Risk factors for surgical site infection after kidney and pancreas transplantation

Abstract

Organ/space SSIs remain a serious and common complication after SPK and PAK. Prolonged cold ischemic time and SPK transplant were the risk factors predictive of SSIs. Appropriate perioperative prophylaxis in high-risk patients targeting the potential pathogens producing SSIs in kidney and/or pancreas transplant recipients and a reduction in cold ischemia may prove beneficial in reducing these SSIs.

Surgical site infections after simultaneous pancreas kidney and pancreas transplantation in the Swiss Transplant Cohort Study

“…The incidence of SSIs was often higher in prior studies ranging between 20% and 50% [5][6][7]12], a single study reported SSIs at a lower frequency with 14% for SPK-Tx and 9% for pancreas after kidney transplantation [13]. One explanation for these differences could be that most studies used older data compared to the present study.…”

“…Risk factors for SSIs were assessed with univariable and multivariable logistic regression. Based on findings from a previous study [5], we decided to include cold ischemia time and the transplant procedure (SPK-Tx vs. P-Tx) in the multivariable model. The duration of hospitalization in patients with and without SSI was compared with the Wilcoxon-Rank test.…”

“…Similarly, in an US point prevalence study from 2014, SSIs and pneumonia, each detected at a frequency of 20.8%, were the most frequent HAIs [4]. SSIs after SPK-Tx or P-Tx were associated with poorer graft survival [5] and prolonged duration of hospital stay [5][6][7]. In addition, SSIs often require re-operation contributing to transplant-related morbidity [6].…”

Robot-Assisted versus Conventional Open Kidney Transplantation: A Meta-Analysis

“…Delayed graft function refers to the incidence of acute kidney injury in the first week of kidney transplantation which necessitates a dialysis intervention [24]. Definitions of SSI, graft rejection, and graft failure were inconsistent with the diagnostic criteria that were applied in the original studies [3,25,26]. Reviews, editorials, preclinical studies, and single-arm studies without an OKT control group were excluded.…”

“…Since the initial successful case in 1954, conventional open kidney transplant (OKT) surgery with anastomosis of the graft vessels to the recipient's iliac vessels has become the standard procedure [2]. However, OKT has been associated with a higher risk of wound complications [3], particularly in recipients with obesity, diabetes, critical illness, and immunosuppression [4][5][6]. Moreover, the relatively larger incision of OKT has been recognized as an important cause of surgical site infection (SSI) after the surgery [7].…”