Acute pancreatitis after liver transplantation: incidence and contributing factors

Abstract

In order to assess the incidence and possible predisposing and contributing factors in the development of acute pancreatitis after liver transplantation, we reviewed the medical records of all 1832 adult patients who underwent 2161 orthotopic liver transplantation (OLTx) procedures in our center between January 1987 and September 1992. Of these patients, 55 (3% incidence) developed clinical pancreatitis and 247 (13.4% incidence) developed hyperamylasemia (biochemical pancratitis). Overall mortality in cases of clinical pancreatitis was 63.6%. The mortality in cases of hyperamylasemia was similar to that found in the general liver transplant population (i.e., 23%). A strong correlation was found between pancreatitis after liver transplantation and end-stage liver disease due to hepatitis B (30% of the cases, P = 0.00001). Extensive surgical dissection around the pancreas (P < 0.05), the type of biliary reconstruction following liver transplantation (P < 0.05), and the number of liver grafts received by the same patient (P = 0.00001) appeared to be possible contributing factors as did the duration of venovenous bypass and the quantity of IV calcium chloride administered intraoperatively.

Pancreatitis after liver transplantation in children: a single-center experience

“…These rates were 1.9% and 43%, respectively, in children (8) ( Table 2). In our series of 26 patients with clinical pancreatitis in 634 LTx (4.1%), the mortality rate of 43% (11/26) is similar to that observed by others (5)(6)(7)(8).…”

“…There has been a high rate of PTAP after LTx in adult patients with hepatitis B (5,9); however, Lupo et al (7), did not find this to be a risk factor. As reported in the series by Tissières et al (8) and in our study, because of its rarity, hepatitis B would not be expected to be a risk factor for acute pancreatitis in children.…”

“…Acute pancreatitis is an uncommon but serious complication after solid organ transplantation (1)(2)(3)(4)(5). The mortality rate ranges between 20% and 100% and varies according to center reports and organs.…”

“…Surgical intervention was performed when indicated by complications of pancreatitis or by computed tomographic scan findings in a patient who was clinically deteriorating or who required exploration for technical complications after transplantation. 5) days. Sixty-one percent of cases occurred within the first week after LTx.…”

“…Posttransplantation acute pancreatitis (PTAP) is an infrequent but serious complication after solid organ transplantation, with reported mortality rates of up to 100% in patients with severe forms of the disease (1)(2)(3)(4)(5). We performed a retrospective review in a large cohort of pediatric liver transplant recipients at a single institution to define the impact of this problem in children.…”