Pancreatitis after renal transplantation

Abstract

Pancreatitis is seldom seen as a severe complication of renal transplantation. In a review on 1321 renal transplants, 23 cases with 12 deaths were reported. Single case reports may be added. In the hospital department, pancreatitis proved to be a fairly frequent complication. It developed in 10 (7%) of 147 patients with renal transplantation one wk to 7.5 yr after transplantation (patients with primary hyperparathyroidism excluded). 3 of the 8 acute cases had hemorrhagic pancreatitis, in 2 of them leading to death. 2 Patients had chronic calcifying pancreatitis. Pancreatitis was complicated in one case by abscess formation and in 2 by severe hemorrhage into a pseudocyst. In 2 patients, the diagnosis was made at necropsy only, and death was probably not related to the acute pancreatitis. The exact pathogenesis of pancreatitis after renal transplantation cannot be precisely assessed. Possible contributing factors are treatment with corticosteroids, azathioprin, and L asparaginase, early hypercalcemia after transplantation, surgery, infections of bacterial or viral origin, and unknown immunological processes.