INVESTIGADORES
CHULUYAN Hector Eduardo
artículos
Título:
LAPAROSCOPIC BIOPSIES IN PANCREAS TRANSPLANTATION
Autor/es:
UVA, PABLO; ODORICO, J; GIUNIPPERO, ALEJANDRO; CABRERA, IGNACIO; GALLO, ANTONIO; LEÓN, LUIS; MINUÉ, ELENA; TONIOLO, MARÍA; PILOTTI, ROXANA; GONZALEZ, IGNACIO; CHULUYAN, EDUARDO; CASADEI, DOMINGO
Revista:
AMERICAN JOURNAL OF TRANSPLANTATION
Editorial:
WILEY-BLACKWELL PUBLISHING, INC
Referencias:
Lugar: Londres; Año: 2017
ISSN:
1600-6135
Resumen:
As there is no precise laboratory test or imaging study for detection of pancreas allograft rejection, there is increasing interest in obtaining pancreas tissue for diagnosis. Pancreas allograft biopsies are most commonly performed percutaneously, transcystoscopically, or endoscopically, yet pancreas transplant surgeons often lack the skills to perform these types of biopsies. We have performed 160 laparoscopic pancreas allograft biopsy attempts in 95 patients without radiologic imaging support. There were 146 simultaneous kidney and pancreas biopsies and 14 pancreas only biopsies due to pancreas alone, kidney loss or extraperitoneal kidney. Biopsies were performed for graft dysfunction (89 cases) or per protocol (71 cases). In 13 cases, an additional laparoscopic procedure was performed at the same operation. The pancreas diagnostic tissue yield was 91.2%; however, the pancreas could not be visualized in 8 cases (5%) and in 6 cases the tissue sample was non-diagnostic (3.8%). In two cases we could not perform the kidney biopsy laparoscopically with a kidney tissue yield of 98.6%. There were four patients with intraoperative complications requiring laparotomy (2.5%) with 2 additional postoperative complications. Half of all these complications were kidney related. There were no episodes of pancreatic enzyme leak or fluid collections and there were no graft losses related to the procedure. We conclude that laparoscopic kidney and pancreas allograft biopsies can be safely performed with very high tissue yields.