Multivariate Analysis of Complications After Simultaneous Pancreas and Kidney Transplantation

• Published in: Transplantation proceedings 2014-10, Vol.46 (8), p.2806-2809
• Main Authors: Grochowiecki, T, Gałązka, Z, Madej, K, Frunze, S, Nazarewski, S, Jakimowicz, T, Paczek, L, Durlik, M, Szmidt, J
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Female; Graft Rejection - prevention & control; Humans; Immunosuppressive Agents - therapeutic use; Kidney; Kidney Transplantation - adverse effects; Male; Middle Aged; Multivariate Analysis; Pancreas Transplantation - adverse effects; Postoperative Complications - epidemiology; Regression Analysis; Renal Dialysis - statistics & numerical data; Retrospective Studies; Risk Factors; Surgery; Time Factors; Tissue Donors - statistics & numerical data; Waiting Lists; Young Adult
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2014.08.010

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.