Top

Published in:

Open Access 01-12-2020 | Relaparotomy | Research

Impact of pre-transplant dialysis modality on the outcome and health-related quality of life of patients after simultaneous pancreas-kidney transplantation

Authors: Uwe Scheuermann, Sebastian Rademacher, Nora Jahn, Elisabeth Sucher, Daniel Seehofer, Robert Sucher, Hans-Michael Hau

Published in: Health and Quality of Life Outcomes | Issue 1/2020

Abstract

Background

Simultaneous pancreas-kidney transplantation (SPKT) profoundly improves the health-related quality of life (HRQoL) of recipients. However, the influence of the pre-transplant dialysis modality on the success of the SPKT and post-transplant HRQoL remains unknown.

Methods

We analyzed the surgical outcome, long-term survival, as well as HRQoL of 83 SPKTs that were performed in our hospital between 2000 and 2016. Prior to transplant, 64 patients received hemodialysis (HD) and nineteen patients received peritoneal dialysis (PD). Physical and mental quality of life results from eight basic scales and the physical and mental component summaries (PCS and MCS) were measured using the Short Form 36 (SF-36) survey.

Results

Peri- and postoperative complications, as well as patient and graft survival were similar between the two groups. Both groups showed an improvement of HRQoL in all SF-36 domains after transplantation. Compared with patients who received HD before transplantation, PD patients showed significantly better results in four of the eight SF-36 domains: physical functioning (mean difference HD - PD: − 12.4 ± 4.9, P = < 0.01), bodily pain (− 14.2 ± 6.3, P < 0.01), general health (− 6.3 ± 2.8, P = 0.04), vitality (− 6.8 ± 2.6, P = 0.04), and PCS (− 5.2 ± 1.5, P < 0.01) after SPKT. In the overall study population, graft loss was associated with significant worsening of the HRQoL in all physical components (each P < 0.01).

Conclusions

The results of this analysis show that pre-transplant dialysis modality has no influence on the outcome and survival rate after SPKT. Regarding HRQoL, patients receiving PD prior to SPKT seem to have a slight advantage compared with patients with HD before transplantation.

Dean PG, Kudva YC, Stegall MD. Long-term benefits of pancreas transplantation. Curr Opin Organ Transplant. 2008;13(1):85–90. https://doi.org/10.1097/MOT.0b013e3282f2fd7f Review. PubMed PMID: 18660712.CrossRefPubMed

Mohan P, Safi K, Little DM, Donohoe J, Conlon P, Walshe JJ, O'Kelly P, Thompson CJ, Hickey DP. Improved patient survival in recipients of simultaneous pancreas-kidney transplant compared with kidney transplant alone in patients with type 1 diabetes mellitus and end-stage renal disease. Br J Surg. 2003;90(9):1137–41 PubMed PMID: 12945083.CrossRef

Sollinger HW, Odorico JS, Becker YT, D’Alessandro AM, Pirsch JD. One thousand simultaneous pancreas-kidney transplants at a single center with 22-year follow-up. Ann Surg. 2009;250:618–30.PubMed

Sutherland DE, Gruessner RW, Dunn DL, Matas AJ, Humar A, Kandaswamy R, Mauer SM, Kennedy WR, Goetz FC, Robertson RP, Gruessner AC, Najarian JS. Lessons learned from more than 1,000 pancreas transplants at a single institution. Ann Surg. 2001;233(4):463–501 Review. PubMed PMID: 11303130; PubMed Central PMCID: PMC1421277.CrossRef

Van Dellen D, Worthington J, Mitu-Pretorian OM, Ghazanfar A, Forgacs B, Pararajasingam R, Campbell B, Parrott NR, Augustine T, Tavakoli A. Mortality in diabetes: pancreas transplantation is associated with significant survival benefit. Nephrol Dial Transplant. 2013;28(5):1315–22. https://doi.org/10.1093/ndt/gfs613 Epub 2013 Mar 19. PubMed PMID: 23512107.CrossRefPubMed

