Pancreas graft loss caused by intra-abdominal infection. A risk factor for a subsequent pancreas retransplantation.
OBJECTIVE
To investigate whether previous pancreas graft loss caused by intra-abdominal infection is a risk factor for a subsequent pancreas retransplantation.


METHODS
Retrospective case-series analysis.


METHODS
Large university hospital.


METHODS
Of 97 pancreatic retransplantations (July 1, 1985 to June 30, 1994), 13 (13%) were performed after previous pancreas grafts had been lost because of intra-abdominal infection.


METHODS
Cause of retransplant graft loss; patient survival.


RESULTS
Of 13 cases of pancreatic retransplantations performed after previous grafts had been lost because of intra-abdominal infection, 12 (92%) were again complicated by intra-abdominal infection. Of these 12 retransplantation infections, 10 were caused by the same microbial species that had caused failure of the previous graft 1 to 5 years earlier (8 required graft pancreatectomy [mortality rate, 25%], and 2 were successfully treated) and 2 were caused by different microbial species (both required graft pancreatectomy [mortality rate, 0%]). In 1 of the 13 retransplantations, prophylactic antimicrobial treatment was directed at the microbial species that had caused failure of the previous graft; no recurrent intra-abdominal infection developed.


CONCLUSIONS
Intra-abdominal infection after a previous pancreas transplantation is a risk factor for recurrence of infection by the same microbial species after a subsequent retransplantation. For the selected patients who are considered for retransplantation in spite of their previous graft loss caused by intra-abdominal infection, periretransplantation antimicrobial prophylaxis should include a prolonged course of an agent directed against the previously identified microbial species.
Benedetti
E
E
Department of Surgery, University of Minnesota, Minneapolis, USA.
Troppmann
C
C
Gruessner
A C
AC
Sutherland
D E
DE
Dunn
D L
DL
Gruessner
W G
WG
D000005:Abdomen; D018784:Abdominal Abscess / Q000150:complications; D000328:Adult; D005260:Female; D006085:Graft Survival; D006801:Humans; D007239:Infections / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors