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 30, 2007

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

References

  1. Hakim NS. Recent developments and future prospects in pancreatic transplantation. Exp Clin Transplant. Jun 2003;1(1):26-34. [Medline].

  2. 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].

  3. 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].

  4. 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].

  5. 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

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, University of Pittsburgh; 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: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Douglas M Heuman, MD, FACP, Director of Hepatology, McGuire Veterans Affairs Medical Center, Professor, Department of Internal Medicine, Division of Gastroenterology, Virginia Commonwealth University School of Medicine
Douglas M Heuman, MD, FACP 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.

CME Editor

Michael E Zevitz, MD, Assistant Professor of Medicine, Finch University of the Health Sciences, The Chicago Medical School; Consulting Staff, Private Practice
Michael E Zevitz, MD is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Medical Association, and Michigan State Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Mary C Mancini, MD, PhD, Director of Cardiothoracic Transplantation, Professor, Department of Surgery, Louisiana State University Health Sciences Center
Mary C Mancini, MD, PhD is a member of the following medical societies: American Heart Association, American Medical Association, American Thoracic Society, Association for Academic Surgery, Association for Surgical Education, International College of Surgeons, International Society for Heart and Lung Transplantation, New York Academy of Sciences, Phi Beta Kappa, and Southern Thoracic Surgical Association
Disclosure: Nothing to disclose.

 
 
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