Preoperative Antibiotics Administration is Important to Prevent Hand Port-Site Infection After Hand-Assisted Laparoscopic Donor Nephrectomy for Living-Donor Kidney Transplantation
Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
Meeting: 2022 American Transplant Congress
Abstract number: 1033
Keywords: Infection, Kidney transplantation, N/A, Nephrectomy
Topic: Clinical Science » Kidney » 40 - Kidney Living Donor: Other
Session Information
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: Due to the profound organ shortage, the number of living donor kidney transplantation (LDKT) is increasing. Hand-assisted laparoscopic donor nephrectomy (HALDN) is widely performed for living donors. One of the major complications after HALDN is hand port-site infections. This study aimed to reveal the impact of preoperative comorbidities, prophylactic subcutaneous suction drain placement, and preoperative antibiotic prophylaxis on hand port-site infection after HALDN.
*Methods: In this single-center, retrospective cohort study, 950 consecutive HALDNs for living-donor kidney transplantation performed between January 2008 and December 2018 were evaluated. Hand port-site infections were identified in 92 HALDN cases. To investigate risk factors for hand port-site infection, donor characteristics, preoperative comorbidities, and operative factors were analyzed using logistic regression analysis.
*Results: In univariate analysis, significant differences in sex, smoking history, glucose intolerance, preoperative antibiotic prophylaxis, and prophylactic subcutaneous suction drain placement at the hand port-site were identified between the infection and no infection groups. In multivariate analysis, significant differences were identified between the two groups in sex (B=0.726, P=0.012, odds ratio [OR] 2.066, 95% confidence interval [CI] 1.169-3.652), preoperative antibiotic prophylaxis (B= -3.205, P<0.001, OR 0.041, 95% CI 0.013-0.122), and prophylactic subcutaneous suction drain placement at the hand port-site (B=0.689, P=0.022, OR 1.991, 95% CI 1.106-3.583). In subgroup analysis of donors with prophylactic subcutaneous suction drain placement, preoperative antibiotic prophylaxis was a significant factor in reducing the hand port-site infection incidence (B=-3.549, P<0.001, OR 0.029, 95% CI 0.006-0.128).
*Conclusions: Preoperative comorbidities may not cause hand port-site infections. Preoperative antibiotic prophylaxis, not prophylactic subcutaneous suction drain placement, is important for preventing hand port-site infection.
To cite this abstract in AMA style:
Hiramitsu T, Tomosugi T, Futamura K, Okada M, Goto N, Ichimori T, Narumi S, Watarai Y. Preoperative Antibiotics Administration is Important to Prevent Hand Port-Site Infection After Hand-Assisted Laparoscopic Donor Nephrectomy for Living-Donor Kidney Transplantation [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/preoperative-antibiotics-administration-is-important-to-prevent-hand-port-site-infection-after-hand-assisted-laparoscopic-donor-nephrectomy-for-living-donor-kidney-transplantation/. Accessed November 24, 2024.« Back to 2022 American Transplant Congress