Early complications related to the transplanted kidney after simultaneous pancreas and kidney transplantation.
OBJECTIVE
Simultaneous pancreas and kidney transplantation (SPKTx) is the most often performed multiorgan transplantation. The main source of complication is transplanted pancreas; as a result, early complications related to kidney transplant are rarely assessed. The aim of this study was to evaluate prevalence, types, and severity of postoperative complications due to kidney graft among the simultaneous pancreas and kidney recipients.


METHODS
Complications related to transplanted kidney among 112 SPKTx recipients were analyzed. The indication for SPKTx was end-stage diabetic nephropathy due to long-lasting diabetes type 1. The cumulative survival rates for kidney graft function and cumulative freedom from complication on days 60 and 90 after transplantation were assessed. Severity of complications was classified according to the modified Dindo-Clavien scale.


RESULTS
The 12-month cumulative survival rate for kidney graft was 0.91. Cumulative freedom from complication on the 60th day after transplantation was 0.84. The rates for II, IIIA, IIIB, IVA, and IVB severity grades were: 34.9%, 4.3%, 26.1%, 26.1%, and 8.6%, respectively. Acute tubular necrosis and rejection were the most frequent (43.4%) cause of complication. The most frequent reasons for graft nephrectomy were infections (2/7; 28.6%) and vascular thrombosis due to atherosclerosis of recipient iliac arteries (2/7; 28.6%). The most severe (IVB) complications were caused by fungal infection.


CONCLUSIONS
Rate and severity of complications due to renal graft after SPKTx was low; however, to prevent the most serious ones reduction of fungal infection was necessary.
Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, Poland. Electronic address: tadeusz.grochowiecki@wum.edu.pl.
T
T
Grochowiecki
Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, Poland.
Z
Z
Gałązka
Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, Poland.
K
K
Madej
Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, Poland.
S
S
Frunze
Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, Poland.
S
S
Nazarewski
Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, Poland.
T
T
Jakimowicz
Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Poland.
L
L
Pączek
Department of Transplantation Medicine and Nephrology, Medical University of Warsaw, Poland.
M
M
Durlik
Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, Poland.
J
J
Szmidt
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology*; D006085:Graft Survival; D006801:Humans; D007673:Kidney Cortex Necrosis / Q000453:epidemiology*; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology; D016035:Pancreas Transplantation; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013927:Thrombosis / Q000453:epidemiology; D055815:Young Adult