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KMID : 0191120000150010105
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Journal of Korean Medical Science
2000 Volume.15 No. 1 p.105 ~ p.110
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Three cases of pancreas allograft dysfunction
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Lee HK
Chung DH/Jung J/Kim SC/Han DJ/Kang KH/Yu E
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Abstract
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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.
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