T Grochowiecki1, Z Gałązka2, K Madej2, S Frunze2, S Nazarewski2, T Jakimowicz2, L Paczek3, M Durlik4, J Szmidt2. 1. Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, Poland. Electronic address: tadeusz.grochowiecki@wum.edu.pl. 2. Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, Poland. 3. Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Poland. 4. Department of Transplantation Medicine and Nephrology, Medical University of Warsaw, Poland.
Abstract
OBJECTIVE: Identification of factors that have an impact on postoperative complications after simultaneous pancreas and kidney transplantation (SPKTx) could help overcome limitations of this kind of treatment. METHODS: Postoperative complications among 112 SPKTx recipients were divided into 3 groups: related to transplanted pancreas (n = 66), related to transplanted kidney (n = 23) and general surgical complications (n = 31) 120 refers to complications among 112 recipients. According to the modified Clavien-Dindo scale, complications were classified according to their severity for each group. Risk factors for complication development related to donor, recipient, surgical technique, and immunosuppression were included to establish the multivariable model using logistic regression. RESULTS: Multiple regression analysis showed the following independent factors influenced mortal complications due to transplanted pancreas: age of donor (OR, 1.07; P < .04), duration of vascular pancreas anastomosis above 35 minutes (OR, 3.94; P < .04) and duration of recipient dialysis above 24 months before transplantation (OR, 0.14; P < .01). Area under receiver operating characteristic curve for this model was 0.8. CONCLUSION: To improve results, the following modification of identified risk factors should be assumed: selection of donor in term of age, shortening of the second warm ischemia time, and adjustment of the waiting list to avoid prolongation of recipient dialysis before SPKTx.
OBJECTIVE: Identification of factors that have an impact on postoperative complications after simultaneous pancreas and kidney transplantation (SPKTx) could help overcome limitations of this kind of treatment. METHODS: Postoperative complications among 112 SPKTx recipients were divided into 3 groups: related to transplanted pancreas (n = 66), related to transplanted kidney (n = 23) and general surgical complications (n = 31) 120 refers to complications among 112 recipients. According to the modified Clavien-Dindo scale, complications were classified according to their severity for each group. Risk factors for complication development related to donor, recipient, surgical technique, and immunosuppression were included to establish the multivariable model using logistic regression. RESULTS: Multiple regression analysis showed the following independent factors influenced mortal complications due to transplanted pancreas: age of donor (OR, 1.07; P < .04), duration of vascular pancreas anastomosis above 35 minutes (OR, 3.94; P < .04) and duration of recipient dialysis above 24 months before transplantation (OR, 0.14; P < .01). Area under receiver operating characteristic curve for this model was 0.8. CONCLUSION: To improve results, the following modification of identified risk factors should be assumed: selection of donor in term of age, shortening of the second warm ischemia time, and adjustment of the waiting list to avoid prolongation of recipient dialysis before SPKTx.
Authors: Natalia Vidal Crespo; Pedro López Cubillana; Pedro A López González; Cristóbal Moreno Alarcón; Javier Rull Hernández; Laura Aznar Martínez; Alicia López Abad; Juan C Fernández Garay; Rocío Martínez Muñoz; Santiago Llorente Viñas; Juan A Fernández Hernández; Guillermo A Gómez Gómez Journal: Can Urol Assoc J Date: 2022-07 Impact factor: 2.052