Acute pancreatitis risk after kidney transplantation: Propensity score matching analysis of a national cohort

• Published in: PloS one Vol. 14; no. 9; p. e0222169
• Main Authors: Chuang, Ya-Wen, Huang, Shih-Ting, Yu, Tung-Min, Li, Chi-Yuan, Chung, Mu-Chi, Lin, Cheng-Li, Chang, Chi-Sen, Wu, Ming-Ju, Kao, Chia-Hung
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 11.09.2019; Public Library of Science (PLoS)
• Subjects: Adult; Alcohol; Alcohols; Biology and Life Sciences; Calculi; Care and treatment; Clinical trials; Cohort analysis; Cytomegalovirus; Databases, Factual; Diabetes; Epidemiology; Fatalities; Female; Gallstones; Health; Health aspects; Hemodialysis; Hepatitis; Hospitals; Humans; Hyperlipidemia; Illnesses; Incidence; Insurance; Kidney diseases; Kidney transplantation; Kidney Transplantation - adverse effects; Kidney transplants; Kidneys; Matching; Medical research; Medicine; Medicine and Health Sciences; Middle Aged; Mortality; National health insurance; Nephrology; Online databases; Organ transplant recipients; Organ transplantation; Pancreas; Pancreatitis; Pancreatitis - epidemiology; Pancreatitis - etiology; Patients; Population; Propensity Score; Public health; Research and Analysis Methods; Retrospective Studies; Risk; Risk Assessment; Risk factors; Studies; Surgery; Taiwan - epidemiology; Transplantation; Transplants & implants; Viral infections; Taiwan; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0222169

Data for elucidating post-kidney transplantation (KT) acute pancreatitis (AP) risk are limited and no large-scale cohort study has investigated the impact of AP after KT. Data from Taiwan National Health Insurance (NHI) Research Database (NHIRD) were calculated through the method of propensity score matching to compare the pancreatitis risk in patients with and without KT. The overall pancreatitis incidence rates were 1.71 and 0.61 per 1,000 person-years in the KT and non-KT groups, respectively and corresponding adjusted HR (aHR [95% CI]) for pancreatitis was 2.48 (1.51-4.09) in the KT group. In the multivariable model, AP risk was higher in transplant patients with alcohol-related illnesses (aHR: 3.78, 95% CI: 1.32-10.8), gall stone disease (aHR: 3.53, 95% CI: 1.48-8.44), or past history of pancreatitis (aHR: 10.3, 95% CI: 5.08-20.8). Of note, recurrent AP risk was significantly higher in the KT group (aHR: 8.19, 95% CI: 2.89-23.2). Patients with post-KT AP demonstrated shorter patient and allograft survival than did those without (both P < 0.001, respectively). In conclusion, KT recipients are very likely to be associated with AP. Moreover, their inferior outcomes are strongly associated with post-KT AP.