Acute pancreatitis after cardiac transplantation and other cardiac procedures: Case-control analysis in 24,631 patients

A. J. Herline, C. W. Pinson, J. K. Wright, J. Debelak, Yu Shyr, D. Harley, W. Merrill, T. Starkey, R. Pierson, William C. Chapman

研究成果: Article

22 引文 斯高帕斯(Scopus)

摘要

Previous series have identified an increased risk of developing acute postoperative pancreatitis in heart transplant recipients and other cardiac surgical patients, and some suggest that mortality is significantly increased when pancreatitis occurs in the transplant setting. We conducted a retrospective case-control analysis of adult patients undergoing orthotopic heart transplant or other cardiac procedures from April 1985 through June 1996 at our medical center. Specific risk factors for outcome were assessed including low cardiac output, intra-aortic balloon pump usage, exogenous calcium repletion, immunosuppression, cytomegalovirus infection, cholelithiasis, prior pancreatitis, and Acute Physiology and Chronic Health Evaluation (APACHE) II scores. There was a 30-fold increase in the incidence of pancreatitis in the heart transplant group [12 of 394 (3%) vs 27 of 24,237 (0.1%); P < 0.01]. Compared with the nontransplant cardiopulmonary bypass patients, the transplant patients experienced a statistically significant increased incidence of immunosuppression and three or more risk factors. Transplant patients with pancreatitis demonstrated a significant increase in APACHE II scores and the incidence of three or more risk factors compared with their transplant control group. Patients undergoing nontransplant cardiac procedures and developing pancreatitis had significantly increased crossclamp times, incidence of low cardiac output, APACHE II scores, and incidence of three or more risk factors compared with their nontransplant cohort. In conclusion, there is a significant increase in the incidence of pancreatitis after orthotopic heart transplant compared with other cardiac procedures. Analysis demonstrates the additive effect of multiple individual risk factors. Immunosuppression confers significant additional risk for pancreatitis in the orthotopic heart transplant patient.

原文English
頁(從 - 到)819-826
頁數8
期刊American Surgeon
65
發行號9
出版狀態Published - 1999 九月 1

All Science Journal Classification (ASJC) codes

  • Surgery

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    Herline, A. J., Pinson, C. W., Wright, J. K., Debelak, J., Shyr, Y., Harley, D., Merrill, W., Starkey, T., Pierson, R., & Chapman, W. C. (1999). Acute pancreatitis after cardiac transplantation and other cardiac procedures: Case-control analysis in 24,631 patients. American Surgeon, 65(9), 819-826.