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19 July 2019 : Original article  

Effect of Pretransplant Dialysis Modality on Outcomes After Simultaneous Pancreas-Kidney Transplantation

Juulia Räihä1ABCDEFG*, Ilkka Helanterä1ABCDEG, Agneta Ekstrand2BE, Arno Nordin1B, Ville Sallinen1ABD, Marko Lempinen1ABCDEG

DOI: 10.12659/AOT.916649

Ann Transplant 2019; 24:426-431

Abstract

BACKGROUND: Pretransplant dialysis modality may affect outcome after simultaneous pancreas-kidney transplantation (SPKT), and it has been suspected that peritoneal dialysis (PD) is associated with more postoperative complications compared to hemodialysis (HD). The aim of this study was to evaluate whether pretransplant dialysis modality affects the risk for postoperative complications in SPKT recipients.

MATERIAL AND METHODS: This was a retrospective longitudinal cohort study of all patients undergoing SPKT from 2010 to 2017, during which 99 simultaneous pancreas-kidney transplantations were performed. Three pre-emptive transplantations were excluded. Patient groups receiving PD (n=59) or HD (n=37) were similar regarding baseline characteristics. All complications occurring during the first 3 months after transplantation, as well as patient and graft survival, were analyzed.

RESULTS: There were no significant differences in postoperative complications between groups, with similar rates of intra-abdominal infections (8% in HD vs. 10% in PD), pancreatitis (16% in HD vs. 17% in PD), gastrointestinal bleedings (22% in HD vs. 10% in PD), and relaparotomies (27% in HD vs. 24% in PD). None of the patients had venous graft thrombosis. Past peritonitis was not associated with increased risk for postoperative complications in PD patients. Patient and graft survival were similar between PD and HD groups.

CONCLUSIONS: Peritoneal dialysis is not a risk factor for postoperative complications after SPKT.

Keywords: Kidney Transplantation, Pancreas Transplantation, Patient Outcome Assessment, Peritoneal Dialysis, Postoperative Complications, Renal Dialysis, Graft Rejection, Longitudinal Studies, Middle Aged, Preoperative Care, Prognosis, Retrospective Studies, Treatment Outcome

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