Contamination of preservation fluid (PF) has been associated with donor-transmitted infection in renal transplantation. Despite the infectious morbidity in simultaneous pancreas-kidney transplantation (SPKT), the role of PF contamination has never been evaluated.
Objective of the study:
To analyze the impact of PF contamination on bacterial infections in SPKT recipients.
Patients and methods:
We retrospectively reviewed 75 SPKT performed in our centre between 2007 and 2010, whose PF were systematically analysed. A systemic venous drainage and enteric drainage for exocrine secretions were performed for all pancreas transplants. We examined the incidence of first bacterial infections within the first three months after transplantation. A multivariate Cox survival model was used to assess the impact of contaminated PF on infection risk.
A total of 30 out of 75 (40%) patients presented with at least one infection. The incidence of infection at 3 months was 6.6 per 1000 patient-days. Infection sites were predominantly intra-abdominal and urinary (30% and 26.7%, respectively). The most common bacteria were gastrointestinal (44.4%). PF cultures were positive in 27 (36%) kidney grafts and 38 (50.7%) pancreas grafts. Overall 19 (25.3%) recipients had positive cultures in both kidney and pancreas PF samples, with similar bacteria in 13 (18.3%) patients. There was no difference between the incidence of post-transplant infections at 1 and 3 months in the group with a contaminated PF compared to the group with a sterile PF (P >0.8).In multivariate analysis pancreatic fistula was significantly associated with early bacterial infection (HR = 3.95, 95% CI [1.66-9.04], p = 0.002). No association was found between positive PF and early bacterial infection (HR = 0.99 95% CI [0.47-2.08], p = 0.97).
In SPKT, a positive PF was not associated with early bacterial infections. Pancreatic fistula appears to be a significant risk factor for early bacterial infections.
To cite this abstract in AMA style:Morelon E, Chaintreuil D, Benet T, Reverdy M, Brunet M, Buron F, Chauvet C, Daoud S, Thaunat O, Vanhems P, Badet L. Early Bacterial Infections in Simultaneous Kidney and Pancreas Transplantation: Impact of Preservation Fluid Contamination [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/early-bacterial-infections-in-simultaneous-kidney-and-pancreas-transplantation-impact-of-preservation-fluid-contamination/. Accessed March 31, 2020.
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