Influence of surgical complications on kidney graft survival in recipients of simultaneous pancreas kidney transplantation
| Autor: | J. Ruiz García, J. Carrasco Valiente, R. Prieto Castro, M.L. Navarro Cabello, F.J. Anglada Curado, E. Gómez Gómez, J.P. Campos Hernández, J. Ruiz Rabelo, M.J. Requena Tapia, F.J. Márquez López |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Multivariate analysis Kaplan-Meier Estimate Severity of Illness Index Postoperative Complications Risk Factors Diabetes mellitus medicine Humans Aged Proportional Hazards Models Retrospective Studies Transplantation Kidney business.industry Incidence (epidemiology) Incidence Hazard ratio Gold standard Graft Survival Panel reactive antibody Middle Aged medicine.disease Kidney Transplantation Surgery medicine.anatomical_structure Diabetes Mellitus Type 1 Treatment Outcome Multivariate Analysis Kidney Failure Chronic Female Pancreas Transplantation business |
| Zdroj: | Transplantation proceedings. 47(1) |
| ISSN: | 1873-2623 |
| Popis: | Purpose Simultaneous pancreas-kidney transplantation is the gold standard treatment for patients with end-stage renal failure secondary to insulin-dependent diabetes mellitus. This kind of transplantation is a complex operation associated with a high incidence of surgical complications and mortality risk which could influence graft survival. The aim of this study was to establish the influence of different grades of postoperative complications, classified according to Clavien-Dindo, on the rate of kidney graft loss. Methods We performed an observational retrospective review of all simultaneous transplantations performed between February 1989 and May 2012. Factors examined were related to recipient and donor characteristics, surgical procedures, and postoperative outcomes. For this purpose, Kaplan-Meier analyses and Cox-Regression tests are used. Results One hundred thirty-nine transplantations were performed. Complications grades I, II, and IIIa were experienced in 81 (58.3%) patients, and grades IIIb and IVa-b in 55 (39.6%). Multivariate analysis showed an influence of panel reactive antibody (hazard ratio [HR]: 10.79; P = .003), incidence of acute rejection (HR: 2.55; P = .03), and complications grouped into grades IIIb and IVa-b (HR: 3.63; P = .02). Kaplan Meier analysis showed worse kidney graft survival rate in groups grades IIIb and IVa-b compared to grades I, II, and IIIa (86.6% vs 98.7% at 1 year and 81.8% vs 97.3% at 5 years; P = .001). Conclusions Despite being the gold standard treatment for these patients, pancreas and kidney transplantations have numerous complications which could influence the prognosis of graft kidney survival. |
| Databáze: | OpenAIRE |
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