J Korean Soc Transplant.  2005 Dec;19(2):210-214.

A Case Report of Acute Pancreatitis following Kidney Transplantation

• Shin HS
• Jung YS
• Rim H
• Chun BK

Abstract

Acute pancreatitis following kidney transplantation is an unusual complication that carries a high mortality. Acute pancreatitis occurs in 1~11% patients following kidney transplantation, a rate much higher than that observed in the general population. Immunosuppresive drugs, viral infections (CMV, Varicella zoster and hepatitis C virus), hypotension, hypercalcemia (as a result of secondary hyperparathyroidism), and graft dysfunction with renal failure have all been implicated. Here, we report a case of acute pancreatitis following kidney transplantation. A 39-year-old hemodialysis patient received a living donor renal allograft which was implanted in the right iliac fossa. Cyclosporine and prednisolone were maintained. Patient complained of fever on the 8th day of transplantation. Chest X-ray showed a pneumonic infiltrates. Pneumonic manifestation was improved slowly under coverage of broad-spectrum antibiotic therapy. Oliguria and azotemia were developed on the 10th day of transplantation. On the 11th day of transplantation, hemodialysis was resumed. Intravenous methylprednisolone pulse therapy was given from the 13th to 15th day of transplantation. Patient complained of epigastric pain on the 8th day of transplantation and laboratory data showed hyperamylasemia. Alimentation was discontinued and total parenteral nutrition was supported under diagnosis of acute pancreatitis. Despite a parenteral nutrition, serum amylase levels ran high. Patient died of an acute episode of gastrointestinal bleeding and GB empyema on the 90th day of transplantation.

Keyword

Acute pancreatitis; Kidney transplantation

MeSH Terms

Adult
Allografts
Amylases
Azotemia
Chickenpox
Cyclosporine
Diagnosis
Empyema
Fever
Hemorrhage
Hepatitis C
Herpes Zoster
Humans
Hyperamylasemia
Hypercalcemia
Hypotension
Kidney Transplantation*
Kidney*
Living Donors
Methylprednisolone
Mortality
Oliguria
Pancreatitis*
Parenteral Nutrition
Parenteral Nutrition, Total
Prednisolone
Renal Dialysis
Renal Insufficiency
Thorax
Transplants
Amylases
Cyclosporine
Methylprednisolone
Prednisolone