J Korean Med Sci.  2000 Feb;15(1):105-110. 10.3346/jkms.2000.15.1.105.

Three cases of pancreas allograft dysfunction

• Lee HK
• Chung DH
• Jung J
• Kim SC
• Han DJ
• Kang KH
• Yu E

• KMID: 1731245
• DOI: http://doi.org/10.3346/jkms.2000.15.1.105

Abstract

We present dincopathologic features of three cases of biopsy-proven pancreas allograft dysfunction in Korea. All patients had advanced insulin-dependent diabetes mellitus (IDDM). Case 1 was a 30-year-old woman who underwent a simultaneous pancreas-kidney transplantation. Urinary infection developed 6 days after the operation, which remitted and reappeared, when urine amylase level was normal. Since the 55th day after the operation, intermittent hematuria has persisted. Cytomegalovirus inclusions were detected on the urinary bladder and grafted duodenal mucosa. The graft was removed due to perforation of the grafted duodenum and panperitonitis. Case 2 was a 27-year-old man undergoing pancreas transplantation alone (PTA). Ten days after the transplatation, the level of 24 urine amylase decreased and the graft was not delineated by 99mTc DTPA scintigraphy. Allograft needle biopsy revealed multiple acinar cell necrosis and mild lymphocytic infiltration which were compatible with mild acute rejection. Case 3 was a 25-year-old man undergoing cadevaric PTA. Three months after the transplantation, graft was removed due to gastric perforation associated with cytomegalovirus and angiodestructive fungal infection. Various causes of pancreas allograft dysfunction can be diagnosed by needle biopsy, thus appropriate biopsy specimen should be taken using improved biopsy technique.

Keyword

Pancreas Transplantation; Biopsy, Needle; Transplantation, Homologous; Graft Rejection; Fungi; Cytomegalovirus Infections

MeSH Terms

Adult
Biopsy, Needle
Case Report
Female
Graft Rejection/physiopathology
Graft Rejection/pathology
Human
Male
Pancreas/physiopathology*
Pancreas Transplantation/pathology*
Transplantation, Homologous