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, Y. Shyr, D. Harley, W. Merrill, T. Starkey, R. Pierson, William C. Chapman

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)819-826
Number of pages8
JournalAmerican Surgeon
Volume65
Issue number9
StatePublished - Sep 1 1999
Externally publishedYes

Fingerprint

Heart Transplantation
Pancreatitis
Transplants
APACHE
Incidence
Immunosuppression
Low Cardiac Output
Cholelithiasis
Cytomegalovirus Infections
Cardiopulmonary Bypass
Calcium
Control Groups
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Herline, A. J., Pinson, C. W., Wright, J. K., Debelak, J., Shyr, Y., Harley, D., ... 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.

Acute pancreatitis after cardiac transplantation and other cardiac procedures : Case-control analysis in 24,631 patients. / Herline, A. J.; Pinson, C. W.; Wright, J. K.; Debelak, J.; Shyr, Y.; Harley, D.; Merrill, W.; Starkey, T.; Pierson, R.; Chapman, William C.

In: American Surgeon, Vol. 65, No. 9, 01.09.1999, p. 819-826.

Research output: Contribution to journalArticle

Herline, AJ, Pinson, CW, Wright, JK, Debelak, J, Shyr, Y, Harley, D, Merrill, W, Starkey, T, Pierson, R & Chapman, WC 1999, 'Acute pancreatitis after cardiac transplantation and other cardiac procedures: Case-control analysis in 24,631 patients', American Surgeon, vol. 65, no. 9, pp. 819-826.
Herline AJ, Pinson CW, Wright JK, Debelak J, Shyr Y, Harley D et al. Acute pancreatitis after cardiac transplantation and other cardiac procedures: Case-control analysis in 24,631 patients. American Surgeon. 1999 Sep 1;65(9):819-826.
Herline, A. J. ; Pinson, C. W. ; Wright, J. K. ; Debelak, J. ; Shyr, Y. ; Harley, D. ; Merrill, W. ; Starkey, T. ; Pierson, R. ; Chapman, William C. / Acute pancreatitis after cardiac transplantation and other cardiac procedures : Case-control analysis in 24,631 patients. In: American Surgeon. 1999 ; Vol. 65, No. 9. pp. 819-826.
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