Results of kidney and pancreas biopsies performed at time of re-laparotomy during the first month after pancreas transplantation

PALBO UVA; QUEVEDO ALEJANDRA; ROSES JOSEFINA; PILOTTI ROXANA; TONIOLO FERNANDA; CHULUYAN, EDUARDO; CASADEI, DOMINGO H.

Lyon

Congreso; World Congress of the International Pancreas and Islet Association (IPITA); 2019

IPITA

Introduction: Graft biopsies can provide valuable information during the immediate post transplant period. Patients that requiere relaparotomyprovide an opportunity to obtain kidney and pancreas tissue for analysis. Since November 2011 we have been performinggraft biopsies at time of re-laparotomy after pancreas transplantation.Objective: To review the results of these biopsies.Materials and methods: We included all patients with biopsy samples obtained at time of relaparotomy during the first month afterpancreas transplantation from January 2012 to March 2019. We excluded re-laparotomies performed to obtain a biopsy for organdysfunction and those because of pancreas thrombosis.Results: We have performed 180 pancreas transplants during the study period. We identified 51 patients with biopsy samples at time ofre-laparotomy during the first post-transplant month meeting inclusion criteria. Re-laparotomy was performed due to bleeding (21cases), infection (10 cases), duodenal fistulae (7 cases), uretheral complications (5 cases), small bowell obstruction (4 cases)and abdominal pain/pancreatitis (4 cases). Time from transplant to biopsy was 1 to 29 days (mean 9 days). Rejection was found in 11cases (1 kidney only, 6 pancreas only and 4 in both organs) during relaparotomy for duodenal fistulae (4), bleeding (4), infection (1),uretheral complication (1) and abdominal pain (1). In addition ATN (4 cases) and CNI toxicity (1case) was found in 5 patients withslow or delayed graft function and graft pancreatitis was found in 6 cases.Discussion: Graft biopsies performed at time of re-laparotomy provided usefull information. Rejection episodes were found in 22% ofthe cases mostly associated with enteric fistulae and bleeding. In addition, ATN was found in patients with slow and delayed kidneygraft function rouling out rejection and saving future biopsies during these dysfunction periods.