Interstitial and vascular pancreas rejection in relation to graft survival

Transplant International : Official Journal of the European Society for Organ Transplantation
J G BoonstraJ A Bruijn

Abstract

To examine the incidence 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 graft 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.

Citations

May 20, 2003·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·John C PapadimitriouStephen T Bartlett
May 1, 2008·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·C B DrachenbergD E R Sutherland
Jun 2, 2006·Critical Reviews in Toxicology·Robert GoldenPeter G Shields

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