Enteric Leaks from Simultaneous Pancreas Kidney Transplantation at a Single Centre: Risk Factors and Management Over a 20-Year Period

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Author Info

Amy Hort Sara Shahrestani Kerry Hitos Taina Lee Richard Allen Lawrence Yuen Jerome Laurence Brendan Ryan Paul Robertson Kathy Kable Angela Webster Germaine Wong Natasha Rogers Phillip O’Connell Brian Nankivell Jeremy Chapman Wayne J. Hawthorne Henry Pleass

Corresponding Author

Henry Pleass
The Department of Surgery, Westmead Hospital, Westmead, Australia

A B S T R A C T

Background: Simultaneous pancreas-kidney transplantation (SPK) remains the gold standard treatment for patients with type I diabetes mellitus and end-stage renal failure. Enteric drainage is utilised to handle exocrine secretions from the graft, with enteric leaks being the most challenging of complications. There remains a lack of published research regarding risk factors for enteric leaks. Methods: As such we undertook a retrospective cohort study of SPK transplants performed at Westmead Hospital over twenty years (between 1998-2017, n=425) to identify the occurrence of enteric leaks as well as donor, recipient and transplantation procedure risk factors. Descriptive statistics were generated using SPSS version 22.0 (IBM SPSS Statistics for Windows, Armonk, NY, USA). The student’s t-test and/or Mann-Whitney U test was used to detect significance. All tests were two tailed and any statistically significant difference was considered at the P <0.05 level. Results: Of the 425 patients, 16 (3.5%) experienced an enteric leak. Of these, 12 (80%) had significant vascular disease, defined as coronary artery disease, cerebrovascular disease, retinopathy, peripheral neuropathy or peripheral vascular disease requiring surgical intervention. The risk of an enteric leak increased in recipients with significant vascular disease. Conclusion: The rates at Westmead Hospital were lower than those published in the literature. We demonstrated that the presence of significant vascular disease predisposed recipients to enteric leak. These findings highlight the importance of careful donor and recipient selection to optimise patient outcomes.

Article Info

Article Type

Research Article

Publication history

Received: Sat 15, Aug 2020
Accepted: Thu 27, Aug 2020
Published: Sat 05, Sep 2020

Copyright

© 2023 Henry Pleass. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JDMC.2020.02.02