Solid pancreatic allograftInfectious Complications After Simultaneous Pancreas–Kidney Transplantation
Section snippets
Patients and methods
From 1988 to 2004, the 51 patients who underwent SPKT were 32 women and 19 men of mean age (34 ± 4 years) with diabetes and end-stage renal disease. Mean duration of diabetes mellitus was 23 ± 4 years. The incidence of HCV and HBV infections were 19.6% and 13.7%, respectively. Preoperative work-up included identification elimination prior to surgery of potential sources of infection. All patients prior to SPKT had been treated by dialysis (26 ± 20 months).
Organs for transplantation were
Results
Thirty-eight recipients are alive from 1 to 14 years after transplantation, 26 with both grafts functioning; 8 with a functioning kidney and 4 with nonfunctioning grafts on dialysis treatment. Thirteen patients (24.5%) died during the first year after transplantation. Infectious complications were the main cause of death. Systemic infections encountered for the death of five patients and CNS infection for death of another five patients. Three patients died with functioning grafts owing to
Discussion
Despite improvements in the results of SPKT, infectious complications remain the main cause of morbidity and mortality.4, 5, 6, 7 Our study demonstrated a high overall rate of infections, which were the main cause of mortality.
Mean duration time of diabetes mellitus treatment was 23 ± 3 years in our group. Diabetic patients normally suffer from impaired responses to pathogens, which contribute to dissemination of infections.6 Obviously, immunosuppressive treatment, especially induction therapy,
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