Pancreatitis in Solid Organ Transplant Patients: A Review of the Literature

Graham, Danielle; Itô, Takahiro; Busuttil, Ronald W.; Kaldas, Fady M.

doi:10.21926/obm.hg.1903029

Cited by 5 publications

(4 citation statements)

References 49 publications

(81 reference statements)

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“…The immunosuppressive drugs including steroids, calcineurin inhibitors, mTOR inhibitors, and antiproliferative therapies like azathioprine are all risk factors for pancreatitis. Because renal transplant recipients are immunocompromised, they are more vulnerable to viral infections such as CMV, EBV, and varicella zoster, which can cause viral pancreatitis [ 23 ]. Other variables, such as hyperglycemia and hypertriglyceridemia, might cause pancreatitis in kidney transplant recipients.…”

Section: Discussionmentioning

confidence: 99%

COVID 19 induced acute pancreatitis in patients with renal impairment: report of five cases

Tadkal

Siddini

Augustine

et al. 2022

Clin J Gastroenterol

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COVID 19 infection is an ongoing pandemic that the world is facing currently. Though SARS-CoV2 infection mainly involves the lungs, it is known to affect other organs like kidneys, brain, heart, endocrine organs and gastrointestinal system. It is hypothesized that the ACE2 and transmembrane serine protease 2 which are expressed in the beta cells of the pancreas are the entry receptors for the SARS-CoV-2 virus, thus causing pancreatitis. A retrospective review of clinical records at our institution during the COVID 19 pandemic from 2019 to 2020 was carried out to find patients with COVID 19 infection presenting with acute pancreatitis. Additionally, a review of literature was conducted about COVID 19 patients presenting with pancreatitis in chronic kidney disease and renal transplantation recipients. Five patients with COVID 19 infection presented with acute pancreatitis during the 2019–2020 pandemic period. All patients were males and mean age of the patients was 48 ± 20 years. Out of 5 patients, 3 were chronic kidney disease patients, 2 were renal transplantation recipients. COVID 19 infection was the cause of acute pancreatitis in all 5 cases. Out of 5, 1 patient had acute necrotizing pancreatitis and the rest had mild to moderate severity pancreatitis. All patients recovered except the patient with acute necrotizing pancreatitis who succumbed to the illness. One patient with chronic kidney disease became dialysis dependent post recovery from pancreatitis. In all 5 patients, there was no correlation between the severity of COVID ARDS and the severity of pancreatitis. There was no correlation between the severity of pancreatitis and the elevation of inflammatory markers. In patients presenting with pancreatitis, we have to keep in mind COVID 19 infection along with other known aetiologies of acute pancreatitis. Supplementary Information The online version contains supplementary material available at 10.1007/s12328-022-01633-5.

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Section: Discussionmentioning

confidence: 99%

COVID 19 induced acute pancreatitis in patients with renal impairment: report of five cases

Tadkal

Siddini

Augustine

et al. 2022

Clin J Gastroenterol

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“…Acute pancreatitis can have a poor prognosis and can complicate the course of organ transplantation. It has been repeatedly documented in patients following kidney, bone marrow, intestine, heart, pancreas, and liver transplantations [ 4 , 13 ]. AP incidence and mortality in this group are often higher than in the general population.…”

Section: Discussionmentioning

confidence: 99%

“…AP is a well-documented complication of organ transplantation, which occurs in up to 35% of transplant patients [ 4 ]. The incidence of AP following kidney transplantation is 1.2–7% and is associated with a high mortality rate [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Acute Pancreatitis in Patients After Liver Transplantation

et al. 2022

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Background Acute pancreatitis (AP) is a relatively rare but serious complication that can occur after organ transplantation. Material/Methods The aim of this study was to evaluate the incidence, potential risk factors, and course of AP in patients following liver transplantation at a single large-volume transplant center. Results Out of a total of 1850 transplanted patients, 49 (2.8%) were diagnosed with AP. Of this group, 37 (75.5%) had a mild form of AP and 12 (24.5%) had a severe form of AP. The mortality rate was 10% overall and 42% in the group of patients with severe AP. An early form of AP (<30 days from transplantation) occurred in 13 patients (26.5%), most of whom presented with severe AP (10 patients, 76.9%); 4 patients died (40%). A late form of AP was diagnosed in 36 patients (73.5%), most of whom had mild AP (34 patients, 94.4%); 1 of 2 patients with severe AP died. The most common AP etiologies were post-ERCP (38.8%), idiopathic (34.7%), and postoperative (18.4%). Chronic HBV infection was a risk factor for development of AP ( P =0.01). Conclusions AP in liver transplant recipients was more frequent and more severe than in the general population. This unfavorable course was associated with the occurrence of AP in the early post-transplant period. Liver transplantation due to complications of HBV infection was a risk factor for the development of AP.

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“…The epidemiology of AP is well characterized in the general population, but more conflicting data are available for solid organ transplanted individuals. Graham D. et al, in a recent review, reported an incidence of 1-35%, with the highest rates in kidney and intestinal transplantation in pediatric populations ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Case report: GLP1RA for the treatment of diabetes in liver transplanted people. Do they increase the risk of pancreatitis?

Grancini,

Cogliati,

Gaglio

et al. 2024

Front. Endocrinol.

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The incidence of acute pancreatitis (AP) in liver transplanted people is reported to be 1.5-8%. On the other hand, the evidence for a causal relationship between glucagon-like peptide 1 receptor agonists (GLP1RAs) and pancreatitis in people with type 2 diabetes is still weak. In addition, there are currently no data on a possible increased risk of AP in liver-transplanted individuals with diabetes treated with GLP1RAs. In a population of liver-transplanted individuals with diabetes receiving GLP1RA-based therapy, we reported an incidence of AP of 3.0% (two subjects). No cases were reported in liver-transplanted individuals with diabetes receiving SGLT2 inhibitors, insulin or metformin, neither in kidney or lung-transplanted patients treated with GLP1RAs. In both patients with AP, the only additional risk factor for its development was a history of re-transplantation (liver or combined kidney/liver). For this reason, we suggest particular caution when considering GLP1RAs-based therapies in liver transplanted patients with multiple risk factors for AP, such as a history of repeated and complex abdominal surgery.

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Pancreatitis in Solid Organ Transplant Patients: A Review of the Literature

Cited by 5 publications

References 49 publications

COVID 19 induced acute pancreatitis in patients with renal impairment: report of five cases

COVID 19 induced acute pancreatitis in patients with renal impairment: report of five cases

Acute Pancreatitis in Patients After Liver Transplantation

Case report: GLP1RA for the treatment of diabetes in liver transplanted people. Do they increase the risk of pancreatitis?

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