DEEP WOUND INFECTIONS IN SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANT RECIPIENTS ON PERITONEAL-DIALYSIS

Peripancreatic abscess formation remains an important cause of surgica l morbidity following simultaneous pancreas-kidney (SPK) transplants. The purpose of this study is to define the association, if any, betwee n the pretransplant method of dialysis and the incidence of peripancre atic abscess formation. We reviewed 57 bladder-drained SPK transplants . Of these, 42 were on haemodialysis (HD) and 15 on peritoneal dialysi s (PD) prior to transplantation. Two grafts were lost and three patien ts died as a result of peripancreatic infections for a total graft los s of 8.8%. The incidence of this complication was higher (P=0.036 Pear son chi-square) in patients on PD (40%) prior to transplant when compa red to patients on HD (14%). The most common organism cultured from th e abscesses was Staphylococcus epidermidis in both groups. Impairment of peritoneal macrophage function and accumulation of peritoneal efflu ent as a result of altered peritoneal membrane function are some of th e changes that occur following chronic peritoneal dialysis and could e xplain our findings.