Clinically Significant Peripancreatic Fluid Collections After Simultaneous Pancreas-Kidney Transplantation
| Autor: | Nizam Mamode, Nicos Kessaris, Sadia Anam, Jonathon Olsburgh, Rajinder Singh, Samiha Hayek, Mariam Aqueel, Rachel Hilton, Francis Calder, Sara Hayek, C. J. Callaghan, John Taylor, Martin Drage, Georgios Vrakas, James M. Pattison, G. Koffman |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Adolescent medicine.medical_treatment Pancreatic Fistula Postoperative Complications Risk Factors Laparotomy Humans Medicine Retrospective Studies Transplantation business.industry Incidence Incidence (epidemiology) Odds ratio Middle Aged medicine.disease Kidney Transplantation Surgery medicine.anatomical_structure Pancreatitis Pancreatic fistula Female Pancreas Transplantation business Pancreas Complication |
| Zdroj: | Transplantation. 95:1263-1269 |
| ISSN: | 0041-1337 |
| DOI: | 10.1097/tp.0b013e318289c978 |
| Popis: | Background. Peripancreatic fluid collections (PPFC) are a serious complication after simultaneous pancreas-kidneytransplantation (SPKTx).Methods. Retrospective study for all 223 SPKTx performed from December 8, 1996, to October 10, 2011, to evaluatethe risk factors (RF) and impact of PPFCs on outcomes was conducted.Results. Clinically significant PPFCs were seen in 36 (16%) cases, all within 3 months after transplantation. Radio-logic drainage resolved 2 (6%) cases, and 34 required laparotomy (mean [SD], 4 [7]). Compared with the non-PPFCgroup (n=186), the PPFC group had similar patient and total kidney graft survivals but significantly lower totalpancreas survival (68% vs. 85%) and greater incidence of infections (75% vs. 46%, all PG0.05) at 5 years. PPFCs wereassociated with early graft pancreatitis in 18 (50%), pancreatic fistula in 20 (56%, 9 with obvious duodenal stumpleak) and infection in the collection in 20 (56%) cases. Comparison of PPFCs with pancreas graft loss to the PPFCswith surviving grafts showed that the incidence of pancreatic fistula was greater in the former (90% pancreas graft lossvs. 42% pancreas graft survival, PG0.01). Binary logistic regression analysis of RF for developing PPFC showed adonor age 930 years to be significant (P=0.03; odds ratio, 3.4; confidence interval, 1.1Y10.5) and a trend of associationwith donor body mass index 930 and pancreas cold ischemia time greater than 12 hr.Conclusions. PPFCs are associated with significant reduction in pancreas allograft survival and impact resource use.Donor age 930 years is a significant RF for their development. PPFCs associated with pancreatic fistula carry a greaterrisk for pancreas graft loss.Keywords: Pancreas, Transplantation, Complications.(Transplantation 2013;00: 00Y00) |
| Databáze: | OpenAIRE |
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