Simultaneous pancreas-kidney transplantation: infectious complications and microbiological aspects.
OBJECTIVE
The purpose of this study was to describe the clinical and microbiological characteristics of the infectious complications among simultaneous pancreas-kidney transplantations (SPKT).


METHODS
Among the first 45 SPKT the mean age was 34 years (range, 21 to 49) and the mean duration of follow-up 13 months (range, 2 to 27 months).


RESULTS
Twenty-three patients (51%) presented at least one to three episodes (1.7 mean) of infectious complications that needed hospitalization. The etiology of the infections included 71% bacterial (44% gram-negative rods and 27% gram-positive cocci), 16% viral (12% from CMV and 4% from Herpes sp) and 13% fungal (8% by Candida sp and 4% by others fungus). Wound and urinary infections were most frequent, occurring in 22% and 28% of the patients, respectively. All patients who were submitted to vesical drainage developed infections in contrast a rate of only 44% among patients undergoing enteric drainage.


CONCLUSIONS
Infectious complications are the main cause of morbidity and mortality following simultaneous pancreas-kidney transplantation, especially with vesical drainage. The use of enteric drainage combined with administration of broad spectrum prophylactic antibiotics is recommended.
Linhares
M M
MM
São Paulo Federal University Medical School-UNIFESP, Sao Paulo, SP, Brazil. marbet@uol.com.br
Gonzalez
A M
AM
Triviño
T
T
Barbosa
M M L S
MM
Schraibman
V
V
Melaragno
C
C
Moura
R M A M
RM
Silva
M H G
MH
Sá
J R
JR
Aguiar
W F
WF
Rangel
E B
EB
Serra
C B
CB
Succi
T
T
Pestana
J O M
JO
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007239:Infections / Q000453:epidemiology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology / Q000382:microbiology*; D012189:Retrospective Studies; D013997:Time Factors