Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Clin Transplant. 2012 Mar-Apr;26(2):238-41. doi: 10.1111/j.1399-0012.2011.01440.x. Epub 2011 Apr 7.
Monitoring pancreas transplant recipients for rejection is an inexact science. Serial monitoring of urinary amylase has been used for patients with a bladder-drained pancreas. An increase in serum amylase and lipase has been utilized as an in vivo measure of pancreas rejection in patients with enteric pancreatic exocrine drainage. Decreases in urinary amylase or increases in serum amylase or lipase, respectively, in these two different types of surgical drainage would prompt a pancreas biopsy for histologic confirmation of rejection. Herein, we describe the case of an enteric-drained pancreatic transplant recipient who presented with peripheral eosinophilia at least one month before she developed increases in serum amylase and lipase. A pancreas allograft biopsy indicated eosinophilic acute cellular rejection. Peripheral eosinophilia may be a useful early indicator of pancreas graft rejection preceding changes in serum pancreatic enzymes by approximately one month.
监测胰腺移植受者的排斥反应是一门不精确的科学。对于接受膀胱引流胰腺的患者，已经使用尿淀粉酶的连续监测。血清淀粉酶和脂肪酶的增加已被用作肠外胰腺外分泌引流患者胰腺排斥的体内测量。在这两种不同类型的手术引流中，尿淀粉酶的减少或血清淀粉酶或脂肪酶的增加分别会促使进行胰腺活检以进行组织学确认排斥反应。在这里，我们描述了一例肠引流胰腺移植受者的病例，该患者在血清淀粉酶和脂肪酶升高之前至少一个月出现外周血嗜酸性粒细胞增多。胰腺移植物活检显示嗜酸性粒细胞性急性细胞排斥反应。外周血嗜酸性粒细胞增多可能是胰腺移植物排斥的有用早期指标，比血清胰腺酶的变化早约一个月。
