eMedicine Specialties > Transplantation > Surgery
Pancreas Transplantation: Differential Diagnoses & Workup
Updated: Nov 30, 2007
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Workup
Laboratory Studies
- Pretransplantation recipient laboratory evaluation: The pertinent components of a complete pretransplantation recipient medical evaluation are outlined below. The emphasis of the evaluation should be to identify and treat all coexisting medical problems that may increase the rate of morbidity and mortality of the surgical procedure and adversely impact the posttransplantation course. In addition to a thorough medical evaluation, the social issues of the patient should be evaluated to determine conditions that may jeopardize the outcome of transplantation, such as financial and travel restraints or a pattern of noncompliance.
- Blood chemistries
- Liver function tests
- CBC count
- Coagulation profile
- Infectious profile
- Hepatitis B and C serologies
- Cytomegalovirus (CMV) serologies (immunoglobulin M/immunoglobulin G [IgM/IgG])
- Epstein-Barr virus serologies (IgM/IgG)
- Varicella-zoster serologies (IgM/IgG)
- Rapid plasma reagin (syphilis)
- HIV serology
- Purified protein derivative (tuberculosis skin test with anergy panel, when indicated)
- Urinalysis, urine culture, and cytospin (when indicated)
Imaging Studies
- Chest radiography (posteroanterior and lateral)
- Exercise/dipyridamole thallium scintigraphy
- Coronary arteriography (if indicated)
- Stress cardiac ultrasonography (if indicated)
Other Tests
- C-peptide level confirms that transplantation candidate has type I diabetes.
- A complete cardiac workup, including angiography, is not necessary in every patient. However, individuals with a significant cardiac history, positive review of systems, type I diabetes, or hypertensive renal disease should undergo a complete evaluation to rule out significant coronary artery disease. A 12-lead ECG may be needed prior to transplantation.
More on Pancreas Transplantation |
| Overview: Pancreas Transplantation |
Differential Diagnoses & Workup: Pancreas Transplantation |
| Treatment & Medication: Pancreas Transplantation |
| Follow-up: Pancreas Transplantation |
| Multimedia: Pancreas Transplantation |
| References |
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References
Hakim NS. Recent developments and future prospects in pancreatic transplantation. Exp Clin Transplant. Jun 2003;1(1):26-34. [Medline].
Demartines N, Schiesser M, Clavien PA. An evidence-based analysis of simultaneous pancreas-kidney and pancreas transplantation alone. Am J Transplant. Nov 2005;5(11):2688-97. [Medline].
Gruessner AC, Sutherland DE. Pancreas transplant outcomes for United States (US) and non-US cases as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR) as of June 2004. Clin Transplant. Aug 2005;19(4):433-55. [Medline].
Ojo AO, Meier-Kriesche HU, Hanson JA, et al. The impact of simultaneous pancreas-kidney transplantation on long-term patient survival. Transplantation. Jan 15 2001;71(1):82-90. [Medline].
United Network for Organ Sharing (UNOS). United Network for Organ Sharing (UNOS). [Full Text].
Further Reading
Keywords
pancreas transplantation, pancreas allotransplantation, simultaneous pancreas-kidney transplantation, SPK, type 1 diabetes, insulin independence, pancreas-after-kidney transplant, islet transplant, pancreatitis, enteric-drained
Differential Diagnoses & Workup: Pancreas Transplantation