgery, 8 cases combined with continuous blood purification treatment, and 1 case had exploratory laparotomy, all of those cases had good clinical outcomes. Conclusion Acute pancreatitis after kidney transplantation were mostly caused by drugs. For early identification of acute pancreatitis, attention should be paid to patient’s abdominal symptoms and physical examination especially when using tigecycline. Basic treatments including remove triggers, fasting and water, acid suppression, pancreatic enzymes suppression and nutritional support should be given. Continuous blood purification can remove inflammatory mediators, which has remarkable effects for acute pancreatitis after kidney transplantation.

Keywords

• Kidney transplantation
• Acute pancreatitis
• Chronic kidney disease
• Continuous blood purification