Similar early complication rate in simultaneous pancreas and kidney recipients on tacrolimus/mycophenolate mofetil versus tacrolimus/sirolimus immunosuppressive regimens
Jazyk angličtina Země Spojené státy americké Médium print
Typ dokumentu časopisecké články, práce podpořená grantem
PubMed
20692391
DOI
10.1016/j.transproceed.2010.05.121
PII: S0041-1345(10)00786-4
Knihovny.cz E-zdroje
- MeSH
- chronické selhání ledvin chirurgie MeSH
- dárci tkání MeSH
- délka pobytu MeSH
- diabetes mellitus 1. typu chirurgie MeSH
- diabetické nefropatie chirurgie MeSH
- hospitalizace MeSH
- imunosupresiva škodlivé účinky MeSH
- kyselina mykofenolová škodlivé účinky analogy a deriváty MeSH
- lidé MeSH
- mozková smrt MeSH
- pooperační komplikace epidemiologie MeSH
- sirolimus škodlivé účinky MeSH
- takrolimus škodlivé účinky MeSH
- transplantace ledvin škodlivé účinky imunologie MeSH
- transplantace slinivky břišní škodlivé účinky imunologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- imunosupresiva MeSH
- kyselina mykofenolová MeSH
- sirolimus MeSH
- takrolimus MeSH
INTRODUCTION: We compared the incidence of severe complications among 123 consecutive simultaneous pancreas and kidney (SPK) recipients randomized for treatment either with tacrolimus plus mycophenolate mofetil (MMF) or tacrolimus plus sirolimus during their initial postoperative hospital stay. METHODS: Patients with type 1 diabetes mellitus (T1DM) and renal failure with no age limit who underwent SPK were randomly assigned to tacrolimus/sirolimus or tacrolimus/MMF immunosuppressive protocols. We analyzed the rate of adverse events that led to death, graft loss, operative revision, or prolonged hospital stay. RESULTS: From 2002 to 2009, 62 recipients were included in the MMF and 61 in the Rapamycin (Rapa) groups. More than 2/3 of recipients suffered from at least 1 complication: 74% MMF and 77 % Rapa group (P > .05). No patient died in the MMF and 3 in the Rapa group (P = .11). Pancreas graftectomy was performed in 13% of the MMF group and in 5% of the Rapa group (P = .20). Ten of 62 recipients in the MMF and 13/61 in the Rapa group required operative treatment of wound infections (P = .49). There were no differences in the rates of gastrointestinal bleeding (11% and 8%), kidney lymphocele (6% and 5%), ileus (1.6% both), pancreatic leak (1.6% both), or ureteral leak (0 and 3%) between the groups. CONCLUSION: We did not observe a difference in the rate of severe postoperative complications between groups. With the use of extraperitoneal placement of the pancreatic graft, fluid collections and wound infections remain the most frequent albeit curable postoperative complications.
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