White SA, Shaw JA, Sutherland DE. Pancreas transplantation. Lancet. 2009;373(9677):1808–17. https://doi.org/10.1016/S0140-6736(09)60609-7 Review. PubMed PMID: 19465236.CrossRefPubMed

Fischer A. Hemo- and peritoneal dialysis: what non-nephrologists should know. Ther Umsch. 2018;75(6):387–94. https://doi.org/10.1024/0040-5930/a001013 Review. German. PubMed PMID: 30880624.CrossRefPubMed

Cozzolino M, Mangano M, Stucchi A, Ciceri P, Conte F, Galassi A. Cardiovascular disease in dialysis patients. Nephrol Dial Transplant. 2018;33(suppl_3):iii28–34. https://doi.org/10.1093/ndt/gfy174 Review. PubMed PMID: 30281132; PubMed Central PMCID: PMC6168816.CrossRefPubMedPubMedCentral

Mehrotra R, Devuyst O, Davies SJ, Johnson DW. The current state of peritoneal Dialysis. J Am Soc Nephrol. 2016;27(11):3238–52 Epub 2016 Jun 23. Review. PubMed PMID: 27339663; PubMed Central PMCID: PMC5084899.CrossRef

10.

Isla Pera P, Moncho Vasallo J, Torras Rabasa A, Oppenheimer Salinas F. Fernández Cruz Pérez L, Ricart Brulles MJ. Quality of life in simultaneous pancreas-kidney transplant recipients. Clin Transpl. 2009;23(5):600–5. https://doi.org/10.1111/j.1399-0012.2009.01054.x Epub 2009 Aug 11. PubMed PMID: 19674015.CrossRef

11.

Martins LS, Outerelo C, Malheiro J, Fonseca IM, Henriques AC, Dias LS, Rodrigues AS, Cabrita AM, Noronha IL. Health-related quality of life may improve after transplantation in pancreas-kidney recipients. Clin Transpl. 2015;29(3):242–51. https://doi.org/10.1111/ctr.12511 Epub 2015 Jan 30. PubMed PMID: 25581297.CrossRef

12.

Rajkumar T, Mazid S, Vucak-Dzumhur M, Sykes TM, Elder GJ. Health-related quality of life following kidney and simultaneous pancreas kidney transplantation. Nephrology (Carlton) 2019 Sep;24(9):975–982. doi: https://doi.org/10.1111/nep.13523. Epub 2019 Apr 29. PubMed PMID: 30393905.

13.

Sureshkumar KK, Patel BM, Markatos A, Nghiem DD, Marcus RJ. Quality of life after organ transplantation in type 1 diabetics with end-stage renal disease. Clin Transpl. 2006;20(1):19–25 PubMed PMID: 16556148.CrossRef

14.

Eurotransplant. Chapter 9: The Donor. https://eurotransplant.org/cms/mediaobject.php?file=H9+The+Donor_August+20161.pdf. Accessed 19 Jan 2020.

15.

Ladurner R, Steurer W. Technik der Multiorganentnahme. Viszeralchirurgie. 2004;39:439–42.CrossRef

16.

Sollinger HW, Odorico JS, Knechtle SJ, D’Alessandro AM, Kalayoglu M, Pirsch JD. Experience with 500 simultaneous pancreas-kidney transplants. Ann Surg. 1998;228:284–96.CrossRef

17.

Dholakia S, Mittal S, Quiroga I, Gilbert J, Sharples EJ, Ploeg RJ, et al. Pancreas transplantation: past, present, future. Am J Med. 2016;129:667–73.CrossRef

18.

Pérez-Sáez MJ, Toledo K, Navarro MD, Redondo MD, León C, Arjona A, Agüera ML, Rodríguez-Benot A, Aljama P. Long-term survival of simultaneous pancreas-kidney transplantation: influence of early posttransplantation complications. Transplant Proc. 2011;43(6):2160–4. https://doi.org/10.1016/j.transproceed.2011.05.025 PubMed PMID: 21839221.CrossRefPubMed

19.

