P-168

Experience in Hospital Italiano de Buenos Aires with percutaneous ultrasonographic-guided (US-guided) pancreas allograft biopsies

R. Luxardo, W. Bonfanti, G. Bratti, M. giordani, N. imperiali, c. mombelli, l. costan, r. lambertini, g. gallo, s. hyon, s.algranati, p. argibay, r.groppa
Hospital Italiano de Buenos Aires, Nefrologia, Buenos Aires, Argentina

Objetives: Report our experience with percutaneous (US-guided) pancreas graft biopsies assesing the correlation between the alteration of the laboratory test of pancreas function (hyperglycemia and hyperamilasemia) with the histological findings. We also analyze the effectiveness and the safety of this method for obtaining adequate tissue for diagnosis of pancreas dysfunction.

Methods: Data were obtained from 19 percutaneous US-guided biopsies performed in 10 recipients of pancreas-kidney transplantation between September 2008 and February 2011. All patients were treated with quadruple immunosuppression with induction with antibodies associated with tacrolimus, mycophenolate and steroids.

Results: The main indications of the procedure were hyperamilasaemia (57.9%), hyperglycemia (31%) and both serologic biomarkers elevated (11%). Hystopathological results showed acute rejection(31%), chronic rejection (26%), normal findings (31%) and calcineurin inhibitors islets toxicity (6%) and reflux pancreatitis (6%). We observed that hyperamilasaemia was the only abnormality test found in the 66.6% of the biopsies with acute rejection; and hyperglycemia in the 66.6% of biopsies with chronic severe rejection. However, normal biopsies were associated with one or both laboratory test abnormalities. Acute pancreas rejection was not associated with increased creatinine level ,except one patient with primary kidney non function. All tissue samples were representative. Bleeding which required blood transfusion was observed in one patient.

Conclusions: Considering the low sensitivity and specificity of biochemical markers,the biopsy of pancreas transplants is the gold standard method to differentiate acute rejection from other pathologic processes. In our Center the incorporation of the percutaneous US-guided pancreas graft biopsy became a routine, safe and effective procedure for diagnosis of pancreas dysfunction.

P-168

Experience in Hospital Italiano de Buenos Aires with percutaneous ultrasonographic-guided (US-guided) pancreas allograft biopsies

R. Luxardo, W. Bonfanti, G. Bratti, M. giordani, N. imperiali, c. mombelli, l. costan, r. lambertini, g. gallo, s. hyon, s.algranati, p. argibay, r.groppa
Hospital Italiano de Buenos Aires, Nefrologia, Buenos Aires, Argentina

Objetives: Report our experience with percutaneous (US-guided) pancreas graft biopsies assesing the correlation between the alteration of the laboratory test of pancreas function (hyperglycemia and hyperamilasemia) with the histological findings. We also analyze the effectiveness and the safety of this method for obtaining adequate tissue for diagnosis of pancreas dysfunction.

Methods: Data were obtained from 19 percutaneous US-guided biopsies performed in 10 recipients of pancreas-kidney transplantation between September 2008 and February 2011. All patients were treated with quadruple immunosuppression with induction with antibodies associated with tacrolimus, mycophenolate and steroids.

Results: The main indications of the procedure were hyperamilasaemia (57.9%), hyperglycemia (31%) and both serologic biomarkers elevated (11%). Hystopathological results showed acute rejection(31%), chronic rejection (26%), normal findings (31%) and calcineurin inhibitors islets toxicity (6%) and reflux pancreatitis (6%). We observed that hyperamilasaemia was the only abnormality test found in the 66.6% of the biopsies with acute rejection; and hyperglycemia in the 66.6% of biopsies with chronic severe rejection. However, normal biopsies were associated with one or both laboratory test abnormalities. Acute pancreas rejection was not associated with increased creatinine level ,except one patient with primary kidney non function. All tissue samples were representative. Bleeding which required blood transfusion was observed in one patient.

Conclusions: Considering the low sensitivity and specificity of biochemical markers,the biopsy of pancreas transplants is the gold standard method to differentiate acute rejection from other pathologic processes. In our Center the incorporation of the percutaneous US-guided pancreas graft biopsy became a routine, safe and effective procedure for diagnosis of pancreas dysfunction.