1. Effect of Pretransplant Dialysis Modality on Outcomes After Simultaneous Pancreas-Kidney Transplantation
- Author
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Juulia Räihä, Ville Sallinen, Marko Lempinen, Arno Nordin, Agneta Ekstrand, Ilkka Helanterä, Department of Surgery, IV kirurgian klinikka, University of Helsinki, HUS Abdominal Center, University Management, Nefrologian yksikkö, Staff Services, and Pertti Panula / Principal Investigator
- Subjects
Adult ,Graft Rejection ,Male ,HEMODIALYSIS ,medicine.medical_specialty ,MORTALITY-RATES ,IMPACT ,medicine.medical_treatment ,030232 urology & nephrology ,030230 surgery ,Pancreas transplantation ,Peritoneal dialysis ,IMPROVED PATIENT SURVIVAL ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Renal Dialysis ,Preoperative Care ,medicine ,Humans ,Longitudinal Studies ,Risk factor ,Kidney transplantation ,Dialysis ,PERITONEAL-DIALYSIS ,Retrospective Studies ,Transplantation ,Original Paper ,business.industry ,Retrospective cohort study ,ASSOCIATION ,General Medicine ,Middle Aged ,3126 Surgery, anesthesiology, intensive care, radiology ,medicine.disease ,Prognosis ,Kidney Transplantation ,RISKS ,3. Good health ,Surgery ,Patient Outcome Assessment ,RECIPIENTS ,Treatment Outcome ,Female ,Hemodialysis ,Pancreas Transplantation ,business ,Peritoneal Dialysis - 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/ 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 intraabdominal 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.
- Published
- 2019