article = {JDMC-2020-2-102}
title = {Enteric Leaks from Simultaneous Pancreas Kidney Transplantation at a Single Centre: Risk Factors and Management Over a 20-Year Period}
journal = {Journal of Diabetes Metabolism and its Complications}
year = {2020}
issn = {2674-4163}
doi = {http://dx.doi.org/10.31487/j.JDMC.2020.02.02}
url = {https://www.sciencerepository.org/enteric-leaks-from-simultaneous-pancreas-kidney-transplantation-at-a-single-centre_JDMC-2020-2-102 
author = {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,}
keywords = {Simultaneous pancreas kidney, transplantation, enteric leaks, risk factors}
abstract ={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.}