Early morbidity after pancreas transplantation.
This study aims to evaluate and compare the early outcome of both pancreas-alone transplantation (PTA) and simultaneous kidney-pancreas transplantation (SPKT) focusing on the complications affecting the first month after the procedures. The records of all patients who underwent PTA or SPKT were reviewed. We considered the length of ICU stay, the need for postoperative ventilatory support, hemodynamic and metabolic data (arterial pH, serum glucose, need for exogenous insulin), infectious diseases incidence, microbiological colonization rate and any kind of postoperative complication arising during the first month after the transplantation. PTA recipients underwent a quicker surgery (P < 0.01) with shorter ICU stay (P < 0.05) and a lower need for postoperative mechanical ventilation (P < 0.05). They also had a higher hemodynamic stability (P < 0.05) with less cardiological complications (P < 0.05) in the intra- and postoperative phases; bacterial colonisation was also less frequent in PTA recipients (P < 0.05). On the contrary, no significant difference was noted with regard to postoperative nausea/vomiting, sudden myocardial death, ICU re-admissions, graft function, rate of rejection, grafts explantation and re-transplantation. PTA could be considered as preemptive for severe diabetic complications in patients with long-lasting severe type I diabetes. However, establishing the correct timing of PTA is of paramount importance in order not to expose the patients early to risks arising from a major surgery and heavy immunosuppressive treatments.
Bindi
Maria Lucia
ML
U.O. Anestesia e Rianimazione 1, Unità di Terapia Intensiva Postchirurgica e Trapianti, Azienda Ospedaliera Universitaria Pisana, Ospedale Cisanello, Pisa, Italy. l.bindi@mail.ao-pisa.toscana.it
Biancofiore
Gianni
G
Meacci
Luca
L
Bellissima
Germana
G
Nardi
Silvia
S
Pieri
Marco
M
Vistoli
Fabio
F
Boggi
Ugo
U
Sansevero
Andrea
A
Mosca
Franco
F
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006439:Hemodynamics; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007166:Immunosuppressive Agents / Q000494:pharmacology / Q000627:therapeutic use; D007328:Insulin / Q000378:metabolism; D007362:Intensive Care Units; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D016035:Pancreas Transplantation / Q000009:adverse effects* / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
D001786:Blood Glucose; D007166:Immunosuppressive Agents; D007328:Insulin