Pancreas transplant rejection episodes are not revealed by biopsies of the donor duodenum in a prospective study with paired biopsies

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
E NordheimT Jenssen

Abstract

The surgical technique with duodeno-duodenal enteroanastomosis of pancreas transplants allows for representative endoscopic ultrasound-guided needle biopsies of the donor duodenum and the pancreas graft. We assessed whether histological findings in transplanted donor duodenal biopsies can indicate rejection in the transplanted pancreas. Since September 2012, a duodeno-duodenal enteroanastomosis has been the default technique for pancreas transplantations at our center. In 67 recipients we prospectively examined 113 endoscopic ultrasound-guided procedures with representative biopsies from the duodenum grafts and the pancreas grafts (97 per protocol and 16 on indication). All graft biopsies were evaluated according to established rejection criteria. A total of 22 biopsy-proven pancreas rejections were detected, with 2 matching duodenal biopsies showing rejection. This gives a sensitivity of 9% for detection of a pancreas rejection by duodenal biopsies. The other matching duodenal biopsies were either normal (n = 13) or indeterminate (n = 7). Rejection of the donor duodenum was found in only 6/113 biopsies, with 2 concurrent pancreas rejections. In conclusion, the donor duodenum is not a useful reporter organ for rejection in the ...Continue Reading

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Citations

Feb 26, 2019·Transplantation·Cinthia B Drachenberg
Feb 20, 2021·Transplant International : Official Journal of the European Society for Organ Transplantation·Uli FehrenbachTimm Denecke
Jun 3, 2021·Scandinavian Journal of Clinical and Laboratory Investigation·Kristiane Birkeland BleskestadKåre I Birkeland
Jul 11, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Ugo BoggiThierry Berney
Aug 21, 2021·Der Pathologe·Maike Büttner-HeroldPeter Schenker
Sep 19, 2021·Mucosal Immunology·Raquel Bartolomé-CasadoFrode L Jahnsen
Oct 6, 2021·The Journal of Immunology : Official Journal of the American Association of Immunologists·Stalin ChellappaEinar Martin Aandahl

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