title: Donor-dependent risk factors for early surgical complications after simultaneous pancreas-kidney transplantation.
abstract: BACKGROUND
  The success of simultaneous pancreas-kidney transplantation (SPK) depends in a large degree on avoidance of surgical complications in the early postoperative period. The aim of the study was to analyze the Pre-procurement Pancreas Allocation Suitability Score (P-PASS) and the deceased donor parameters included within it as risk factors for early surgical complications after SPK.
  
  
  METHODS
  Forty-six consecutive donors whose kidney and pancreas were simultaneously transplanted were included in the study.
  
  
  RESULTS
  Donor age was older among recipients who lost their pancreatic grafts: 30.4±6.9 versus 24.1±6.9 years. Donor age was also older among recipients who lost their pancreatic grafts or died compared with those discharged with a functioning graft: 29.3±5.7 versus 24.0±6.9 years. Donor body mass index (BMI) was higher among patients who died compared with those who were discharged: 25.3±1.1 versus 23.2±2.5 kg/m2. P-PASS was higher in patients who lost their pancreatic grafts (17.6±2.1 vs 15.2±1.8) or died (15.3±1.9 vs 17.2±1.9), or lost pancreatic graft or died (15.2±1.8 vs 17.0±2.2) or with intra-abdominal infections (IAI; 17.1±1.7 vs 15.0±1.8). The incidence of donors≥30 years old was higher among recipients with IAI (45.4% vs 14.3%; P=.04). An higher rate of donors with P-PASS>16 was revealed among patients who lost their pancreatic grafts (26.7% vs 3.2%), died (26.7% vs 3.2%), lost the pancreatic graft or died (33.3% vs 6.4%), or experienced IAI (46.7% vs 9.7%). Multivariate logistic regression analysis revealed P-PASS (odds ratio 2.57; P=.014) and serum sodium (odds ration, 0.91; P=.048) to be important predictors of IAI development.
  
  
  CONCLUSIONS
  Older age and higher BMI among deceased donors increased the risk of IAI, pancreatic graft loss, or recipient death after SPK. Transplantation of a pancreas from a donor with a low P-PASS score was associated with a lower risk of surgical complications after SPK.
authors: Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Warsaw, Poland. ziacek@mp.pl
authors: J
authors: J
authors: Ziaja
authors: R
authors: R
authors: Król
authors: J
authors: J
authors: Pawlicki
authors: M
authors: M
authors: Heitzman
authors: J
authors: J
authors: Wilk
authors: A
authors: A
authors: Kowalik
authors: D
authors: D
authors: Bożek-Pająk
authors: S
authors: S
authors: Sekta
authors: L
authors: L
authors: Cierpka
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality / Q000502:physiology; D008297:Male; D016035:Pancreas Transplantation / Q000009:adverse effects* / Q000401:mortality / Q000502:physiology; D011044:Poland / Q000453:epidemiology; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology*; D019106:Postoperative Hemorrhage / Q000097:blood / Q000209:etiology; D012307:Risk Factors; D012964:Sodium / Q000097:blood; D013530:Surgical Wound Infection / Q000097:blood / Q000209:etiology; D013997:Time Factors; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D012964:Sodium