Management of acute pancreatitis after kidney transplantation: our experiences of 12 patients

Objective To summarize the experiences of diagnosing and treating acute pancreatitis (AP) after kidney transplantation. Methods From September 2007 to December 2017, clinical data were retrospectively analyzed for 12 AP patients after kidney transplantation. Results They were diagnosed as AP within 72 h after an onset of abdominal pain. Among 4 recurrent cases within 1 week post-transplantation, the curative interventions included non-operative therapy (n=2) and peripancreatic puncture & drainage (n=2). AP occurred at 1 year post-transplantation (n=8). Three cases were cured non-surgically while another 5 cases underwent surgery. The procedures included laparoscopic cholecystectomy (n=1), endoscopic retrograde cholangiopancreatography (ERCP) for cholelithiasis (n=1) and peripancreatic puncture & drainage (n=2). One patient died after surgical debridement for adjacent pancreatic tissue. Conclusions After kidney transplantation, the occurrence of AP may be associated with immunosuppressants interfering with triglyceride metabolism and pancreatic microcirculation. For those with cholelithiasis-related pancreatitis, surgical removal of precipitating factor is required. Mini-invasive puncture and drainage are preferred for severe non-gallstone pancreatitis while surgery is performed whenever necessary. Key words: Kidney transplantation; Complication; Acute pancreatitis; Immunosuppressant