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01-07-2010

Impact of Peritoneal Dialysis Versus Hemodialysis on Incidence of Intra-abdominal Infection After Simultaneous Pancreas–Kidney Transplant

Authors: Javier Padillo-Ruiz, Alvaro Arjona-Sánchez, Cristobal Muñoz-Casares, Juan Ruiz-Rabelo, Maria Dolores Navarro, Juan C. Regueiro

Published in: World Journal of Surgery | Issue 7/2010

Abstract

Background

Whether peritoneal dialysis is a risk factor for the development of intra-abdominal infection after simultaneous pancreas–kidney (SPK) transplantation is controversial.

Methods

We investigated the incidence of intra-abdominal infection and graft survival rates in 100 patients who underwent SPK transplantation. Prior to transplantation, 25 patients received peritoneal dialysis (PD) and 75 received hemodialysis (HD); mean duration of dialysis was 25 ± 35 months and 17 ± 10 months, respectively.

Results

The two groups displayed similar gender distribution, cold ischemia time, dialysis duration, diabetes duration, and method of exocrine drainage. Intra-abdominal infections developed in 23 patients in the HD group (30%) and in 6 (24%) patients in the PD group (P = 0.41). In the HD group, 61% of patients with intra-abdominal infections had grades 3 and 4 complications requiring surgery, compared with only 33% in the PD group. The 1-year pancreas graft survival rate was 88% for HD and 94% for PD (P = 0.67) (mean follow-up = 55 ± 38 months). There were no significant intergroup differences in acute rejection episodes, kidney graft survival rates, or length of hospital stay.

Conclusions

In our experience, PD prior to SPK transplantation is not associated with increased incidence of intra-abdominal infection compared to HD.

Agüera ML, Navarro MD, Pérez Calderon R et al (2007) Simultaneous pancreas–kidney transplant: a single-center long-term outcome. J Nephrol 20:173–176PubMed

Arjona A, Martínez-Cecilia D, Ruiz-Rabelo JF et al (2009) One hundred one simultaneous pancreas–kidney transplants: a single-center long-term outcome. Transplant Proc 41:2463–2465CrossRefPubMed

Demartines N, Schiesser M, Clavien PA (2005) An evidence-based analysis of simultaneous pancreas–kidney and pancreas transplantation alone. Am J Transplant 5:2688–2697CrossRefPubMed

Becker BN, Brazy PC, Becker YT et al (2000) Simultaneous pancreas–kidney transplantation reduces excess mortality in type 1 diabetic patients with end-stage renal disease. Kidney Int 57:2129–2131CrossRefPubMed

Knight RJ, Bodian C, Rodriguez-Laiz G et al (2000) Risk factors for intraabdominal infection after pancreas transplantation. Am J Surg 179(2):99–102CrossRefPubMed

Kim RD, Oreopoulos DG, Qiu K et al (2005) Impact of mode of dialysis on intra-abdominal infection after simultaneous pancreas–kidney transplantation. Transplantation 80(3):339–343CrossRefPubMed

Sollinger HW, Odorico JS, Knechtle SJ et al (1998) Experience with 500 simultaneous pancreas–kidney transplants. Ann Surg 228(3):284–296CrossRefPubMed

Malaise J, Squifflet JP, Van Ophem D et al (2002) Influence of type of renal replacement therapy on peritonitis rate after simultaneous pancreas–kidney transplantation. Transplant Proc 34:2823–2827CrossRefPubMed

Nakache R, Weinbroum A, Breitman I et al (2001) Surgical risk of pancreas transplantation: the influence of pretransplant management with peritoneal dialysis. Trasplant Proc 33:2947–2951CrossRef

10.

Douzdjian V, Abbecassis M (1995) Deep wound infections in simultaneous pancreas–kidney transplantation recipient on peritoneal dialysis. Nephrol Dial Transplant 10:533–536PubMed

11.

US Renal Data System (2003) Excerpts from the USRDS 2002 Annual Data Report: atlas of end-stage renal disease in the United States. Am J Kideny Dis 41(Suppl 2):S1–S260

12.

Troidle L, Gorban-Brennan N, Kliger A et al (2003) Continuous peritoneal dialysis-associated peritonitis: a review and current concepts. Semin Dial 16:428–433CrossRefPubMed

13.

Everett JE, Wahoff DC, Statz C et al (1994) Characterization and impact of wound infection after pancreas transplantation. Arch Surg 129:1310–1317PubMed

14.

Padillo FJ, Regueiro JC, Canis M et al (1999) Percutaneous management of a high-output duodenal fistula after pancreas transplantation using occluding coiled embolus and fibrin sealant. Transplant Proc 31:1715–1716CrossRefPubMed

15.

Goldfarb-Rumyantzev AS, Hurdle JF, Scandling JD et al (2005) The role of pretransplantation renal replacement therapy modality in kidney allograft and recipient survival. Am J Kidney Dis 46:537–549CrossRefPubMed

16.

Van Biesen W, Veys N, Vanholder R et al (2006) The impact of pre-transplant renal replacement modality on outcome after cadaveric kidney transplantation: the Ghent experience. Contrib Nephrol 150:254–258CrossRefPubMed

Title: Impact of Peritoneal Dialysis Versus Hemodialysis on Incidence of Intra-abdominal Infection After Simultaneous Pancreas–Kidney Transplant
Authors: Javier Padillo-Ruiz
Alvaro Arjona-Sánchez
Cristobal Muñoz-Casares
Juan Ruiz-Rabelo
Maria Dolores Navarro
Juan C. Regueiro
Publication date: 01-07-2010
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 7/2010
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-010-0527-z

At a glance: The STEP trials

Springer Medicine

Impact of Peritoneal Dialysis Versus Hemodialysis on Incidence of Intra-abdominal Infection After Simultaneous Pancreas–Kidney Transplant

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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