Human fibrinogen patches application reduces intra-abdominal infectious complications in pancreas transplant with enteric drainage.
OBJECTIVE
The purpose of the study was to analyze the incidence of intra-abdominal infectious complications after the application of a fibrinogen sealant to the duodenojejunal anastomosis in simultaneous pancreas-kidney transplants (SPK) with enteric drainage.


METHODS
Results of 68 SPKs with enteric drainage were prospectively assessed. A fibrinogen and thrombin sheet was applied to the duodenojejunal anastomosis in 34 patients, who were compared to a control group of 34 patients. The incidence and severity of intra-abdominal infectious complications and the 1-year patient and grafts survival were analyzed.


RESULTS
Eighteen patients experienced intra-abdominal infectious complications. Grade 1a complications occurred in the study group, whereas surgery was required only in patients from the control group: complications grade 3a (15%) and complications grade 3b (18%) (p = 0.003 vs. study group, respectively). The overall rate of anastomotic leakage (complications grade 2b and 3b) was 10%, all of which occurred in the control group. The length of hospital stay was higher in the control group was 34.6 ± 11.3 days vs. 22.8 ± 11.1 days (p = 0.03). There were no significant differences in 1-year patient and graft survival between groups.


CONCLUSIONS
In our study, the application of fibrinogen and thrombin sheets was associated to a decrease in the number and severity of intra-abdominal infectious complications.
Padillo
J
J
Department of Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, 14004, Cordoba, Spain. javierpadilloruiz@gmail.com
Arjona-Sánchez
A
A
Ruiz-Rabelo
J
J
Regueiro
J C
JC
Canis
M
M
Rodriguez-Benot
A
A
D034841:Abdominal Cavity; D000287:Administration, Topical; D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D057868:Anastomotic Leak / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D001424:Bacterial Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000601:surgery; D004322:Drainage; D004386:Duodenum / Q000601:surgery; D005260:Female; D005340:Fibrinogen / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D007583:Jejunum / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects*; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000209:etiology / Q000601:surgery; D013917:Thrombin / Q000008:administration & dosage; D014014:Tissue Adhesives / Q000008:administration & dosage*
D014014:Tissue Adhesives; D005340:Fibrinogen; D013917:Thrombin
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