eMedicine Specialties > Transplantation > Surgery

Pancreas Transplantation: Differential Diagnoses & Workup

Author: Dixon B Kaufman, MD, PhD, Director of Pancreas Transplantation, Professor, Department of Surgery, Division of Transplantation, Feinberg School of Medicine, Northwestern University
Contributor Information and Disclosures

Updated: Nov 11, 2009

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
[ CLOSE WINDOW ]

References

  1. 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].

  2. Ziaja J, Bozek-Pajak D, Kowalik A, Krol R, Cierpka L. Impact of pancreas transplantation on the quality of life of diabetic renal transplant recipients. Transplant Proc. Oct 2009;41(8):3156-8. [Medline].

  3. Decker E, Coimbra C, Weekers L, et al. A retrospective monocenter review of simultaneous pancreas-kidney transplantation. Transplant Proc. Oct 2009;41(8):3389-92. [Medline].

  4. McCullough KP, Keith DS, Meyer KH, Stock PG, Brayman KL, Leichtman AB. Kidney and pancreas transplantation in the United States, 1998-2007: access for patients with diabetes and end-stage renal disease. Am J Transplant. Apr 2009;9(4 Pt 2):894-906. [Medline].

  5. 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].

  6. 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].

  7. United Network for Organ Sharing (UNOS). United Network for Organ Sharing (UNOS). [Full Text].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

pancreas transplantation, pancreas allotransplantation, simultaneous pancreas-kidney transplantation, SPK, type 1 diabetes, insulin independence, pancreas-after-kidney transplant, islet transplant, pancreatitis, enteric-drained

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Dixon B Kaufman, MD, PhD, Director of Pancreas Transplantation, Professor, Department of Surgery, Division of Transplantation, Feinberg School of Medicine, Northwestern University
Dixon B Kaufman, MD, PhD is a member of the following medical societies: American College of Surgeons, American Society of Transplant Surgeons, American Surgical Association, Association for Academic Surgery, Central Surgical Association, National Kidney Foundation, Phi Beta Kappa, and Society of University Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Ron Shapiro, MD, Professor of Surgery, Robert J Corry Chair in Transplantation Surgery, Director, Kidney, Pancreas, and Islet Transplantation, Thomas E Starzl Transplantation Institute, University of Pittsburgh Medical Center
Ron Shapiro, MD is a member of the following medical societies: American College of Surgeons, American Society of Transplant Surgeons, Association for Academic Surgery, Central Surgical Association, and Society of University Surgeons
Disclosure: Astellas Honoraria Speaking and teaching; Brystol Meyer Squibb StemCell Data Monitoring Committee Consulting fee Review panel membership; Wyeth Honoraria Speaking and teaching; Stem Cells, Inc Consulting fee Review panel membership; Up To Date contracted Author; Medscape contracted Video Blogger

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Douglas M Heuman, MD, FACP, FACG, AGAF, Chief of Hepatology, Hunter Holmes McGuire Department of Veterans Affairs Medical Center; Professor, Department of Internal Medicine, Division of Gastroenterology, Virginia Commonwealth University School of Medicine
Douglas M Heuman, MD, FACP, FACG, AGAF is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Physicians, and American Gastroenterological Association
Disclosure: Nothing to disclose.

Chief Editor

Mary C Mancini, MD, PhD, Professor and Chief, Cardiothoracic Surgery, Department of Surgery, Louisiana State University Health Sciences Center-Shreveport
Mary C Mancini, MD, PhD is a member of the following medical societies: American Association for Thoracic Surgery, American College of Surgeons, American Surgical Association, Phi Beta Kappa, Society of Thoracic Surgeons, and Southern Surgical Association
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.