Kidney and pancreas transplantation is a preferred treatment modality to ameliorate the renal failure and other comorbidities associated with type I diabetes. Postoperative surgical site infections (SSIs) and urinary tract infections have been noted to be the most common infections seen after SKP transplantation. This study assessed the incidence of SSIs and risk factors for these SSIs in SKP transplant recipients within the first three months after transplantation.
Methods: This retrospective, single-center, cohort study was conducted at the Toronto General Hospital of the University Health Network, Toronto, Canada from January 2000 to December 2015. SSIs were classified according to the Centers for Disease Control classification as superficial, deep and organ/space.
Results: Four hundred and forty-five adult patients were enrolled. The median age of the recipients was 51 (range 19 to 71) years old, and 64.9% were males. SSIs were documented in 108 (24.3%) patients. Organ/space SSIs predominated, accounting for 59 (54.6%) patients followed by superficial SSI (n=47, 43.5%) with only deep infections. Factors predictive of SSIs by multivariate analysis were pancreas cold ischemic time (Odds ratio 1.002, p=0.11) and simultaneous SKP transplant (as compared to pancreas transplant alone, Odds ratio 2.38, p=0.003). SSIs were associated with longer duration of hospital stay (p<0.001).
Organ/space SSIs remain a serious and common complication after SKP transplant. Longer pancreas cold ischemic time and simultaneous kidney and pancreas transplantation were the risk factors predictive of SSI. Efforts to improve pancreatic cold ischemic time and optimize perioperative antimicrobial prophylaxis in high-risk patients targeting potential pathogens producing SSIs in SKP transplant patients are warranted.
C. Rotstein, None