Nach morphologischen Kriterien finden sich nach der Reperfusion von Pankreastransplantaten Veränderungen, die den Intitialstadien der akuten Pankreatitis entsprechen. Zur Charakterisierung der Pathophysiologie der frühen Form der Transplantatpankreatitis wurden systematische Untersuchungen in 12 Fallen nach kombinierter Pankreas-/Nie-rentransplantation durchgeführt. Dabei wurden die Plasmaparameter Pankreas-Amylase, Lipase, p-Elastase, α1-Antitrypsin, α2-Makroglobulin, PMN-Elastase, Prothrombin, An-tithrombin III (AT III), Thrombin-Antithrombin-III-Kornplexe (TAT) und Präkallikrein bestimmt. Daneben wurden die Pankreassekretion (Volumen, p-Amylase) und Proben aus dem Effluat der Peritoneallavage (p-Amylase) untersucht. Die Ergebnisse zeigen, daβ es nach der Reperfusion von Pankreastransplantaten zu einem deutlichen Anstieg der Pankreasenzyme im Plasma bei zeitgleich deutlichem Abfall der Plasmaantiprotea-sen (α1-Antitrypsin, α2-Makroglobulin) kommt. Zudem besteht eine Aktivierung der Blutgerinnung und des Kallikrein-Kinin-Systems. Bei einer hohen Enzymkonzentration in der Lavageflüssigkeit ist die Pankreassekretion initial deutlich reduziert.

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