ACUTE-PANCREATITIS AFTER LIVER-TRANSPLANTATION - INCIDENCE AND CONTRIBUTING FACTORS

In order to assess the incidence and possible predisposing and contrib uting factors in the development of acute pancreatitis after liver tra nsplantation, we reviewed the medical records of all 1832 adult patien ts who underwent 2161 orthotopic liver transplantation (OLTx) procedur es in our center between January 1987 and September 1992. Of these pat ients, 55 (3 % incidence) developed clinical pancreatitis and 247 (13. 4 % incidence) developed hyperamylasemia (biochemical pancreatitis). O verall mortality in cases of clinical pancreatitis was 63.6 %. The mor tality in cases of hyperamylasemia was similar to that found in the ge neral liver transplant population (i, e., 23 %). A strong correlation was found between pancreatitis after liver transplantation and end-sta ge liver disease due to hepatitis B (30 % of the cases, P = 0.00001). Extensive surgical dissection around the pancreas (P < 0.05), the type of biliary reconstruction following liver transplantation (P < 0.05), and the number of liver grafts received by the same patient (P = 0.00 001) appeared to be possible contributing factors as did the duration of venovenous bypass and the quantity of IV calcium chloride administe red intraoperatively.