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Outcome of patients with hemodialysis or peritoneal dialysis undergoing simultaneous pancreas‐kidney transplantation. Comparative study
Author(s) -
Marcacuzco Alberto,
JiménezRomero Carlos,
Manrique Alejandro,
Calvo Jorge,
Cambra Félix,
Caso Óscar,
GarcíaSesma Álvaro,
Nutu Anisa,
Justo Iago
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13268
Subject(s) - medicine , peritoneal dialysis , hemodialysis , surgery , pancreas transplantation , dialysis , transplantation , pancreas , kidney transplantation , perioperative , gastroenterology , pancreatitis , urology
Background Controversy remains with regard to the higher risk of intra‐abdominal infections and lower patient and graft survival when peritoneal dialysis ( PD ) rather than hemodialysis ( HD ) is used in simultaneous pancreas‐kidney transplantation ( SPKT ). Methods From March 1995 to December 2015, we performed 165 SPKT s. Prior to transplant, patients received hemodialysis (group HD ; n = 98) or peritoneal dialysis (group PD ; n = 67). A comparison was made to analyze post‐transplant complications and patient, pancreas, and kidney graft survivals. Results Donor, pretransplant, and perioperative recipient variables were similar in both groups. Overall rates of infections (69.4% in HD vs 73.1% in PD ; P = .50) and intra‐abdominal infections (31.6% in HD vs 35.8 in PD ; P = .57) were similar in both groups. The rates of pancreatitis, hemorrhage or thrombosis of the graft, duodenal graft leak, relaparotomy, transplantectomy, pancreas rejection, and retransplantation were similar in both groups. Patient survival at 1, 3, and 5 years (95.9%, 93.9%, and 93.9% in HD vs 95.5%, 92.2%, and 90.4% in PD ; P = .54) and pancreas graft survival (83.6%, 78.0%, and 71.8% in HD vs 79.2%, 77.4%, and 71.0% in PD ; P = .8) were similar in both groups. Kidney graft survival was similar in both groups. Pancreas graft thrombosis, rejection, and relaparotomy for intra‐abdominal complications were independent predictors of lower pancreas graft survival, but dialysis modality did not influence patient or graft survival. Conclusions Pre‐ SPKT modality of dialysis does not significantly influence overall or intra‐abdominal infection and patient, pancreas, or kidney graft survivals.