MARKERS FOR PANCREATIC ALLOGRAFT-REJECTION - COMPARISON OF SERUM ANODAL TRYPSINOGEN, SERUM AMYLASE, SERUM CREATININE AND URINARY AMYLASE

Currently, the markers of acute rejection in pancreas allografts are n ot consistently reliable. The purpose of this study was to evaluate th e ability of sAT to predict acute rejection as compared to serum creat inine (sCr), urinary amylase (uAmy) and serum amylase (sAmy). Eleven f irst-time acute rejection episodes in bladder-drained SPK recipients w ere studied. All rejection episodes were biopsy-proven (core kidney 9, fine needle kidney 2, fine needle pancreas 5). Sera obtained from day s -7 to -1 (pre-treatment), day 0 (start of anti-rejection treatment), and +1 to +7 (post-treatment) periods were analyzed. Peak median sAT and sAmy levels occurred at day 0 compared to day 1 for sCr. uAmy trou gh levels occurred on days -4, -5 and +2. The difference between pre-t reatment levels and those on day 0 were significant for sAT, sAmy and sCr but not for uAmy. Only in the case of sAT was the difference betwe en day 0 levels and post-treatment levels significant. Both sAmy (0.87 ) and sCr (0.85) demonstrated positive correlation when compared to sA T whereas uAmy demonstrated a weak negative correlation (-0.24). This study confirms that sAT accurately predicts rejection after SPK transp lantation.