Influence of the type of renal replacement therapy on peritonitis rate after simultaneous pancreas kidney transplantation

Outcome of patients with hemodialysis or peritoneal dialysis undergoing simultaneous pancreas‐kidney transplantation. Comparative study

“…Several authors have reported that the use of PD compared to HD before SPKT constitutes a higher risk factor for the development of intra‐abdominal infections, showing an incidence between 23.5% and 44% in PD groups vs 7.7% and 34% in HD groups . However, other studies do not find any significant differences between the groups in the overall incidence of intra‐abdominal infections (9.6%‐28% in PD groups vs 8.8%‐30% in HD groups) .…”

“…Series comparing PD and HD prior to SPKT have also shown discordant results with respect to patient and pancreas graft survival and the rate of post‐transplant intra‐abdominal infections …”

“…Ninety percent of patients who suffer severe intra‐abdominal infections will need a relaparotomy, and 70% of these will require a pancreas explant . Many risk factors can contribute to the development of intra‐abdominal infections after SPKT, such as pancreas graft age >45 years, prolonged graft ischemia time, long duration of diabetes, PD (association of progressive peritoneal fibrosis), enteric exocrine drainage, immunosuppression, retransplantation, older recipient, prolonged time of surgery, graft pancreatitis, and leakage from the duodeno‐enteric anastomosis …”

“…There is some controversy regarding the best modality of dialysis before SPKT. Thus, several authors have compared the outcomes of peritoneal dialysis (PD) and hemodialysis (HD) before SPKT, showing discordant results mainly with regard to patient and graft survivals and the development of intra‐abdominal infections …”

“…Thus, several authors have compared the outcomes of peritoneal dialysis (PD) and hemodialysis (HD) before SPKT, showing discordant results mainly with regard to patient and graft survivals and the development of intra-abdominal infections. [6][7][8][9][10][11][12][13] The aim of this study, to our knowledge the largest series considering patients who have undergone SPKT with previous HD vs PD, is to compare both groups regarding the rates of post-transplant complications, patient survival, and survival of pancreas and kidney grafts.…”