Impact of peritoneal dialysis versus hemodialysis on incidence of intra-abdominal infection after simultaneous pancreas-kidney transplant.

ABSTRACT

BACKGROUND: Whether peritoneal dialysis is a risk factor for the development of intra-abdominal infection after simultaneous pancreas-kidney (SPK) transplantation is controversial. METHODS: We investigated the incidence of intra-abdominal infection and graft survival rates in 100 patients who underwent SPK transplantation. Prior to transplantation, 25 patients received peritoneal dialysis (PD) and 75 received hemodialysis (HD); mean duration of dialysis was 25 +/- 35 months and 17 +/- 10 months, respectively. RESULTS: The two groups displayed similar gender distribution, cold ischemia time, dialysis duration, diabetes duration, and method of exocrine drainage. Intra-abdominal infections developed in 23 patients in the HD group (30%) and in 6 (24%) patients in the PD group (P = 0.41). In the HD group, 61% of patients with intra-abdominal infections had grades 3 and 4 complications requiring surgery, compared with only 33% in the PD group. The 1-year pancreas graft survival rate was 88% for HD and 94% for PD (P = 0.67) (mean follow-up = 55 +/- 38 months). There were no significant intergroup differences in acute rejection episodes, kidney graft survival rates, or length of hospital stay. CONCLUSIONS: In our experience, PD prior to SPK transplantation is not associated with increased incidence of intra-abdominal infection compared to HD.