Surowiecka Agnieszka, Feng Shanshan, Matejak-Górska Marta, Durlik Marek
From the Department of Gastroenterological Surgery and Transplantation of Medical Centre of Postgraduate Education at the Central Clinical Hospital of the Ministry of the Interior in Warsaw, Warsaw, Poland; and the Mossakowski Medical Research Centre of the Polish Academy of Sciences, Department of Surgical Research and Transplantology, Warsaw, Poland.
Exp Clin Transplant. 2020 Feb;18(1):8-12. doi: 10.6002/ect.2019.0204. Epub 2019 Nov 13.
The influence of peritoneal dialysis on outcomes after simultaneous pancreas and kidney transplant is still vague. In addition, whether peritoneal dialysis leads to a higher risk of infectious complications and higher mortality rates in these transplant patients has not been unambiguously confirmed. In this study, our aim was to verify whether dialysis type determined outcomes on the pancreas graft and whether dialysis type was a risk factor for graftectomy or recipient death.
Our study group included 44 simultaneous pancreas and kidney transplant patients. Analyzed parameters included type and duration of dialysis treatment, age, sex, long-term pancreas graft survival and patient survival, overall mortality, and number of graftectomies.
Of 44 patients, 3 (7%) required a graftectomy. Mortality rate of the group was 5%. Of 44 patients, 33 had hemodialysis and 11 had peritoneal dialysis. In those who had hemodialysis, the mean duration of renal replacement therapy was 30.5 months, which was significantly longer than duration for those who had peritoneal dialysis (20.4 mo; P < .01). There were 3 graftectomies and 1 death in the hemodialysis group. In the peritoneal dialysis group, there were no graftectomies and 1 death, with no significant differences in the number of graftectomies and mortality rates between the groups. Long-term survival also did not differ between the groups.
We found that type of dialysis did not affect outcomes in our group of simultaneous pancreas and kidney transplant patients. Before transplant, each patient requires an individual approach to treatment. The type of dialysis performed should not be viewed as a contradiction for transplant.
腹膜透析对胰肾联合移植术后结局的影响仍不明确。此外，腹膜透析是否会导致这些移植患者发生感染并发症的风险更高以及死亡率更高，尚未得到明确证实。在本研究中，我们的目的是验证透析类型是否决定胰腺移植物的结局，以及透析类型是否是移植胰腺切除或受者死亡的危险因素。
我们的研究组包括44例胰肾联合移植患者。分析的参数包括透析治疗的类型和持续时间、年龄、性别、胰腺移植物长期存活情况和患者存活情况、总死亡率以及移植胰腺切除的次数。
44例患者中，3例（7%）需要进行移植胰腺切除。该组的死亡率为5%。44例患者中，33例接受血液透析，11例接受腹膜透析。接受血液透析的患者中，肾脏替代治疗的平均持续时间为30.5个月，显著长于接受腹膜透析的患者（20.4个月；P < 0.01）。血液透析组有3例移植胰腺切除和1例死亡。腹膜透析组无移植胰腺切除，有1例死亡，两组之间的移植胰腺切除次数和死亡率无显著差异。两组的长期存活率也无差异。
我们发现透析类型对我们的胰肾联合移植患者组的结局没有影响。移植前，每位患者都需要个体化的治疗方法。所进行的透析类型不应被视为移植的禁忌。
