Division of Nephrology, Taichung Veterans General Hospital, Taichung, Taiwan.
College of Medicine, China Medical University, Taichung, Taiwan.
PLoS One. 2019 Sep 11;14(9):e0222169. doi: 10.1371/journal.pone.0222169. eCollection 2019.
Data for elucidating post-kidney transplantation (KT) acute pancreatitis (AP) risk are limited and no large-scale cohort study has investigated the impact of AP after KT.
Data from Taiwan National Health Insurance (NHI) Research Database (NHIRD) were calculated through the method of propensity score matching to compare the pancreatitis risk in patients with and without KT.
The overall pancreatitis incidence rates were 1.71 and 0.61 per 1,000 person-years in the KT and non-KT groups, respectively and corresponding adjusted HR (aHR [95% CI]) for pancreatitis was 2.48 (1.51-4.09) in the KT group. In the multivariable model, AP risk was higher in transplant patients with alcohol-related illnesses (aHR: 3.78, 95% CI: 1.32-10.8), gall stone disease (aHR: 3.53, 95% CI: 1.48-8.44), or past history of pancreatitis (aHR: 10.3, 95% CI: 5.08-20.8). Of note, recurrent AP risk was significantly higher in the KT group (aHR: 8.19, 95% CI: 2.89-23.2). Patients with post-KT AP demonstrated shorter patient and allograft survival than did those without (both P < 0.001, respectively).
In conclusion, KT recipients are very likely to be associated with AP. Moreover, their inferior outcomes are strongly associated with post-KT AP.
阐明肾移植(KT)后急性胰腺炎(AP)风险的数据有限,尚无大规模队列研究调查 KT 后 AP 的影响。
通过倾向评分匹配的方法,利用台湾全民健康保险(NHI)研究数据库(NHIRD)的数据,比较了 KT 组和非 KT 组患者的胰腺炎风险。
KT 组和非 KT 组的总体胰腺炎发生率分别为 1.71 和 0.61/1000人年,相应的胰腺炎调整后 HR(aHR[95%CI])在 KT 组为 2.48(1.51-4.09)。在多变量模型中,患有酒精相关疾病(aHR:3.78,95%CI:1.32-10.8)、胆结石病(aHR:3.53,95%CI:1.48-8.44)或既往胰腺炎病史(aHR:10.3,95%CI:5.08-20.8)的移植患者发生 AP 的风险更高。值得注意的是,KT 组复发性 AP 的风险明显更高(aHR:8.19,95%CI:2.89-23.2)。与无 AP 的患者相比,发生 KT 后 AP 的患者的患者和移植物生存率更短(均 P <0.001)。
总之,KT 受者发生 AP 的风险非常高。此外,他们较差的预后与 KT 后 AP 密切相关。