Impact of peritoneal dialysis versus hemodialysis on incidence of intra-abdominal infection after simultaneous pancreas-kidney transplant

Whether peritoneal dialysis is a risk factor for the development of intra-abdominal infection after simultaneous pancreas-kidney (SPK) transplantation is controversial.We investigated the incidence of intra-abdominal infection and graft survival rates in 100 patients who underwent SPK transplantation. Prior to transplantation, 25 patients received peritoneal dialysis (PD) and 75 received hemodialysis (HD); mean duration of dialysis was 25 +/- 35 months and 17 +/- 10 months, respectively.The two groups displayed similar gender distribution, cold ischemia time, dialysis duration, diabetes duration, and method of exocrine drainage. Intra-abdominal infections developed in 23 patients in the HD group (30%) and in 6 (24%) patients in the PD group (P = 0.41). In the HD group, 61% of patients with intra-abdominal infections had grades 3 and 4 complications requiring surgery, compared with only 33% in the PD group. The 1-year pancreas graft survival rate was 88% for HD and 94% for PD (P = 0.67) (mean follow-up = 55 +/- 38 months). There were no significant intergroup differences in acute rejection episodes, kidney graft survival rates, or length of hospital stay.In our experience, PD prior to SPK transplantation is not associated with increased incidence of intra-abdominal infection compared to HD.