Burnstein M, Salter D, Cardella C, Himal H S
Can J Surg. 1982 Sep;25(5):547-9, 563.
Acute necrotizing pancreatitis developed in 5 of 405 patients who underwent renal transplantation. All five patients were taking immunosuppressive medication (azathioprine and steroids). Three patients also received rabbit antithymus serum. Alcohol ingestion or cholelithiasis did not play any causative role in the pancreatitis, which began between 7 days and 13 months after renal transplantation. The delay from the time of admission for pancreatitis to surgical exploration was a mean of 17 days. Operative findings included pancreatic necrosis, hemorrhage and abscess formation. All five patients died of the complications of necrotizing pancreatitis--persistent sepsis, respiratory and renal failure, upper gastrointestinal bleeding and disseminated intravascular coagulation. This review demonstrates that prolonged conservative therapy in renal transplant patients with necrotizing pancreatitis is associated with high mortality. The authors believe that earlier surgical intervention will lead to increased survival.
405例接受肾移植的患者中有5例发生了急性坏死性胰腺炎。所有5例患者均在服用免疫抑制药物（硫唑嘌呤和类固醇）。3例患者还接受了兔抗胸腺细胞血清治疗。酒精摄入或胆石症在胰腺炎发病过程中未起任何作用，胰腺炎发生在肾移植后7天至13个月之间。从胰腺炎入院到手术探查的平均延迟时间为17天。手术所见包括胰腺坏死、出血和脓肿形成。所有5例患者均死于坏死性胰腺炎的并发症——持续性脓毒症、呼吸和肾衰竭、上消化道出血及弥散性血管内凝血。本综述表明，肾移植合并坏死性胰腺炎的患者长期保守治疗死亡率高。作者认为早期手术干预将提高生存率。
