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 not consistently reliable. The purpose of this study was to evaluate the ability of sAT to predict acute rejection as compared to serum creatinine (sCr), urinary amylase (uAmy) and serum amylase (sAmy). Eleven first-time acute rejection episodes in bladder-drained SPK recipients were studied. All rejection episodes were biopsy-proven (core kidney 9, fine needle kidney 2, fine needle pancreas 5). Sera obtained from days -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 trough levels occurred on days -4, -5 and +2. The difference between pre-treatment 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 between day 0 levels and post-treatment levels significant. Both sAmy (0.87) and sCr (0.85) demonstrated positive correlation when compared to sAT whereas uAmy demonstrated a weak negative correlation (-0.24). This study confirms that sAT accurately predicts rejection after SPK transplantation.