Correlation between cystoscopic biopsy results and hypoamylasuria in bladder-drained pancreas transplants

Benedetti, Enrico; Najarian, J. S.; Gruessner, Angelika C.; Nakhleh, Raouf E.; Troppmann, Christoph; Hakim, Nadey; Pirenne, Jacques; Sutherland, David E.R.; Gruessner, Rainer W.G.

doi:10.1016/s0039-6060(05)80277-6

Cited by 62 publications

(28 citation statements)

References 14 publications

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“…In their study on cystoscopic biopsies in bladder-drained grafts, however, interstitial and vascular pancreas rejection could occur independently [2]. In our study, we also often found acute interstitial rejection in percutaneously taken biopsies without the presence of VR.…”

Section: Discussionsupporting

confidence: 42%

“…Biopsies of the pancreas were taken with ultrasound guidance using an 18-gauge Biopty needle (Biopty, Lund, Sweden). Indications for biopsy were: (1) hypoamylasuria (25 % decrease in 24-h urinary amylase when compared to two prior samples), (2) an edematous pancreas on CT scan, (3) an elevated serum amylase ( > 600 U/l), and (4) hyperglycemia (fasting and postprandial). One biopsy was performed because of severe hematuria.…”

Section: Biopsiesmentioning

confidence: 99%

“…For IR, we used the grading system presented by Benedetti et al [2], based on the mononuclear infiltrate and involvement of morphological changes in the acinar area. For the definition of mild, moderate, and severe VR, we used the grading system used before for the definition of VR in the kidney [3]; this was somewhat more detailed than the gradation proposed by Benedetti et al Leukocyte common antigen staining was used in additional to HE staining to evaluate the amount of infiltration.…”

Section: Biopsiesmentioning

confidence: 99%

“…Serum amylase and pancreas-specific protein have been shown to be sensitive, but not specific, markers for rejection [ S , 13,291. Hypoamylasuria may be used as a marker in bladder-drained transplants as it correlates with histologically defined pancreas rejection; however, major differences in specificity have been reported [2,12,14,181. Serum anodal trypsinogen has been reported to be a reliable, graftspecific rejection marker [5, 12,201.…”

Section: Introductionmentioning

confidence: 99%

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Interstitial and vascular pancreas rejection in relation to graft survival

Boonstra¹,

Pijl²,

Es³

et al. 1997

Transplant Int

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Interstitial and vascular pancreas rejection in relation to graft survivalAbstract To examine the incidence Key words Pancreas of interstitial and vascular rejection in pancreas allografts and its impact on graft survival, we studied 36 percutaneous pancreas biopsies and 10 pancreas transplantectomy specimens from 32 patients who had undergone simultaneous pancreas-kidney transplantation. Interstitial rejection (IR) was predominantly found in the biopsies, while vascular rejection (VR) was most prominent in the transplantectomies. Pancreas graft survival was significantly decreased for pancreas grafts that had suffered from vascular rejection when compared to those with only interstitial rejection. Potential rejection markers, i. e., serum amylase, glucose, creatinine, and urinary amylase, did not correlate with histological signs of rejection, although increased levels of serum amylase were, in all but one case, associated with rejection.We conclude that a percutaneous pancreas biopsy remains the most reliable method to determine pancreas rejection, and that by distinguishing between IR and VR, a pancreas biopsy may provide important diagnostic as well as prognostic information.

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Section: Discussionsupporting

confidence: 42%

Section: Biopsiesmentioning

confidence: 99%

Section: Biopsiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Interstitial and vascular pancreas rejection in relation to graft survival

Boonstra¹,

Pijl²,

Es³

et al. 1997

Transplant Int

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“…[20][21][22] However late 1990s there was shift again from bladder to enteric drainage, in particular for simultaneous pancreas and kidney (SPK) transplants. 23 Enteric drainage is a more physiologic way to drain pancreatic exocrine secretions, and improvements in antimicrobial and immunosuppressive therapy reduced the risks of complications as well as rejection.…”

Section: History Of Pancreas Transplantationmentioning

confidence: 99%

Pancreas Transplantation

Han¹,

Sutherland²

2010

Gut Liver

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Diabetes mellitus is generally treated with oral diabetic drugs and/or insulin. However, the morbidity and mortality associated with this condition increases over time, even in patients receiving intensive insulin treatment, and this is largely attributable to diabetic complications or the insulin therapy itself. Pancreas transplantation in humans was first conducted in 1966, since when there has been much debate regarding the legitimacy of this procedure. Technical refinements and the development of better immunosuppressants and better postoperative care have brought about marked improvements in patient and graft survival and a reduction in postoperative morbidity. Consequently, pancreas transplantation has become the curative treatment modality for diabetes, particularly for type I diabetes. An overview of pancreas transplantation is provided herein, covering the history of pancreas transplantation, indications for transplantation, cadaveric and living donors, surgical techniques, immunosuppressants, and outcome following pancreas transplantation. The impact of successful pancreas transplantation on the complications of diabetes will also be reviewed briefly. (Gut Liver 2010;4:450-465)

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Clinical Allograft Rejection Syndromes in Pancreas and Islet Transplantation

Vagefi

Stock

2014

Textbook of Organ Transplantation

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Correlation between cystoscopic biopsy results and hypoamylasuria in bladder-drained pancreas transplants

Cited by 62 publications

References 14 publications

Interstitial and vascular pancreas rejection in relation to graft survival

Interstitial and vascular pancreas rejection in relation to graft survival

Pancreas Transplantation

Clinical Allograft Rejection Syndromes in Pancreas and Islet Transplantation

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