Binaut R, Hazzan M, Pruvot FR, Dracon M, Lelièvre G, Noël C. Comparative study of chronic ambulatory peritoneal dialysis versus hemodialysis patients after kidney transplantation: clinical and financial assessment. Transplant Proc. 1997;29(5):2428 PubMed PMID: 9270795.CrossRef

20.

Martins LS, Malheiro J, Pedroso S, Almeida M, Dias L, Henriques AC, Silva D, Davide J, Cabrita A, Noronha IL, Rodrigues A. Pancreas-kidney transplantation: impact of dialysis modality on the outcome. Transpl Int 2015 Aug;28(8):972–979. doi: https://doi.org/10.1111/tri.12565. Epub 2015 Apr 8. PubMed PMID: 25790131.

21.

Kim RD, Oreopoulos DG, Qiu K, McGilvray ID, Greig PD, Wright E, Grant DR, Cattral MS. Impact of mode of dialysis on intra-abdominal infection after simultaneous pancreas-kidney transplantation. Transplantation. 2005;80(3):339–43 PubMed PMID: 16082329.CrossRef

22.

Marcacuzco A, Jiménez-Romero C, Manrique A, Calvo J, Cambra F, Caso Ó, García-Sesma Á, Nutu A, Justo I. Outcome of patients with hemodialysis or peritoneal dialysis undergoing simultaneous pancreas-kidney transplantation. Comparative study. Clin Transplant 2018 Jun;32(6):e13268. doi: https://doi.org/10.1111/ctr.13268. Epub 2018 May 17. PubMed PMID: 29683218.

23.

Padillo-Ruiz J, Arjona-Sánchez A, Muñoz-Casares C, Ruiz-Rabelo J, Navarro MD, Regueiro JC. Impact of peritoneal dialysis versus hemodialysis on incidence of intra-abdominal infection after simultaneous pancreas-kidney transplant. World J Surg 2010 Jul;34(7):1684–1688. doi: https://doi.org/10.1007/s00268-010-0527-z. PubMed PMID: 20300749.

24.

Räihä J, Helanterä I, Ekstrand A, Nordin A, Sallinen V, Lempinen M. Effect of Pretransplant Dialysis Modality on Outcomes After Simultaneous Pancreas-Kidney Transplantation. Ann Transplant. 2019;24:426–31. https://doi.org/10.12659/AOT.916649 PubMed PMID: 31320604; PubMed Central PMCID: PMC6668491.CrossRefPubMedPubMedCentral

25.

Ojo AO, Hanson JA, Wolfe RA, Agodoa LY, Leavey SF, Leichtman A, Young EW, Port FK. Dialysis modality and the risk of allograft thrombosis in adult renal transplant recipients. Kidney Int 1999 May;55(5):1952–1960. PubMed PMID: 10231459.

26.

Snyder JJ, Kasiske BL, Gilbertson DT, Collins AJ. A comparison of transplant outcomes in peritoneal and hemodialysis patients. Kidney Int. 2002;62(4):1423–30 PubMed PMID: 12234315.CrossRef

27.

Zazzeroni L, Pasquinelli G, Nanni E, Cremonini V, Rubbi I. Comparison of quality of life in patients undergoing hemodialysis and peritoneal Dialysis: a systematic review and meta-analysis. Kidney Blood Press Res 2017;42(4):717–727. doi: https://doi.org/10.1159/000484115. Epub 2017 Oct 19. Review. PubMed PMID: 29049991.

28.

Kalender B, Ozdemir AC, Dervisoglu E, Ozdemir O. Quality of life in chronic kidney disease: effects of treatment modality, depression, malnutrition and inflammation. Int J Clin Pract. 2007;61(4):569–76 Epub 2007 Jan 29. PubMed PMID: 17263698.CrossRef

29.

