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30 September 2011

Intra-abdominal infections after simultaneous pancreas – kidney transplantation

Jacek ZiajaACDEF, Robert KrolADEF, Jerzy ChudekCDEF, Jacek PawlickiEF, Aureliusz KolonkoDF, Marek HeitzmanEF, Dominika Bozek-PajakB, Adrian KowalikB, Jaroslaw WilkB, Sylwia SektaB, Andrzej WiecekDE, Lech CierpkaDE

Ann Transplant 2011; 16(3): 36-43 :: ID: 881993

Abstract

Background: Intra-abdominal infections (IAI) are among the most common causes of pancreatic graft loss and recipient death in the early period after simultaneous pancreas – kidney transplantation (SPK). The aim of the study was to analyze risk factors and clinical consequences of IAI in SPK patients.
Material/Methods: Forty-six consecutive SPK performed from 2004 to 2010 were subjected to analysis.
Results: IAI developed in 10 recipients (21.7%). The group of recipients with IAI had a higher rate of patients that required transfusion of more than 2 blood units (90% vs. 47%, p=0.028) or relaparotomy (80% vs. 14%, p<0.001), in comparison with patients without IAI. Additionally, in patients with IAI, both delayed kidney graft function or primary kidney graft nonfunction (40% vs. 11%, p=0.001) and recipient death (40% vs. 3%, p=0.006) were more frequently observed. Logistic regression analysis revealed an increased risk of IAI development in patients who required early relaparotomy (OR=24.8, p<0.001), transfusion of more than 2 blood units (OR=12.6, p=0.02), or postoperative dialysis therapy (OR=14.1, p=0.003).
Conclusions: Perioperative blood loss requiring transfusion and necessity of relaparotomy increase the risk of IAI after SPK. Development of IAI after SPK may result in impaired kidney graft function and increases patient mortality in the early postoperative period.

Keywords: simultaneous pancreas-kidney transplantation, intraabdominal infection, kidney graft function, blood loss, relaparotomy

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358