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Dtsch Med Wochenschr. 2007 Nov;132(44):2318-22.

[Morbidity and mortality of kidney and pancreas transplantation. Analysis of 810 transplantations at one center].

[Article in German]

Author information

1
Chirurgische Universitätsklinik Bochum am Knappschaftskrankenhaus, Bochum-Langendreer, Deutschland. michael.schaeffer@kk-bochum.de

Abstract

BACKGROUND:

Simultaneous pancreas kidney transplantation (SPK) is well established in the treatment of patients with type 1 diabetes and end-stage renal disease, but despite improved surgical techniques morbidity is still high.

PATIENTS AND METHODS:

A retrospective analysis of morbidity and mortality after first-time kidney transplantation (KTA: kidney transplant alone), pancreas transplantation (PTA: pancreas transplant alone), and SPK in a total of 810 patients was undertaken in our institution between January 1993 and December 2005.

RESULTS:

Of the total of 810 patients who had first-time transplantations, 524 underwent KTA, 4 underwent PTA, and 282 underwent SPK. Morbidity and mortality was significantly higher in SPK than in KTA (p < 0.05). Risk of early postoperative loss of a transplant organ was higher in SPK than in KTA, and there were more re-operations in SPK than in KTA (p < 0.05). More patients had infections infections after SPK than after KTA (p < 0.001). There were 23.0 % wound infections in SPK and 11.8 % in KTA (p < 0.05). Organ rejection occurred in 18.1 % of the patients after SPK and in 13.4 % after KTA (p = 0.07). At the time of discharge 95.0 % of KTA patients did no longer need dialysis treatment, compared with 97.1 % of SPK patients, of whom 88 % became insulin independent. One-year organ survival rate was 88 % in KTA patients and 89 % (kidney) and 86 % (pancreas) in SPK patients.

CONCLUSION:

Morbidity and mortality rates are still high after SPK. Excellent 1- and 5-year organ survival rates favor the use of SPK in type 1 diabetics associated with end-stage renal disease.

PMID:
17957594
DOI:
10.1055/s-2007-991649
[Indexed for MEDLINE]
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