Similar early complication rate in simultaneous pancreas and kidney recipients on tacrolimus/mycophenolate mofetil versus tacrolimus/sirolimus immunosuppressive regimens
Language English Country United States Media print
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
20692391
DOI
10.1016/j.transproceed.2010.05.121
PII: S0041-1345(10)00786-4
Knihovny.cz E-resources
- MeSH
- Kidney Failure, Chronic surgery MeSH
- Tissue Donors MeSH
- Length of Stay MeSH
- Diabetes Mellitus, Type 1 surgery MeSH
- Diabetic Nephropathies surgery MeSH
- Hospitalization MeSH
- Immunosuppressive Agents adverse effects MeSH
- Mycophenolic Acid adverse effects analogs & derivatives MeSH
- Humans MeSH
- Brain Death MeSH
- Postoperative Complications epidemiology MeSH
- Sirolimus adverse effects MeSH
- Tacrolimus adverse effects MeSH
- Kidney Transplantation adverse effects immunology MeSH
- Pancreas Transplantation adverse effects immunology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Immunosuppressive Agents MeSH
- Mycophenolic Acid MeSH
- Sirolimus MeSH
- Tacrolimus 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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