Serum lipase as a marker for pancreatic allograft rejection.
In patients with enteric drainage of pancreas transplants, urinary amylase cannot be used as a marker of rejection. Since most of the patients in our center have enteric drainage, the aim of this study was to evaluate serum lipase as a potential marker for rejection. From July 1994 to March 1997, 100 patients underwent pancreas transplantation with enteric (78) or bladder (22) drainage. Forty-two of the 100 patients had both daily serum lipase (sLip) values and either kidney core or fine needle aspiration biopsies of the pancreas and/or kidney. Thirty-one of the 42 had biopsy proven rejection and were treated on day 0 (D0). From day -7 (D -7) to day +7 (D +7), sLip, serum amylase (sAmy), fasting blood sugar (FBS) and serum creatinine (sCr) were measured daily. Serum lipase values rose from 322 +/- 107 IU/L on D -2 to 634 +/- 247 IU/L on D -1 (p = 0.0203) in 22 of the 31 patients with biopsy proven rejection (sensitivity 71%). The rise in sCr in combined kidney pancreas transplants with biopsy proven rejection was a better marker than sLip (sensitivity 86%). The sensitivity of sAmy and FBS was 50 and 33%, respectively. Other than sCr, sLip appeared to be the best marker for acute rejection in enterically drained pancreas transplants which should be useful as a non-invasive indicator of rejection in solitary pancreas transplants where sCr cannot be used.
Sugitani
A
A
1st Department of Surgery, Kyushu University, Fukuoka, Japan.
Egidi
M F
MF
Gritsch
H A
HA
Corry
R J
RJ
D000681:Amylases / Q000097:blood; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D001786:Blood Glucose / Q000378:metabolism; D003404:Creatinine / Q000097:blood; D006084:Graft Rejection / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D016030:Kidney Transplantation; D008049:Lipase / Q000097:blood*; D016035:Pancreas Transplantation; D012680:Sensitivity and Specificity; D014184:Transplantation, Homologous
D015415:Biomarkers; D001786:Blood Glucose; D003404:Creatinine; D008049:Lipase; D000681:Amylases