PROPHYLACTIC WOUND ANTIBIOTICS FOR COMBINED KIDNEY AND PANCREAS TRANSPLANTS

For combined kidney and pancreas transplant recipients infectious comp lications remain a major source of morbidity. With as many antibiotic protocols as transplant centers, the exact type and duration for proph ylactic wound antibiotics remains undefined. A retrospective review of our series of 40 combined kidney and pancreas transplants was perform ed using a single 1 g dose of cefazolin preoperatively along with cefa zolin bladder and intra-abdominal irrigation. Two patients developed s uperficial wound infections for a rate of 5% (2/37). The deep wound in fection rate was 11% (4/37), and all followed either a bladder anastom otic leak or the initial development of transplant pancreatitis. Our o verall rate of 16% is very comparable with other series of combined ki dney and pancreas transplant recipients. To help eliminate the potenti al development of superinfections and resistant organisms, a single do se of antibiotics appears to be as effective for wound prophylaxis in these patients when compared to multiple-antibiotic and multiple-day r egiments,A randomized prospective study of prophylactic antibiotics in combined kidney and pancreas transplants is needed.