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KMID : 0361120050190020210
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Korean Journal of Transplantation
2005 Volume.19 No. 2 p.210 ~ p.214
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A Case Report of Acute Pancreatitis following Kidney Transplantation
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신호식/Shin HS
정연순/임학/천봉권/Jung YS/Rim H/Chun BK
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Abstract
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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.
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