ABSTRACT
Background: The aim of this multicentre retrospective study is to determine the incidence, etiology, clinical characteristics, and outcomes of kidney transplant recipients diagnosed and treated for acute pancreatitis. Methods: We analyzed data from kidney transplant recipients who received kidney allografts between October 1973 and December 2023 and were diagnosed and treated for acute pancreatitis. Results: Of 2482 patients who received kidney allografts, 10 (0.4%) (5 male) were diagnosed with acute pancreatitis, with a mean age of 48.6 years. Patients were diagnosed with acute pancreatitis between 3 weeks and 24 years after the transplantation. Possible etiologies included cholecystolithiasis, COVID-19, hypercalcemia, postprocedural, use of cannabis, trimetoprim-sulphometoxasole, statins, sirolimus, tacrolimus and obesity. There was no suspected etiology in two patients. Patients were treated with aggressive hydration, pain alleviation and antibiotics if indicated. Four patients developed complications. Local complications included peripancreatic collections, pseudocyst, and abscesses formation, while systemic complications occurred in the form of Cytomegalovirus (CMV) reactivation and urinary tract infection. All patients survived with preserved kidney allograft function. Conclusions: Acute pancreatitis in kidney transplant recipients is rare. However, it may be linked to significant morbidity and mortality. While symptoms may be nonspecific and brought on by a variety of viral and non-infectious illnesses, as well as adverse effects from immunosuppressive medications, a high degree of awareness is required.
ABSTRACT
BACKGROUND: In Central/Eastern European countries, cerebrovascular diseases are among the leading causes of mortality. We aimed to determine the incidence of first-ever stroke (FES) in the north-western part of Croatia. METHODS: A population-based prospective incidence study was conducted between July 1, 2007, and June 30, 2009. Cases were sought from multiple overlapping sources. Incidence rates by stroke type and gender were calculated. RESULTS: A total of 1,487 events were recorded, 1,017 of which were FESs. European age-adjusted incidence rates (per 100,000 population) were: total FESs 223.6 [women/men rate ratio (w/m RR) = 0.65 (95% CI 0.57-0.73)]; ischemic stroke 162.4 (w/m RR = 0.65, 0.56-0.76); intracerebral hemorrhage 28.4 (w/m RR = 0.44, 0.30-0.63); subarachnoid hemorrhage 7.2 (w/m RR = 1.18, 0.55-2.54); unknown etiology 25.5 (w/m RR = 0.78, 0.54-1.14). Adjusted incidence rates of ischemic strokes by subtype were: cardioembolic 52.9 (w/m RR = 0.77, 0.59-0.99); large-artery atherosclerosis 14.4 (w/m RR = 0.22, 0.13-0.38); small-artery occlusion 24.5 (w/m RR = 0.53, 0.37-0.77) and 'other or uncertain causes' 70.6 (w/m RR = 0.77, 0.62-0.97). Thirty-day case-fatality rate was 23.5% overall and 17.1% for ischemic stroke. CONCLUSIONS: The incidence of FES and 30-day mortality of patients with ischemic strokes in the studied population is higher than in Western European countries.
