Immunoreactive trypsinogen levels in pediatric patients with intestinal failure awaiting intestinal transplantation

The aim of this study was to evaluate pancreatic function in total parenter al nutrition (TPN)-dependent children with permanent intestinal failure by measuring immunoreactive trypsinogen (IRT) levels. Between 1992 and 1996, 1 05 pediatric patients with permanent intestinal failure were referred to th e Children's Hospital of Pittsburgh for small intestinal transplant evaluat ion. Serum samples were available from 55 of them. Ten suffered from intest inal pseudo-obstruction or microvillus inclusion disease, while 45 had shor t bowel syndrome (SBS). IRT levels were significantly higher (p < 0.001) in SBS patients (89.4 +/- 9.2 ng/mL) compared to controls (43.4 +/- 5.6 ng/mL ) without liver, gastrointestinal, or kidney disease. IRT levels did not co rrelate with liver injury, length of bowel, or the cause of SBS. Five of 20 patients who underwent intestinal transplantation developed pancreatitis d uring a median post-operative follow up 15.4 months later. IRT levels faile d to predict who would develop pancreatitis post-transplant. The data sugge st that elevated plasma IRT levels are common among children with intestina l failure, but fail to identify patients at risk for pancreatitis post-tran splant.