title: Laparoscopic Biopsies in Pancreas Transplantation.
abstract: 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 biopsies in 95 patients. There were 146 simultaneous kidney-pancreas biopsies and 14 pancreas-only biopsies due to pancreas alone, kidney loss, or extraperitoneal kidney. Biopsies were performed for graft dysfunction (89) or per protocol (71). 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 eight cases (5%) and in 6 cases the tissue sample was nondiagnostic (3.8%). The kidney tissue yield was 98.6%. There were four patients with intraoperative complications requiring laparotomy (2.5%) with two additional postoperative complications. Half of all these complications were kidney related. There were no episodes of pancreatic enzyme leak 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.
authors.affiliation: Kidney Pancreas Transplantation, Instituto de Nefrología-Nephrology, Buenos Aires, Argentina.|Kidney Pancreas Transplantation, Hospital de Alta Complejidad "Pte J. D. Perón", Formosa, Argentina.|CEFYBO-CONICET, Buenos Aires, Argentina.
authors.forename: P D
authors.initials: PD
authors.lastname: Uva
authors.affiliation: Division of Transplantation, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: J S
authors.initials: JS
authors.lastname: Odorico
authors.affiliation: Kidney Pancreas Transplantation, Instituto de Nefrología-Nephrology, Buenos Aires, Argentina.
authors.forename: A
authors.initials: A
authors.lastname: Giunippero
authors.affiliation: Kidney Pancreas Transplantation, Instituto de Nefrología-Nephrology, Buenos Aires, Argentina.
authors.forename: I C
authors.initials: IC
authors.lastname: Cabrera
authors.affiliation: Kidney Pancreas Transplantation, Instituto de Nefrología-Nephrology, Buenos Aires, Argentina.
authors.forename: A
authors.initials: A
authors.lastname: Gallo
authors.affiliation: Kidney Pancreas Transplantation, Instituto de Nefrología-Nephrology, Buenos Aires, Argentina.
authors.forename: L R
authors.initials: LR
authors.lastname: Leon
authors.affiliation: Kidney Pancreas Transplantation, Instituto de Nefrología-Nephrology, Buenos Aires, Argentina.
authors.forename: E
authors.initials: E
authors.lastname: Minue
authors.affiliation: Kidney Pancreas Transplantation, Instituto de Nefrología-Nephrology, Buenos Aires, Argentina.
authors.forename: F
authors.initials: F
authors.lastname: Toniolo
authors.affiliation: Kidney Pancreas Transplantation, Hospital de Alta Complejidad "Pte J. D. Perón", Formosa, Argentina.
authors.forename: I
authors.initials: I
authors.lastname: Gonzalez
authors.affiliation: Kidney Pancreas Transplantation, Instituto de Nefrología-Nephrology, Buenos Aires, Argentina.|CEFYBO-CONICET, Buenos Aires, Argentina.
authors.forename: E
authors.initials: E
authors.lastname: Chuluyan
authors.affiliation: Kidney Pancreas Transplantation, Instituto de Nefrología-Nephrology, Buenos Aires, Argentina.
authors.forename: D H
authors.initials: DH
authors.lastname: Casadei
mesh_terms: D001706:Biopsy; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000379:methods*; D016035:Pancreas Transplantation; D010182:Pancreatic Diseases / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies
keywords: biopsy; clinical research/practice; pancreas/simultaneous pancreas-kidney transplantation; rejection