Influence of simultaneous pancreas and preemptive kidney transplantation on severity of postoperative complications
| Autor: | S. Frunze, Magdalena Durlik, Tomasz Jakimowicz, Jacek Szmidt, M. Lao, Leszek Paczek, Sławomir Nazarewski, Z Galazka, Tadeusz Grochowiecki |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Pancreas transplantation Severity of Illness Index Pharmacotherapy Postoperative Complications Diabetes mellitus Severity of illness medicine Humans Diabetic Nephropathies Kidney transplantation Retrospective Studies Transplantation business.industry Retrospective cohort study Middle Aged medicine.disease Kidney Transplantation Surgery medicine.anatomical_structure Diabetes Mellitus Type 1 Female Pancreas Transplantation Poland Pancreas Complication business |
| Zdroj: | Transplantation proceedings. 43(8) |
| ISSN: | 1873-2623 |
| Popis: | Simultaneous pancreas and preemptive kidney transplantation (SPpreKT) seems to be the optimal treatment for the patients with diabetes type 1 who are progressing to end-stage renal disease. On the other hand, surgical complications with a high rate of relaparatomy are a limiting factor in pancreas transplantation.Comparison of severity of surgical complications was performed between a group of preemptive (SPpreKT group) and nonpreemptive recipients of SPKT (SPKT group).Between 1988 and 2010, we performed 112 SPKTs including 25 preemptive recipients (22.3%). The SPKT Group included 87 recipients (77.7%). The severity of complications was classified according to a modified Clavien scale: grade I, no complication; grade II, drug therapy; grade IIIA, invasive intervention not requiring general anesthesia; grade IIIB, invasive intervention requiring general anesthesia; grade IVA, graft failure; and grade IVB, death.Among the SPpreKT group, 64% of recipients were free from postoperative complications compared with 40.3% of the SPKT group (P.01). Among the SPKT group, 52 recipients (59.7%) developed 58 postoperative complications, including 15 (17.3%) deaths due to graft pancreatitis (80%) or pancreatic fistula (20%). Among the SPpreKT group, 9 recipients developed 9 complications. None of the preemptively transplanted group subjects experienced a lethal complication. Among the SPpreKT group, the most severe complication was graft pancreatitis leading to graft removal in 2 recipients.Recipients of preemptive SPKT developed significantly fewer postoperative complications, especially deaths. However the rates of mild (II, IIIA) and moderate (IIIB) complications as well as graft failures (IVA) were similar to the nonpreemptive group. |
| Databáze: | OpenAIRE |
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