Incidence of minor and major amputations after pancreas/kidney transplantation.
Among other complications, diabetes mellitus leads to peripheral vascular disease with the risk of limb amputation. This retrospective study analyzed the incidence of amputations after simultaneous pancreas-kidney transplantation (SPK). Between June 1994 and February 2001, 200 SPKs, nine pancreas-after-kidney- (PAK) and one pancreas transplantation alone (PTA) were performed. The overall 5-year patient, pancreas-, and kidney-graft survival rates were 92.4%, 80.2% and 85.6%, respectively. Mean age at transplantation was 38.7 years, mean duration of diabetes was 26.9 years, mean duration of dialysis was 26.7 months. Nineteen (9.5%) patients after SPK (seven female/12 male) underwent 33 amputations, on average 18.7 months after transplantation. Longer duration of dialysis and a previous history of amputation were significant risk factors for an amputation after SPK ( P=0.014, P<0.001). Thus, early referral for SPK before dialysis initiation may be beneficial in preventing amputation.
Woeste
Guido
G
Department of Surgery, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. g.woeste@em.uni-frankfurt.de
Wullstein
Christoph
C
Pridöhl
Olaf
O
Lübke
Peter
P
Schwarz
Rene
R
Kohlhaw
Kay
K
Bechstein
Wolf O
WO
D000328:Adult; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D016381:Islets of Langerhans Transplantation / Q000706:statistics & numerical data*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000453:epidemiology* / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies