Tacrolimus and Indomethacin for Reducing Post-ERCP Pancreatitis in Liver Transplant Recipients

Both drugs showed protective effects, and indomethacin use magnified the benefit of tacrolimus at therapeutic levels.

Patients who have undergone liver transplantation often require endoscopic retrograde cholangiopancreatography (ERCP) in the postoperative period to treat common surgical adverse events, most notably biliary strictures and leaks. As these patients are often quite ill, reducing risk for post-ERCP pancreatitis (PEP) is a priority. A recent study retrospectively evaluated the effectiveness of both rectal indomethacin and the immunosuppressant tacrolimus in achieving this goal. Results were as follows:

Of 937 ERCP procedures analyzed (performed in 342 patients), PEP developed following 21 procedures (2.2%; case severity: 7 mild, 12 moderate, 2 severe).
In patients taking tacrolimus, PEP occurrence varied by drug trough level (≤2.5 ng/mL, 7.5%; >2…

Reviewing Author

Douglas G. Adler, MD, FACG, AGAF, FASGE

Disclosures

Consultant/Advisory BoardBSC; Merit; Olympus

Speaker’s BureauAbbVie

Editorial BoardsGastrointestinal Endoscopy

Douglas G. Adler, MD, FACG, AGAF, FASGE

Disclosures

Consultant/Advisory BoardBSC; Merit; Olympus

Speaker’s BureauAbbVie

Editorial BoardsGastrointestinal Endoscopy

Tacrolimus and Indomethacin for Reducing Post-ERCP Pancreatitis in Liver Transplant Recipients

Topics

Reviewing Author