title: Intra-abdominal infections after simultaneous pancreas - kidney transplantation.
abstract: BACKGROUND
  Intra-abdominal infections (IAI) are among the most common causes of pancreatic graft loss and recipient death in the early period after simultaneous pancreas - kidney transplantation (SPK). The aim of the study was to analyze risk factors and clinical consequences of IAI in SPK patients.
  
  
  METHODS
  Forty-six consecutive SPK performed from 2004 to 2010 were subjected to analysis.
  
  
  RESULTS
  IAI developed in 10 recipients (21.7%). The group of recipients with IAI had a higher rate of patients that required transfusion of more than 2 blood units (90% vs. 47%, p=0.028) or relaparotomy (80% vs. 14%, p<0.001), in comparison with patients without IAI. Additionally, in patients with IAI, both delayed kidney graft function or primary kidney graft nonfunction (40% vs. 11%, p=0.001) and recipient death (40% vs. 3%, p=0.006) were more frequently observed. Logistic regression analysis revealed an increased risk of IAI development in patients who required early relaparotomy (OR=24.8, p<0.001), transfusion of more than 2 blood units (OR=12.6, p=0.02), or postoperative dialysis therapy (OR=14.1, p=0.003).
  
  
  CONCLUSIONS
  Perioperative blood loss requiring transfusion and necessity of relaparotomy increase the risk of IAI after SPK. Development of IAI after SPK may result in impaired kidney graft function and increases patient mortality in the early postoperative period.
authors.affiliation: Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland. ziacek@mp.pl
authors.forename: Jacek
authors.initials: J
authors.lastname: Ziaja
authors.forename: Robert
authors.initials: R
authors.lastname: Krol
authors.forename: Jerzy
authors.initials: J
authors.lastname: Chudek
authors.forename: Jacek
authors.initials: J
authors.lastname: Pawlicki
authors.forename: Aureliusz
authors.initials: A
authors.lastname: Kolonko
authors.forename: Marek
authors.initials: M
authors.lastname: Heitzman
authors.forename: Dominika
authors.initials: D
authors.lastname: Bozek-Pajak
authors.forename: Adrian
authors.initials: A
authors.lastname: Kowalik
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Wilk
authors.forename: Sylwia
authors.initials: S
authors.lastname: Sekta
authors.forename: Andrzej
authors.initials: A
authors.lastname: Wiecek
authors.forename: Lech
authors.initials: L
authors.lastname: Cierpka
mesh_terms: D000293:Adolescent; D000328:Adult; D001803:Blood Transfusion; D051799:Delayed Graft Function / Q000209:etiology; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality / Q000502:physiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects* / Q000401:mortality / Q000502:physiology; D011044:Poland / Q000453:epidemiology; D019106:Postoperative Hemorrhage / Q000209:etiology; D006435:Renal Dialysis; D012086:Reoperation; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology*; D055815:Young Adult