Three cases of pancreas allograft dysfunction

We present clincopathologic features of three cases of biopsy-proven pancre as allograft dysfunction in Korea. All patients had advanced insulin-depend ent diabetes mellitus (IDDM). Case 1 was a 30-year-old woman who underwent a simultaneous pancreas-kidney transplantation. Urinary infection developed 6 days after the operation, which remitted and reappeared, when urine amyl ase level was normal. Since the 55th day after the operation, intermittent hematuria has persisted. Cytomegalovirus inclusions were detected on the ur inary bladder and grafted duodenal mucosa. The graft was removed due to per foration of the grafted duodenum and panperitonitis. Case 2 was a 27-year-o ld man undergoing pancreas transplantation alone (PTA). Ten days after the transplatation, the level of 24 urine amylase decreased and the graft was n ot delineated by Tc-99m DTPA scintigraphy. Allograft needle biopsy revealed multiple acinar cell necrosis and mild lymphocytic infiltration which were compatible with mild acute rejection. Case 3 was a 25-year-old man undergo ing cadevaric PTA. Three months after the transplantation, graft was remove d due to gastric perforation associated with cytomegalovirus and angiodestr uctive fungal infection. Various causes of pancreas allograft dysfunction c an be diagnosed by needle biopsy, thus appropriate biopsy specimen should b e taken using improved biopsy technique.