64 Acute Pancreatitis Outcomes May Not Be Worse in Post-Transplant Patients

Abstract

INTRODUCTION: The average incidence of acute pancreatitis (AP) in patients with a history of solid organ transplant ranges from 2 to 8%. Patients with a history of bone marrow transplant are reported to have an incidence of 4%. Presentations include “chemical” pancreatitis with enzymes elevation only and clinical pancreatitis according to the revised Atlanta criteria. A few previous studies have shown that multi-organ failure and death are frequent complications of AP in transplanted patients. Most of the studies individualize their findings based on a specific organ transplanted (such as kidney or heart or liver, etc.) The aim of our study was to evaluate the outcomes of patients with acute pancreatitis with a history of any solid organ or bone marrow transplant using a national database. METHODS: We performed a retrospective cross-sectional analysis using the National Inpatient Sample (NIS) database from 2014. We included all patients with acute pancreatitis (ICD 9 Code: 577.0). Next, we divided the AP patients into two groups - one with history of a transplant and those without a history of transplant. We compared the outcomes of both groups. Both univariable and multivariable analyses were performed to assess the risk factors and outcomes of patients with acute pancreatitis in post transplant patients. RESULTS: We analyzed more than 35 million US hospitalizations in 2014 out of which 279,145 were acute pancreatitis related hospitalizations. There were 1,265 hospitalizations for acute pancreatitis in previously transplanted patients, an incidence of 4.53%. The mortality rate of AP was similar in non-transplanted patients (0.66%) than in transplanted patients (0.4%). The mean length of stay (4.62 days vs. 4.61 days) and mean total charges ($35,723 vs. $31,202) were similar in acute pancreatitis for transplant and non-transplant patients. Multivariable regression analysis showed that multiorgan dysfunction risk among AP patients was significantly higher if they had a history of transplant (OR of 2.27; P < 0.01). CONCLUSION: Our study showed that AP generally has similar outcomes in transplant and non-transplant patients even with a higher risk of multiorgan failure. More data is needed to determine if this holds true for subjects who develop AP in the immediate post transplant period.