Risk Factors of Surgical Site Infections after Simultaneous Kidney Pancreas (SKP) Transplantation

Natori, Yoichiro; Bahrani, Salma Al; Rotstein, Coleman

doi:10.1093/ofid/ofx163.1745

Cited by 1 publication

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2,3 We previously reported an incidence of 24.3% SSIs in simultaneous pancreas and kidney transplants (SPK) as well as pancreas after kidney transplantation (PAK), with organ-space infections predominating. 4 Others have demonstrated that infections may complicate 7%-50% of these procedures. 5,6 Factors implicated in predisposing pancreas transplant recipients to SSI were cold pancreas ischemic time and simultaneous pancreas and kidney transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 Factors implicated in predisposing pancreas transplant recipients to SSI were cold pancreas ischemic time and simultaneous pancreas and kidney transplantation. 4 As a result of the whole pancreas-duodenal segment graft being removed from a deceased donor and transplanted into the recipient with connection of the venous system to an appropriate venous drainage system such as the iliac vein, vena cava, or superior mesenteric vein, 7 organ-space infections may arise due to contamination from the duodenal segment. In an effort to prevent this postoperative complication, a practice of culturing the transplanted duodenal segment was initiated to preemptively prevent SSIs due to the contaminated stump by administering antibiotics directed against the microorganisms isolated from positive duodenal-segment cultures.…”

Section: Discussionmentioning

confidence: 99%

“…Also, maintenance immunosuppression commenced immediately after induction immunosuppression therapy had been completed as previously described. 4 After hospital discharge, follow-up for all transplant recipients was performed weekly for the first 4 weeks and then weekly or biweekly over the next 8 weeks depending on the patient's condition and complications (3 months total).…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Correlation of intraoperative donor duodenal-segment swab cultures with the subsequent occurrence of surgical site infections in kidney and pancreas transplant recipients

Alabdulla

Alrehily

Natori

et al. 2020

Infect. Control Hosp. Epidemiol.

Self Cite

View full text Add to dashboard Cite

Background: Pancreas transplantation is employed for the treatment of type I diabetes mellitus. It is postulated that surgical site infection (SSI), particularly organ-space infections, after pancreas transplantation may arise from microbial contamination arising from the donor duodenal segment. Therefore, some centers have adopted the practice of culturing the donor duodenal segment and subsequently administering antimicrobial therapy to the recipient directed at the microorganisms isolated to prevent SSI. Methods: In this retrospective cohort study, we evaluated the correlation between positive donor duodenal-segment cultures and SSIs in the recipients. Data were recorded and analyzed to assess the correlation of the organisms isolated in the donor duodenal cultures with those producing SSI in the recipients. Results: We evaluated 379 consecutive pancreas transplant recipients from January 2000 to December 2015. Donor duodenal swab cultures were performed at the time of pancreas transplantation, and 206 (54.3%) were positive. SSIs occurred in 51 of the 206 recipients (24.8%) with positive duodenal-segment cultures and in 41 of 173 individuals (23.7%) with negative cultures (P = .81; r = 0.00). Notably, deep and organ-space SSIs were observed in 27 of 206 of the positive duodenal culture groups (13.1%) versus 29 of 173 of the negative duodenal culture groups (16.8%; P = 0.31; r = −0.059). No differences were detected in the pathogens producing SSIs between the group with a positive duodenal swab versus the group with a negative swab. Microorganisms producing SSIs matched those found in the positive donor duodenal cultures in only 15 patients (7.8%). Conclusion: Although positive cultures from the donor duodenal segment prompted the administration of antimicrobial therapy in the recipient directed against the pathogen isolated, this practice did not reduce SSIs compared with those transplant recipients with culture-negative duodenal swabs. In addition, the organisms isolated from the donor duodenal segment were not predictive of subsequent SSI.

show abstract