Influence of Peritoneal or Hemodialysis on Results of Simultaneous Pancreas and Kidney Transplant

Exp Clin Transplant. 2020 Feb;18(1):8-12. doi: 10.6002/ect.2019.0204. Epub 2019 Nov 13.

Abstract

Objectives: The influence of peritoneal dialysis on outcomes after simultaneous pancreas and kidney transplant is still vague. In addition, whether peritoneal dialysis leads to a higher risk of infectious complications and higher mortality rates in these transplant patients has not been unambiguously confirmed. In this study, our aim was to verify whether dialysis type determined outcomes on the pancreas graft and whether dialysis type was a risk factor for graftectomy or recipient death.

Materials and methods: Our study group included 44 simultaneous pancreas and kidney transplant patients. Analyzed parameters included type and duration of dialysis treatment, age, sex, long-term pancreas graft survival and patient survival, overall mortality, and number of graftectomies.

Results: Of 44 patients, 3 (7%) required a graftectomy. Mortality rate of the group was 5%. Of 44 patients, 33 had hemodialysis and 11 had peritoneal dialysis. In those who had hemodialysis, the mean duration of renal replacement therapy was 30.5 months, which was significantly longer than duration for those who had peritoneal dialysis (20.4 mo; P < .01). There were 3 graftectomies and 1 death in the hemodialysis group. In the peritoneal dialysis group, there were no graftectomies and 1 death, with no significant differences in the number of graftectomies and mortality rates between the groups. Long-term survival also did not differ between the groups.

Conclusions: We found that type of dialysis did not affect outcomes in our group of simultaneous pancreas and kidney transplant patients. Before transplant, each patient requires an individual approach to treatment. The type of dialysis performed should not be viewed as a contradiction for transplant.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Clinical Decision-Making
  • Female
  • Graft Survival
  • Humans
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation* / adverse effects
  • Kidney Transplantation* / mortality
  • Male
  • Pancreas Transplantation* / adverse effects
  • Pancreas Transplantation* / mortality
  • Peritoneal Dialysis* / adverse effects
  • Peritoneal Dialysis* / mortality
  • Postoperative Complications / mortality
  • Postoperative Complications / surgery
  • Renal Dialysis* / adverse effects
  • Renal Dialysis* / mortality
  • Reoperation
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome