Simultaneous pancreas-kidney transplantation: infectious complications and microbiological aspects

Transplant Proc. 2004 May;36(4):980-1. doi: 10.1016/j.transproceed.2004.03.114.

Abstract

Objective: The purpose of this study was to describe the clinical and microbiological characteristics of the infectious complications among simultaneous pancreas-kidney transplantations (SPKT).

Materials and methods: Among the first 45 SPKT the mean age was 34 years (range, 21 to 49) and the mean duration of follow-up 13 months (range, 2 to 27 months).

Results: Twenty-three patients (51%) presented at least one to three episodes (1.7 mean) of infectious complications that needed hospitalization. The etiology of the infections included 71% bacterial (44% gram-negative rods and 27% gram-positive cocci), 16% viral (12% from CMV and 4% from Herpes sp) and 13% fungal (8% by Candida sp and 4% by others fungus). Wound and urinary infections were most frequent, occurring in 22% and 28% of the patients, respectively. All patients who were submitted to vesical drainage developed infections in contrast a rate of only 44% among patients undergoing enteric drainage.

Conclusion: Infectious complications are the main cause of morbidity and mortality following simultaneous pancreas-kidney transplantation, especially with vesical drainage. The use of enteric drainage combined with administration of broad spectrum prophylactic antibiotics is recommended.

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Infections / epidemiology*
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Pancreas Transplantation / adverse effects*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / microbiology*
  • Retrospective Studies
  • Time Factors