Polinder-Bos HA, García DV, Kuipers J, Elting JWJ, Aries MJH, Krijnen WP, Groen H, Willemsen ATM, van Laar PJ, Strijkert F, Luurtsema G, Slart RHJA, Westerhuis R, Gansevoort RT, Gaillard CAJM, Franssen CFM. Hemodialysis Induces an Acute Decline in Cerebral Blood Flow in Elderly Patients. J Am Soc Nephrol. 2018;29(4):1317–25. https://doi.org/10.1681/ASN.2017101088 Epub 2018 Mar 1. Erratum in: J Am Soc Nephrol. 2018 Aug;29(8):2256. PubMed PMID: 29496888; PubMed Central PMCID: PMC5875962.CrossRefPubMedPubMedCentral

30.

Murray AM, Tupper DE, Knopman DS, Gilbertson DT, Pederson SL, Li S, Smith GE, Hochhalter AK, Collins AJ, Kane RL. Cognitive impairment in hemodialysis patients is common. Neurology. 2006;67(2):216–23 Erratum in: Neurology. 2007 Jul 3;69(1):120. PubMed PMID: 16864811.CrossRef

31.

Van Biesen W, Vanholder RC, Veys N, Dhondt A, Lameire NH. An evaluation of an integrative care approach for end-stage renal disease patients. J Am Soc Nephrol. 2000;11(1):116–25. 10616847.PubMed

32.

Sapilak BJ. Assessment of severity of symptoms of anxiety and depression and quality of life of patients chronically treated with renal replacement therapy. In: Applications of statistical methods scientific research, III StatSoft; 2008.

33.

Smith GC, Trauer T, Kerr PG, Chadban SJ. Prospective quality-of-life monitoring of simultaneous pancreas and kidney transplant recipients using the 36-item short form health survey. Am J Kidney Dis 2010 Apr;55(4):698–707. doi: https://doi.org/10.1053/j.ajkd.2009.12.025. Epub 2010 Feb 21. PubMed PMID: 20176426.

34.

Maglakelidze N, Pantsulaia T, Tchokhonelidze I, Managadze L, Chkhotua A. Assessment of health-related quality of life in renal transplant recipients and dialysis patients. Transplant Proc 2011 Jan-Feb;43(1):376–379. doi:https://doi.org/10.1016/j.transproceed.2010.12.015. PubMed PMID: 21335226.

35.

Drognitz O, Benz S, Pfeffer F, Fischer C, Makowiec F, Schareck W, Hopt UT. Long-term follow-up of 78 simultaneous pancreas-kidney transplants at a single-center institution in Europe. Transplantation. 2004;78(12):1802–8 PubMed PMID: 15614154.CrossRef

Title: Impact of pre-transplant dialysis modality on the outcome and health-related quality of life of patients after simultaneous pancreas-kidney transplantation
Authors: Uwe Scheuermann
Sebastian Rademacher
Nora Jahn
Elisabeth Sucher
Daniel Seehofer
Robert Sucher
Hans-Michael Hau
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Relaparotomy
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Peritoneal Dialysis
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Published in: Health and Quality of Life Outcomes / Issue 1/2020
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/s12955-020-01545-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Impact of pre-transplant dialysis modality on the outcome and health-related quality of life of patients after simultaneous pancreas-kidney transplantation

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2020

Exploring the relation between the EQ-5D-5L pain/discomfort and pain and itching in a sample of burn patients

Personality traits and the risk of becoming lonely in old age: A 5-year follow-up study

The Chinese version of the Perceived Stress Questionnaire: development and validation amongst medical students and workers

Health-related quality of life and work productivity in UK patients with HER2-positive breast cancer: a cross-sectional study evaluating the relationships between disease and treatment stage

Understanding the burden of illness of excessive daytime sleepiness associated with obstructive sleep apnea: a qualitative study

Measuring health-related quality of life in chronic otitis media in a Chinese population: cultural adaption and validation of the Zurich Chronic Middle Ear Inventory (ZCMEI-21-Chn)