In pancreas transplantation there is no reliable laboratory test or imaging study for detection of graft rejection. There is an increasing interest in obtaining pancreas tissue for diagnosis of rejection, type and grade of rejection, evaluation of chronic damage, drug toxicity and recurrence. We describe our series of 83 “for cause” biopsies in pancreas and kidney-pancreas transplant patients over the past four years.

Methods: This is a retrospective review of a prospectively collected database. Only biopsies performed because of graft dysfunction were included from 1/2012 until 11/2015. Kidney dysfunction was defined as an unexplained raise in creatinine levels. Pancreas dysfunction was defined as elevated pancreatic enzymes or hyperglycemia. Most of our biopsies were performed laparoscopically.

Results: There were 45 biopsies for kidney dysfunction. 16 had kidney rejection, only 2 of them simultaneous pancreas rejection. Of the 29 without kidney rejection, there were 2 pancreas rejections. 12 patients were biopsied for both kidney and pancreas rejection. 6 patients had kidney rejection, and 5 of them had simultaneous pancreas rejection. Of the 6 patients without kidney rejection, there was 1 patient with pancreas rejection. Finally there were 26 patients biopsied for pancreas dysfunction. 5 were PTA cases and 2 of them had pancreas rejection. 8 patients had kidney rejection and 6 of them had simultaneous pancreas rejection. Of the 13 patients without kidney rejection, 6 had pancreas rejection.

Conclusion: Pancreas tissue is highly desirable in pancreas transplantation for kidney biopsy results are not reliable for pancreas diagnosis. We found a high incidence of asynchronous rejection in the three reasons for biopsy. We propose to perform both kidney and pancreas biopsies in the setting of graft dysfunction.

CITATION INFORMATION: Uva P, Leon L, Minue E, Cabrera I, Giunippero A, Norese M, Toniolo M, Chuluyan E, Casadei D. Results of Biopsies in Pancreas and Kidney-Pancreas Patients with Graft Dysfunction. Am J Transplant. 2016;16 (suppl 3).

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