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Clin Transplant ; 38(5): e15339, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38775413

RESUMEN

Simultaneous pancreas-kidney transplantation (SPKT) is the best treatment for selected individuals with type 1 diabetes mellitus and end-stage renal disease. Despite advances in surgical techniques, donor and recipient selection, and immunosuppressive therapies, SPKT remains a complex procedure with associated surgical complications and adverse consequences. We conducted a retrospective study that included 263 SPKT procedures performed between May 2000, and December 2022. A total of 65 patients (25%) required at least one relaparotomy, resulting in an all-cause relaparotomy rate of 2.04 events per 100 in-hospital days. Lower donor body mass index was identified as an independent factor associated with reoperation (OR .815; 95% CI:  .725-.917, p = .001). Technical failure (TF) occurred in 9.9% of cases, primarily attributed to pancreas graft thrombosis, intra-abdominal infections, bleeding, and anastomotic leaks. Independent predictors of TF at 90 days included donor age above 36 years (HR 2.513; 95% CI 1.162-5.434), previous peritoneal dialysis (HR 2.503; 95% CI 1.149-5.451), and specific pancreas graft reinterventions. The findings highlight the importance of carefully considering donor and recipient factors in SPKT. The incidence of TF in our study population aligns with the recent series. Continuous efforts should focus on identifying and mitigating potential risk factors to enhance SPKT outcomes, thereby reducing post-transplant complications.


Asunto(s)
Diabetes Mellitus Tipo 1 , Supervivencia de Injerto , Fallo Renal Crónico , Trasplante de Riñón , Trasplante de Páncreas , Complicaciones Posoperatorias , Humanos , Femenino , Masculino , Trasplante de Páncreas/efectos adversos , Estudios Retrospectivos , Trasplante de Riñón/efectos adversos , Adulto , Complicaciones Posoperatorias/etiología , Estudios de Seguimiento , Factores de Riesgo , Fallo Renal Crónico/cirugía , Pronóstico , Diabetes Mellitus Tipo 1/cirugía , Diabetes Mellitus Tipo 1/complicaciones , Rechazo de Injerto/etiología , Persona de Mediana Edad , Reoperación/estadística & datos numéricos , Pruebas de Función Renal , Tasa de Supervivencia , Tasa de Filtración Glomerular
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